The Impact of Type of Liver Conditions on the Patients’ Health Related Quality of Life

OBJECTIVES: Liver diseases (LDs) have a high impact on morbidity, mortality and health-related quality of life (HRQoL). LDs may have different impact on patients’ HRQoL. The aim of our study was to evaluate HRQoL in the major liver conditions: hepatitis B(HBV), hepatitis C(HCV), cirrhosis(compensated and decompensated), hepatocellular carcinoma(HCC), autoimmune hepatitis(AIH), primary biliary cirrhosis(PBC), primary sclerosing cholangitis(PSC), NAFLD/NASH, patients in the liver transplant list and post-transplant METHODS: a naturalistic, prospective, multicenter study has been conducted to generate and validate a set of health care outcomes indicators for the major liver conditions. LDs patients (age>18 years) were enrolled in 3 major Italian medical centers and are still being followed up (median f-up:13 months). Within this study, socio-demographic, clinical and HRQoL were collected using the EQ-5D-3L. The HRQoL data was analyzed dividing the patients in sub-groups according to the most recently diagnosed and most severe condition. RESULTS: we enrolled 3,217 patients, 64.8% male, aged 19-91 (median=61) years; 95.0% of them filled in the EQ-5D at baseline visit. Patients in the HCC group were 22.6%; while in the AIH group were 1.6%. The highest percentage of problems in Mobility dimension (39.2%) was reported by decompensated cirrhosis sub-group, the highest percentage in Self-care (22.6%) and Usual Activities (47.1%) by patients in liver transplant list, in Pain/Discomfort (59.2%) by AIH and in Anxiety/Depression (57.8%) by PBC. The HBV sub-group reported the best HRQoL with a mean EQ-5D VAS of 77.8; while AIH and listed for liver transplant patients reported the worst HRQoL levels (mean EQ-5D VAS=67.7 and 63.5, respectively). CONCLUSIONS: our study shows how HRQoL is different between LDs and how it is negatively related with the clinical severity. Understanding the different impact of LDs on the patients’ HRQoL could help physicians and decision makers to better estimate the burden of these conditions and to improve the quality of care.