Clinical and patient‐reported outcome profile of patients with hepatitis B viral infection from the Global Liver Registry™

Author:

Younossi Zobair M.123ORCID,Yu Ming‐Lung45ORCID,Yilmaz Yusuf67,Alswat Khalid Aida8,Buti Maria9,Fernandez Marlen Ivon Castellanos10,Papatheodoridis Georgios11ORCID,Hamid Saeed S.12,El‐Kassas Mohamed13ORCID,Chan Wah Kheong14,Duseja Ajay K.15,Gordon Stuart C.16,Eguchi Yuichiro17,Isakov Vasily A.18,Roberts Stuart K.1920ORCID,Fan Jian‐Gao21,Singal Ashwani K.22ORCID,Romero‐Gómez Manuel23,Ahmed Aijaz24ORCID,Ong Janus25,Lam Brian P.123,Younossi Issah26,Nader Fatema26,Racila Andrei26,Stepanova Maria12326,Alqahtani Saleh2627

Affiliation:

1. Center for Liver Diseases, Department of Medicine Inova Fairfax Medical Campus Falls Church Virginia USA

2. Inova Medicine Service Line Inova Health System Falls Church Virginia USA

3. Betty and Guy Beatty Center for Integrated Research Inova Health System Falls Church Virginia USA

4. School of Medicine, College of Medicine National Sun Yat‐sen University Kaohsiung Taiwan

5. Hepatobiliary Division, Department of Internal Medicine Kaohsiung Medical University Hospital, College of Medicine, Kaohsiung Medical University Kaohsiung Taiwan

6. Liver Research Unit Institute of Gastroenterology Marmara University İstanbul Turkey

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

8. Liver Disease Research Center, College of Medicine King Saud University Riyadh Saudi Arabia

9. Liver Unit Universitario Vall d'Hebron and CIBEREHD del Instituto Carlos III Barcelona Spain

10. Institute of Gastroenterology University of Medical Science Havana Cuba

11. Academic Department of Gastroenterology General Hospital of Athens “Laiko”, Medical School of the National and Kapodistrian University of Athens Athens Greece

12. Department of Medicine Aga Khan University Karachi Pakistan

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

14. Department of Gastroenterology and Hepatology University of Malaya Kuala Lumpur Malaysia

15. Department of Hepatology Post Graduate Institute of Medical Education and Research Chandigarh India

16. Department of Hepatology and Gastroenterology, Henry Ford Hospital System Wayne State University School of Medicine Detroit Michigan USA

17. Loco Medical General Institute Saga Japan

18. Division of Gastroenterology and Hepatology Federal Research Center of Nutrition and Biotechnology Moscow Russia

19. Department of Medicine Monash University Melbourne Australia

20. Department of Gastroenterology and Hepatology Alfred Health Melbourne Australia

21. Department of Gastroenterology Xinhua Hospital, Shanghai Jiaotong University School of Medicine Shanghai China

22. University of South Dakota and Avera Transplant Institute Sioux Falls South Dakota USA

23. Digestive Diseases Department Virgen del Rocío University Hospital, Institute of Biomedicine of Seville, University of Seville Seville Spain

24. Division of Gastroenterology and Hepatology Stanford University Medical Center Stanford California USA

25. College of Medicine University of the Philippines Manila Philippines

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

27. King Faisal Specialist Hospital & Research Center Riyadh Saudi Arabia

Abstract

AbstractChronic hepatitis B (CHB) infection is one of the most common causes of cirrhosis and liver cancer worldwide. Our aim was to assess clinical and patient‐reported outcome (PRO) profile of CHB patients from different regions of the world using the Global Liver Registry. The CHB patients seen in real‐world practices are being enrolled in the Global Liver Registry. Clinical and PRO (FACIT‐F, CLDQ, WPAI) data were collected and compared to baseline data from CHB controls from clinical trials. The study included 1818 HBV subjects (48 ± 13 years, 58% male, 14% advanced fibrosis, 7% cirrhosis) from 15 countries in 6/7 Global Burden of Disease super‐regions. The rates of advanced fibrosis varied (3–24%). The lowest PRO scores across multiple domains were in HBV subjects from the Middle East/North Africa (MENA), the highest – Southeast/East and South Asia. Subjects with advanced fibrosis had PRO impairment in 3 CLDQ domains, Activity of WPAI (p < 0.05). HBV subjects with superimposed fatty liver had more PRO impairments. In multivariate analysis adjusted for location, predictors of PRO impairment in CHB included female sex, advanced fibrosis, and non‐hepatic comorbidities (p < 0.05). In comparison to Global Liver Registry patients, 242 controls from clinical trials had better PRO scores (Abdominal, Emotional, and Systemic scores of CLDQ, all domains of WPAI) (p < 0.05). In multivariate analysis with adjustment for location and clinicodemographic parameters, the associations of PROs with the enrollment setting (real‐life Global Liver Registry vs. clinical trials) were no longer significant (all p > 0.10). The clinico‐demographic portrait of CHB patients varies across regions of the world and enrollment settings. Advanced fibrosis and non‐hepatic comorbidities are independently associated with PRO impairment in CHB patients.

Publisher

Wiley

Subject

Virology,Infectious Diseases,Hepatology

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