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HBV suppression improves long-term patient-reported outcomes

Hepatitis B viral suppression had a sustainable, positive impact on patient-reported outcomes, according to results of a long-term follow-up study.

“HBV infection and its complications are responsible for a tremendous clinical burden related to cirrhosis and hepatocellular carcinoma,” Zobair M. Younossi, MD, and colleagues wrote. “In contrast, long-term HBV suppression can improve hepatic fibrosis and clinical outcomes. In addition to the clinical burden, HBV can negatively impact patient-reported outcomes (PROs) while viral suppression leads to their improvement.

Younossi and colleagues enrolled 229 patients with HBV in the registry, 87.8% of whom were on standard-of-care oral antiviral therapy at baseline. Thirteen patients had detectable HBV viremia at baseline and 15 additional patients developed detectable viremia at least once during follow-up.

PROs were similar or higher than general population norms except for the “Worry” domain of the Chronic Liver Disease Questionnaire (P < .01) and the “Presenteeism” and “Activity” domains of the Work Productivity and Activity Impairment tool (P < .0001).

PRO scores were similar between Asian and non-Asian patients and between patients from different countries. Men had higher “Physical Functioning” scores compared with women (P = .03). Patients who discontinued oral antiviral therapy were more frequently viremic (P < .0001) and had lower scores in the “Emotional” domain of the Chronic Liver Disease Questionnaire (P = .02) at baseline.

By week 48, the researchers observed significant improvements in the “General Health” and “Role Emotional” domains of the Short Form-36 PRO tool (P < .05).

“Patient-reported outcomes are essential for understanding the comprehensive impact of HBV infection on patients’ health. Additionally, PROs are important when assessing the effect of any treatment regimen because PROs are tightly linked to adherence which is critically important for long-term suppression of HBV,” Younossi and colleagues wrote. “These PRO data, coupled with clinical outcomes, should inform patients, providers, and payers about the benefit of long-term viral suppression in patients with chronic HBV infection.” – by Talitha Bennett

Disclosure: Younossi reports he is a consultant to or has received research funds from AbbVie, Bristol-Myers Squibb, Gilead, GlaxoSmithKline, Intercept, NovoNordisk and Shinogi. Please see the full study for the other authors’ relevant financial disclosures.