Health-related quality of life in Cuban patients with chronic liver disease: A real-world experience

Introduction and objectives: Patient-reported outcomes (PROs) are important for comprehensive assessment of chronic liver disease (CLD). Latin America and the Caribbean have a high burden of CLD, but PROs are lacking. We assessed health-related quality of life (HRQL) in Cuban patients with compensated CLD. Materials and methods: A cross sectional study performed of adult patients with a diagnosis of chronic viral infection B and C (HBV, HCV), non-alcoholic fatty liver diseases (NAFLD) and autoimmune liver diseases (AILD) including autoimmune hepatitis (AIH), primary biliary cholangitis (PBC) and overlap syndrome (AIH + PBC). PROs were collected using: Functional Assessment of Chronic Illness Therapy-Fatigue (FACITF), Work Productivity and Activity-Specific Health Problem (WPAI: SHP), and the Chronic Liver Disease Questionnaire (CLDQ)-disease-specific. Results: 543 patients enrolled, n = 91 (HBV), n = 188 (HCV), n = 221 (NAFLD), n = 43 (AILD). Of those with AILD, 22 had AIH, 14 PBC, and 7 overlap AIH/PBC. Mean age was 53.5 years, 64.1% female, 69.2% white, and 58.0% employed. Patients with HCV and AILD had more severe liver disease. A significant impairment in PROs was observed in HCV group whereas the AILD patients had more activity impairment. CLDQHRQL scores were significantly lower for patients with NAFLD and AILD compared to HBV. Male gender and exercising >= 90 min/week predicted better HRQL. The strongest independent predictors of HRQL impairment were fatigue, abdominal pain, anxiety, and depression (p < 0.05). Conclusions: HRQL for Cuban patients with compensated CLD differs according to the CLD etiology. Patients with HCV and AILD had the worst PRO scores most likely related to severe underlying liver disease and/or extrahepatic manifestations. (c) 2020 Fundaci & oacute;n Cli & acute;nica M & eacute;dica Sur, A.C. Published by Elsevier Espana, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Automated summary

This study assessed health-related quality of life (HRQL) in Cuban patients with compensated chronic liver disease (CLD). The results showed that patients with HCV and autoimmune liver diseases (AILD) had the worst PRO scores, likely due to severe underlying liver disease and/or extrahepatic manifestations. Male gender and regular exercise were predictors of better HRQL, while fatigue, abdominal pain, anxiety, and depression were strong independent predictors of HRQL impairment.