Xiaoning Wu1,2,3, Jia Hong1, Jialing Zhou1, Yameng Sun1, Lei Li4, Wen Xie5, Hongxin Piao6, Xiaoyuan Xu7, Wei Jiang8, Bo Feng9, Yongpeng Chen10, Mingyi Xu11, Jilin Cheng12, Tongtong Meng1, Bingqiong Wang1, Shuyan Chen1, Yuanyuan Kong3, Xiaojuan Ou1, Hong You13,14,15, Jidong Jia16,17,18. 1. Liver Research Center, Beijing Friendship Hospital, Capital Medical University, 95 Yong-an Road, Xi-Cheng District, Beijing, 100050, China. 2. Beijing Key Laboratory of Translational Medicine on Liver Cirrhosis, Beijing, China. 3. National Clinical Research Center for Digestive Diseases, Beijing, China. 4. Department of Gastroenterology, Beijing You-an Hospital, Capital Medical University, Beijing, China. 5. Liver Research Center, Beijing Ditan Hospital, Capital Medical University, Beijing, China. 6. Office of Clinical Trials, Affiliated Hospital of Yanbian University, Yanji, Jilin, China. 7. Division of Infectious Diseases, Peking University First Hospital, Beijing, China. 8. Department of Gastroenterology, Zhongshan Hospital, Fudan University, Shanghai, China. 9. Liver Research Center, Peking University People's Hospital, Beijing, China. 10. Department of Infectious Diseases, Nan-Fang Hospital, Southern Medical University, Guangzhou, Guangdong, China. 11. Department of Gastroenterology and Hepatology, Shanghai General Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China. 12. Department of Gastroenterology, Shanghai Public Health Clinical Center, Shanghai, China. 13. Liver Research Center, Beijing Friendship Hospital, Capital Medical University, 95 Yong-an Road, Xi-Cheng District, Beijing, 100050, China. youhongliver@ccmu.edu.cn. 14. Beijing Key Laboratory of Translational Medicine on Liver Cirrhosis, Beijing, China. youhongliver@ccmu.edu.cn. 15. National Clinical Research Center for Digestive Diseases, Beijing, China. youhongliver@ccmu.edu.cn. 16. Liver Research Center, Beijing Friendship Hospital, Capital Medical University, 95 Yong-an Road, Xi-Cheng District, Beijing, 100050, China. jia_jd@ccmu.edu.cn. 17. Beijing Key Laboratory of Translational Medicine on Liver Cirrhosis, Beijing, China. jia_jd@ccmu.edu.cn. 18. National Clinical Research Center for Digestive Diseases, Beijing, China. jia_jd@ccmu.edu.cn.
Abstract
BACKGROUND AND AIM: Antiviral therapy is effective in decreasing disease progression in HBV cirrhosis. However, the long-term effect of antiviral therapy on health-related quality of life (HRQoL) in patients with compensated HBV cirrhosis is unknown. METHODS: The patients with compensated HBV cirrhosis enrolled in a randomized controlled trial of entecavir-based therapy were recruited in the present study, if they had HRQoL score at 5-year follow-up or who developed liver-related events (LRE) during follow-up were included. HRQoL was measured with 36-Item Short-Form Health Survey (SF-36) and EuroQol-5D (EQ-5D) at baseline and yearly during follow-up. LRE was defined as the development of decompensation, HCC, or death. RESULTS: A total of 161 patients were included in the present study, with a median age of 48.0 (41.0, 53.0) years, 77.6% being male and 37.2% being HBeAg-positive. During 5 years, 45 patients developed LRE. All eight dimensions of SF-36 were significantly improved after 5 years of antiviral therapy (all p < 0.001), with all dimensions improved more than five points except for physical functioning. Proportion of patients reporting no problems in all five dimensions in EQ-5D increased from 57.8 to 72.0%; visual analogue scale (VAS) and utility index (UI) increased significantly (VAS 79.8 ± 16.4 to 84.4 ± 13.2, UI 0.91 ± 0.13 to 0.95 ± 0.10, both p < 0.001). HRQoL improved or kept stable in the majority of patients who had LRE during follow-up, even stratified by Baveno VI criteria for clinically significant portal hypertension. CONCLUSION: After 5 years of ETV treatment, HRQoL significantly improved in patients with compensated HBV cirrhosis. (NCT01943617, NCT02849132).
BACKGROUND AND AIM: Antiviral therapy is effective in decreasing disease progression in HBV cirrhosis. However, the long-term effect of antiviral therapy on health-related quality of life (HRQoL) in patients with compensated HBV cirrhosis is unknown. METHODS: The patients with compensated HBV cirrhosis enrolled in a randomized controlled trial of entecavir-based therapy were recruited in the present study, if they had HRQoL score at 5-year follow-up or who developed liver-related events (LRE) during follow-up were included. HRQoL was measured with 36-Item Short-Form Health Survey (SF-36) and EuroQol-5D (EQ-5D) at baseline and yearly during follow-up. LRE was defined as the development of decompensation, HCC, or death. RESULTS: A total of 161 patients were included in the present study, with a median age of 48.0 (41.0, 53.0) years, 77.6% being male and 37.2% being HBeAg-positive. During 5 years, 45 patients developed LRE. All eight dimensions of SF-36 were significantly improved after 5 years of antiviral therapy (all p < 0.001), with all dimensions improved more than five points except for physical functioning. Proportion of patients reporting no problems in all five dimensions in EQ-5D increased from 57.8 to 72.0%; visual analogue scale (VAS) and utility index (UI) increased significantly (VAS 79.8 ± 16.4 to 84.4 ± 13.2, UI 0.91 ± 0.13 to 0.95 ± 0.10, both p < 0.001). HRQoL improved or kept stable in the majority of patients who had LRE during follow-up, even stratified by Baveno VI criteria for clinically significant portal hypertension. CONCLUSION: After 5 years of ETV treatment, HRQoL significantly improved in patients with compensated HBV cirrhosis. (NCT01943617, NCT02849132).