Donna M Evon1, Abdus S Wahed2, Geoffrey Johnson2, Mandana Khalili3, Mauricio Lisker-Melman4, Robert J Fontana5, Souvik Sarkar6, Bryce B Reeve7, Jay H Hoofnagle8. 1. Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina, CB# 7584, 8010 Burnett-Womack, Chapel Hill, NC, 27599, USA. donna_evon@med.unc.edu. 2. Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA. 3. Department of Medicine, University of California, San Francisco, CA, USA. 4. Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA. 5. Department of Medicine, University of Michigan, Ann Arbor, MI, USA. 6. Department of Medicine, University of California, Davis, CA, USA. 7. Department of Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. 8. NIDDK Liver Disease Research Branch, Bethesda, MD, USA.
Abstract
BACKGROUND: Fatigue is a common symptom of liver disease but not well characterized in patients with chronic hepatitis B virus (HBV). AIMS: We assessed the rate of fatigue using a validated instrument in patients with HBV and identified demographic, virologic, and clinical features associated with fatigue in a cross-sectional cohort study from the Hepatitis B Research Network. METHODS: Participants were English- and Spanish-speaking adults with chronic HBV who were not pregnant nor on treatment. Fatigue was measured using the PROMIS® Fatigue 7-item Short Form. RESULTS: The sample included 948 adults: median age 42; 51 % female; 71 % Asian; 74 % college educated; 77 % employed; 41 % inactive HBV carriers; 36 % with active chronic disease; and 2 % with advanced fibrosis, defined as AST-platelet ratio index (APRI) > 1.50. Patients with chronic HBV had a mean fatigue T-score of 46.8 ± SD = 7.9, compared to a mean fatigue T-score of 50.0 ± 10 in the US general population (p < .0001). In univariate analyses, greater fatigue was associated with demographic and clinical features such as female sex, lower income, more comorbidities, higher APRI score, and poorer mental health (p < 0.05). In multivariate analysis, female sex (p < .001), poorer mental health (p < .001), APRI score (p = .005), and history of diabetes (p = .039) were the strongest independent predictors. CONCLUSIONS: The frequency of fatigue in this large cohort of North American chronic HBV patients may be equal to or lower than that reported in the US general population. Patients with advanced fibrosis, more comorbidities, and poorer mental health report worse fatigue.
BACKGROUND:Fatigue is a common symptom of liver disease but not well characterized in patients with chronic hepatitis B virus (HBV). AIMS: We assessed the rate of fatigue using a validated instrument in patients with HBV and identified demographic, virologic, and clinical features associated with fatigue in a cross-sectional cohort study from the Hepatitis B Research Network. METHODS:Participants were English- and Spanish-speaking adults with chronic HBV who were not pregnant nor on treatment. Fatigue was measured using the PROMIS® Fatigue 7-item Short Form. RESULTS: The sample included 948 adults: median age 42; 51 % female; 71 % Asian; 74 % college educated; 77 % employed; 41 % inactive HBV carriers; 36 % with active chronic disease; and 2 % with advanced fibrosis, defined as AST-platelet ratio index (APRI) > 1.50. Patients with chronic HBV had a mean fatigue T-score of 46.8 ± SD = 7.9, compared to a mean fatigue T-score of 50.0 ± 10 in the US general population (p < .0001). In univariate analyses, greater fatigue was associated with demographic and clinical features such as female sex, lower income, more comorbidities, higher APRI score, and poorer mental health (p < 0.05). In multivariate analysis, female sex (p < .001), poorer mental health (p < .001), APRI score (p = .005), and history of diabetes (p = .039) were the strongest independent predictors. CONCLUSIONS: The frequency of fatigue in this large cohort of North American chronic HBVpatients may be equal to or lower than that reported in the US general population. Patients with advanced fibrosis, more comorbidities, and poorer mental health report worse fatigue.
Authors: Carolyn A Lang; Sue Conrad; Lyndall Garrett; Diana Battistutta; W Graham E Cooksley; Michael P Dunne; Graeme A Macdonald Journal: J Pain Symptom Manage Date: 2006-04 Impact factor: 3.612
Authors: T Poynard; P Cacoub; V Ratziu; R P Myers; M H Dezailles; A Mercadier; P Ghillani; F Charlotte; J C Piette; J Moussalli Journal: J Viral Hepat Date: 2002-07 Impact factor: 3.728
Authors: Donna M Evon; Hsing-Hua S Lin; Mandana Khalili; Robert J Fontana; Colina Yim; Abdus S Wahed; Michael W Fried; Jay H Hoofnagle Journal: Aliment Pharmacol Ther Date: 2020-01-14 Impact factor: 8.171
Authors: Donna M Evon; Hsing-Hua S Lin; Robert J Fontana; Mandana Khalili; Colina Yim; Abdus S Wahed; Jay H Hoofnagle Journal: GastroHep Date: 2021-05-05