Impaired Health-Related Quality of Life in Hepatitis B Virus Carriers: A Comparative Study Using the WHO-QOL-BREF
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Background and Aim
Health-related quality of life (HRQoL) is a multidimensional concept encompassing the physical, psychological, and social aspects of health. Although inactive hepatitis B virus (HBV) carriers appear healthy, they live with lifelong chronic infections that may present various challenges in their daily lives. Understanding these impacts enables clinicians to address the broader consequences of the disease on patients' well-being.
Objectives
This study aims to assess the HRQoL of HBV carriers compared to healthy controls using the World Health Organization Quality of Life-BREF (WHOQOL-BREF) scale and identify the most affected domains among HBV carriers.
Patients and Methods
This case–control study enrolled chronic HBV patients attending the Viral Hepatitis Outpatient Clinic (OPC) at Ain Shams University. Patients were included if they met the criteria for chronic carrier status, had undetectable or low HBV DNA levels (< 2,000 IU/mL), and exhibited normal alanine aminotransferase (ALT) levels (ULN < 40 IU/L). Healthy controls with no history of chronic illness were also included. To assess HRQoL, the Arabic version of the World Health Organization Quality of Life Assessment Instrument, Short Version (WHOQOL-BREF), was used. Scores were analyzed and compared between the two groups.
Results
A total of 60 patients with chronic HBV infection, confirmed to be in the carrier state by low viremia were included in the study. Among them, HBV quantitative PCR was negative in 10 carriers (16.7%) and positive in 50 carriers, with a mean viral load of 431 ± 512 IU/mL. Aspartate Aminotransferase (AST) and Alanine Aminotransferase (ALT) levels were within the normal range (20 ± 7 IU/mL and 20 ± 9 IU/mL, respectively). The majority of participants were female (62%), with a mean age of 41 ± 9 years. Additionally, 55% had at least a primary level of education, most were married (90%), and 36.7% were housewives. The total HRQoL score in HBV carriers (77 ± 19) was significantly lower than that of healthy controls (86 ± 12) ( p = 0.001). Among HBV carriers, scores in the physical (23.5 ± 7), psychological (19 ± 4.6), and environmental (22.5 ± 6.3) domains were significantly lower compared to controls (29 ± 4, 21 ± 3, and 26 ± 6, respectively) ( p < 0.001, p = 0.001, and p = 0.004, respectively), with the greatest difference observed in the physical domain. Factors such as age, comorbidities, and laboratory findings did not significantly impact overall QoL scores.
Conclusion
HBV carriers experience impaired quality of life, with physical functioning being the most significantly affected domain. These findings highlight the need for holistic care strategies for HBV carriers.
