In aggressive hepatitis B, the liver becomes chronically inflamed and fibrotic, shrinking slightly.

The relationship between progression of liver disease due to chronic hepatitis B virus (HBV) infection and health-related quality of life (HRQoL) is an important aspect of the overall management of patients with hepatitis B, yet it is not well characterized, wrote the authors of a study published in the April 2008 issue of Hepatology.

The investigators, from Singapore, examined HRQoL in HBV patients stratified by disease severity, compared with healthy HBV negative control subjects and patients with hypertension (high blood pressure) using the Short Form 36 Health Survey (SF-36) and the EQ-5D self-report questionnaire. Univariate and multivariate analyses were performed.

The study included:

• A total of 432 patients with HBV:

• 156 asymptomatic carriers;
• 142 with chronic hepatitis B but no advanced disease;
• 66 with compensated liver cirrhosis;
• 24 with decompensated cirrhosis;
• 22 with hepatocellular carcinoma;
• 22 liver transplant recipients;

• 93 hypertensive patients without HBV;

• 108 healthy control subjects without HBV.

• Multivariate analysis showed that healthy control subjects and asymptomatic HBV carriers had similar SF-36 scores.

• These were better than scores for patients with hypertension.

• However, as patients developed chronic hepatitis B and compensated cirrhosis, they showed a significant decrease in general health and SF-36 the mental dimension.

• Patients with advanced liver disease (decompensated cirrhosis and hepatocellular carcinoma) had significantly lower scores in all SF-36 components (P < 0.05).

• These findings indicated that the SF-36 physical component deteriorated only with advanced liver disease.

• Similar results were obtained with the EQ5D.

• Post-liver transplant patients had similar HRQoL to patients with decompensated cirrhosis and hepatocellular carcinoma, although there was a trend toward improvement.