Impaired Health-Related Quality of Life in Hepatitis B Virus Carriers: A Comparative Study Using WHO-QOL-BREF

Background and Aim: Health-related quality of life (HRQoL) is a multidimensional concept encompassing the physical, psychological, and social domains of health. Inactive hepatitis B virus (HBV) carriers although apparently healthy have a lifelong chronic infection that might impose different challenges on their daily life. Understanding these impacts helps clinicians address the broader consequences of the disease on patients' well-being. Objectives : This study aimed to evaluate the HRQoL of HBV carriers compared to healthy controls using the World Health Organization Quality of Life-BREF (WHO-QOL-BREF) scale and to identify the most affected domains in HBV carriers Patients and Methods: This a cross sectional prospective study where Chronic HBV patients attending to Viral Hepatitis outpatient clinic (OPC) at Ain Shams University were enrolled if they fulfilled criteria of chronic carrier state, undetectable or low (<2,000 IU/ml) HBV DNA levels and normal ALT (ULN <40 IU/L), healthy controls without past history of chronic illnesses were also included. To evaluate HRQL the World Health Organization Qualify of Life Assessment Instrument, Short Version (Arabic WHOQOL Bref) questionnaire was used. Scores were analyzed and compared between the two groups. Results: 60 patients with chronic HBV infection proved to be in the carrier state by low viremia in whom HBV quantitative PCR was negative in 10 carriers (16.7%) and positive in 50 carriers the mean of which was 431±512), AST and ALT were within the normal range (20±7 and 20±9 IU/ML) respectivel y. The majority were females (62%) the mean of their age was 41±9 years, 55% had at least primary education, most of them were married (90%) and (36.7%) were housewife . The total score of HRQL in HBV carriers (77±19) is significantly lower than healthy controls (86±12) (p=0.001). In carriers the scores of 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 & 26 ±6) (p<0.001, p=0.001 &p=0.004) respectively and the highest difference was recorded in the physical domain. Factors such as age, co-morbidities, and laboratory findings did not significantly influence the overall QOL scores; however, females had lower scores in the psychological domain compared to males (p = 0.05). Conclusion: HBV carriers have impaired quality of life & the physical function is mainly affected.