Product information and disease descriptionPlace of product in therapyDisease descriptionBurden of Chronic hepatitis B virus infection in adults without cirrhosis
Humanistic burden and health-related quality of life
9 evidence topics · 9 sources
Utility values by disease stage: global meta-analysis of 19 studies with 10,311 patients
“Twenty-two articles from 19 studies, comprising 10,311 patients, were included. Of these studies, 74% were performed in the Western Pacific Region, and 47% used the EuroQoL-5D-3L instrument. HRQOL was found to decrease with advancing stages of HBV-related disease.” (opens the original PMC page at this quote in a new tab)View highlighted excerpt for this quote
“Meta-regression showed the following predicted mean utility scores for the different stages of chronic HBV infection: non-cirrhotic, 0.842; compensated cirrhosis, 0.820 ( p = 0.474 compared with non-cirrhotic); decompensated cirrhosis, 0.722 ( p = 0.001); and hepatocellular carcinoma, 0.749 ( p = 0.008).” (opens the original PMC page at this quote in a new tab)View highlighted excerpt for this quote
“Chronic HBV infection impairs the HRQOL of patients, even when there is no evidence of cirrhosis. HRQOL is particularly impaired in the advanced stages of decompensated cirrhosis and hepatocellular carcinoma.” (opens the original PMC page at this quote in a new tab)View highlighted excerpt for this quote
Utility values by disease stage in the United States, Europe, Canada, Australia, and New Zealand: meta-analysis of chronic hepatitis B studies
| Health state (chronic hepatitis B, any instrument) | Mean utility | 95% CI |
|---|---|---|
| Noncirrhotic (F0-F3) | “0.84” | “0.78-0.90” |
| Compensated cirrhosis (F4) | “0.77” | “0.65-0.89” |
| Decompensated cirrhosis | “0.35” | “0.31-0.40” |
| Hepatocellular carcinoma | “0.49” | “0.23-0.75” |
| Post liver transplantation, year 1 | “0.57” | “0.51-0.62” |
| Post liver transplantation, year 2 and later | “0.67” | “0.62-0.72” |
Standard gamble utilities from infected and uninfected respondents in six jurisdictions, including the United States
“Standard gamble utilities were elicited from hepatitis patients and uninfected respondents using an interviewer-administered survey in the United States, Canada, United Kingdom, Spain, Hong Kong, and mainland China.” (opens the original PubMed page at this quote in a new tab)View highlighted excerpt for this quote
“The sample included 534 CHB-infected patients and 600 uninfected respondents. CHB and compensated cirrhosis had a moderate impact on HRQOL with utilities ranging from 0.68 to 0.80. Decompensated cirrhosis and hepatocellular carcinoma had a stronger impact with utilities ranging from 0.35 to 0.41.” (opens the original PubMed page at this quote in a new tab)View highlighted excerpt for this quote
“Significant variation was observed between countries, with both types of respondents in mainland China and Hong Kong reporting systematically lower utilities.” (opens the original PubMed page at this quote in a new tab)View highlighted excerpt for this quote
Patient-reported outcomes and viral suppression in 242 phase 2 trial participants without advanced fibrosis or cirrhosis
“We collected and analyzed PRO data from 242 patients with chronic HBV infection (without advanced fibrosis or cirrhosis) enrolled in 2 international phase 2 blinded controlled clinical trials from 2015 through 2017.” (opens the original PubMed page at this quote in a new tab)View highlighted excerpt for this quote
“At baseline, patients with viral suppression (HBV DNA level, <20 IU/mL) had higher PRO scores (by up to +10.6% of a PRO range size).” (opens the original PubMed page at this quote in a new tab)View highlighted excerpt for this quote
“In multivariate analysis, a reduction in viral load was independently associated with increases in PROs (β values up to 1.6% per log10 IU/mL decrease; P < .05).” (opens the original PubMed page at this quote in a new tab)View highlighted excerpt for this quote
Fatigue, patient-reported outcomes, and work productivity in 1561 registry participants with chronic hepatitis B from 14 countries
“Among 2888 patients from 14 countries, 1561 had CHB (mean age 47 ± 13 years; 60% male; 13% advanced fibrosis; 13% depression; 17% fatigue)” (opens the original PubMed page at this quote in a new tab)View highlighted excerpt for this quote
“CHB-fatigue was associated with younger age, female, obesity, anxiety, depression (all p < 0.01) and worse PRO scores: CLDQ (scale 1-7): 4.1 ± 0.9 vs. 5.8 ± 0.9; FACIT score (range 0-108): 67.6 ± 14.5 vs. 87.7 ± 13.7; work productivity impairment (range 0-1): 0.33 ± 0.29 vs. 0.11 ± 0.22 (all p < 0.0001).” (opens the original PubMed page at this quote in a new tab)View highlighted excerpt for this quote
Depressive and anxiety symptoms: meta-analysis of 31 studies
“We identified a high prevalence of depressive symptoms (Proportion=19%, 95% CI: 11-31) and anxiety (Proportion=30%, 95% CI: 18-45) among individuals with hepatitis B. There was also a significantly increased risk of depressive symptoms (RR=1.45, 95% CI: 1.00-2.09, P=0.049) and anxiety (RR=1.40, 95% CI: 1.11-1.78) in individuals with hepatitis B compared to controls.” (opens the original PMC page at this quote in a new tab)View highlighted excerpt for this quote
“Subgroup analyses indicated that older age and chronic hepatitis B infection were associated with a higher prevalence of anxiety and depressive symptoms.” (opens the original PMC page at this quote in a new tab)View highlighted excerpt for this quote
Qualitative health-related quality of life interviews with 19 adults in the United States
“A sample of 19 individuals living with chronic HBV were included within this study.” (opens the original PMC page at this quote in a new tab)View highlighted excerpt for this quote
“The psychological impact of chronic HBV on study participants’ HRQL overall was considerable and contributed to depression, anxiety, homelessness, drug use, and incarceration.” (opens the original PMC page at this quote in a new tab)View highlighted excerpt for this quote
“Our analysis supports the hypothesis that HBV impacts HRQL and often negatively affects emotional health.” (opens the original PMC page at this quote in a new tab)View highlighted excerpt for this quote
Stigma: systematic review of 23 studies
“A total of 23 (17 quantitative and 6 qualitative) articles examined HBV-related stigma.” (opens the original PMC page at this quote in a new tab)View highlighted excerpt for this quote
“Some people also perceived structural/institutional stigma, with up to 20% believing that they may be denied healthcare and up to 30% stating they may experience workplace discrimination due to HBV.” (opens the original PMC page at this quote in a new tab)View highlighted excerpt for this quote
“HBV-related stigma is common, particularly in some countries in Southeast Asia and the Western Pacific region and among Asian immigrant communities, but is poorly characterized in non-Asian populations.” (opens the original PMC page at this quote in a new tab)View highlighted excerpt for this quote
Discrimination: global registry of 569 respondents from 65 countries
“A total of 569 individuals responded to the survey between May 2021 and December 2023.” (opens the original PMC page at this quote in a new tab)View highlighted excerpt for this quote
“Of these, 461 individuals shared details about their experiences of discrimination with most relating to restrictions on access to work visas, followed by in-country hepatitis B-related employment restrictions, educational-based discrimination, discrimination within the community and health facilities, and the emotional impact of hepatitis B discrimination.” (opens the original PMC page at this quote in a new tab)View highlighted excerpt for this quote