Clinical and patient‐reported outcomes in patients with chronic hepatitis B and C and non‐alcoholic fatty liver disease from real‐world practices in Saudi Arabia, Turkey and Egypt

Author:

Alqahtani Saleh A.123,Yilmaz Yusuf14,El‐Kassas Mohamed15ORCID,Alswat Khalid16,Sanai Faisal7ORCID,AlZahrani May8,Abaalkhail Faisal910,AlShaikh Manal8,Al‐Hamoudi Waleed K.26,Nader Fatema11112,Stepanova Maria11112,Younossi Zobair M.11112ORCID,

Affiliation:

1. The Global NASH Council Washington DC USA

2. Organ Transplant Center of Excellence King Faisal Specialist Hospital and Research Center Riyadh Saudi Arabia

3. Division of Gastroenterology and Hepatology Johns Hopkins University Baltimore Maryland USA

4. Department of Gastroenterology, School of Medicine Recep Tayyip Erdoğan University Rize Turkey

5. Endemic Medicine Department, Faculty of Medicine Helwan University Cairo Egypt

6. Department of Medicine, Liver Disease Research Centre, College of Medicine King Saud University Riyadh Saudi Arabia

7. Gastroenterology Unit, Department of Medicine King Abdulaziz Medical City Jeddah Saudi Arabia

8. Department of Internal Medicine King Faisal Specialist Hospital and Research Center Riyadh Saudi Arabia

9. Gastroenterology Section, Department of Medicine King Faisal Specialist Hospital and Research Center Riyadh Saudi Arabia

10. College of Medicine Alfaisal University Riyadh Saudi Arabia

11. Beatty Liver and Obesity Research Program Inova Health System Falls Church Virginia USA

12. Center for Outcomes Research in Liver Diseases Washington DC USA

Abstract

AbstractPatients with chronic liver disease (CLD) experience health‐related quality of life (HRQoL) and patient‐reported outcomes (PROs) impairments. We assessed and identified predictors of HRQoL and PROs in CLD patients from Saudi Arabia (SA), Turkey and Egypt. Patients enrolled in Global Liver Registry™ with chronic hepatitis B (CHB), chronic hepatitis C (CHC) and non‐alcoholic fatty liver disease (NAFLD) or non‐alcoholic steatohepatitis (NASH) were included. Clinical data and PRO questionnaires (FACIT‐F, CLDQ and WPAI) were compared across countries. Linear regression identified PRO predictors. Of the 4014 included patients, 26.9% had CHB, 26.9% CHC and 46.1% NAFLD/NASH; 19.2% advanced fibrosis. Compared across countries, CHB patients were younger in Egypt (mean age [years] 41.2 ± 11.4 vs. 45.0 ± 10.3 SA, 46.1 ± 12.0 Turkey), most often employed in SA (64.8% vs. 53.2% Turkey) and had the lowest prevalence of obesity in Turkey (26.7% vs. 37.8% SA, 38.5% Egypt). In SA, CHB patients had lowest prevalence of fibrosis and comorbidities (all p < .01). There was a higher frequency of males with NAFLD/NASH in SA (70.0% vs. 49.6% Turkey, and 35.5% Egypt). Among NAFLD/NASH patients, CLDQ‐NAFLD/NASH scores were highest in SA (mean total score: 5.3 ± 1.2 vs. 4.8 ± 1.2 Turkey, 4.1 ± 0.9 Egypt, p < .01). Independent predictors of worse PROs included younger age, female sex, advanced fibrosis, non‐hepatic comorbidities and lack of regular exercise (all p < .05). Clinical presentation and PRO scores of CLD patients vary across SA, Turkey and Egypt. Impairment of HRQoL is associated with demographic factors, lack of regular exercise, advanced fibrosis and non‐hepatic comorbidities.

Publisher

Wiley

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