title: Dynamics and liver disease specific aspects of quality of life among patients with chronic liver disease in Yunnan, China.
abstract: BACKGROUND
  Patients with chronic liver diseases (CLD) may have compromised health related quality of life (HRQoL). Hepatitis B virus (HBV) infection has long been the leading cause of CLD including liver cancer and cirrhosis. Knowledge on different symptom profiles of CLD should help in development of comprehensive treatment and patient care plans.
  
  
  OBJECTIVE
  To access the facets of HRQoL in chronic liver diseases throughout their spectrum of severity.
  
  
  METHODS
  A cross-sectional study was conducted in the First Affiliated Hospital of Kunming Medical University in Yunnan Province of China. Both out- and inpatients undergoing treatment protocols for different HBV related liver disease states were consecutively collected from December 2012 to June 2013. ANOVA was used to compare the mean scores of EQ-5D and chronic liver disease questionnaire (CLDQ) among 5 disease groups. The relationship between demographic variables predicting global CLDQ scores and the domains of CLDQ was analysed.
  
  
  RESULTS
  A total of 1040 patients including 520 without complications, 91 with compensated cirrhosis, 198 with decompensated cirrhosis, 131 with HCC and 100 with liver failure were recruited. All domains of CLDQ, the means of EQ-5D value and EQ VAS exhibited significant decline with worsening of disease severity from uncomplicated HBV to liver failure. The multivariate regression demonstrated the reduction of mean scores of CLDQ domain at advanced stage. Patients with liver failure and HCC had more HRQoL impairment than other disease states. No effect of patient gender was found. Patient age was associated with 'fatigue' and 'worry' domains (p=0.006; p=0.004) but not with other domains and global scores of CLDQ and ED-5D.
  
  
  CONCLUSIONS
  The HRQoL in chronic hepatitis B patients is greatly affected by disease states. Care for HBV-related diseases should consider not only the outcomes of treatment strategies but also improvement in patient wellbeing.
authors.affiliation: Breast Disease Center, The First Peoples Hospital of Kunming, Yunnan province, Kunming, China E-mail : hutcha.s@gmail.com.
authors.forename: Yan-Hua
authors.initials: YH
authors.lastname: Che
authors.forename: Jing
authors.initials: J
authors.lastname: You
authors.forename: Virasakdi
authors.initials: V
authors.lastname: Chongsuvivatwong
authors.forename: Li
authors.initials: L
authors.lastname: Li
authors.forename: Hucha
authors.initials: H
authors.lastname: Sriplung
authors.forename: Yuan-Zhi
authors.initials: YZ
authors.lastname: Yan
authors.forename: Si-Jia
authors.initials: SJ
authors.lastname: Ma
authors.forename: Xiaoli
authors.initials: X
authors.lastname: Zhang
authors.forename: Ting
authors.initials: T
authors.lastname: Shen
authors.forename: He-Min
authors.initials: HM
authors.lastname: Chen
authors.forename: Shao-Feng
authors.initials: SF
authors.lastname: Rao
authors.forename: Ru-Yi
authors.initials: RY
authors.lastname: Zhang
mesh_terms: D000328:Adult; D002681:China / Q000453:epidemiology; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008107:Liver Diseases / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires