title: Correlates of disease-specific knowledge among patients with chronic hepatitis B or hepatitis C infection in India.
abstract: BACKGROUND
  Patient knowledge about chronic diseases increases health-promoting behaviors and improves clinical outcomes. We assessed this association for patients with chronic viral hepatitis.
  
  
  METHODS
  Untreated patients chronically infected with HBV (n = 500) or HCV (n = 500) were enrolled at 19 centers across India. A survey, adapted from the US CDC National Health and Nutrition Examination Survey (NHANES) questionnaire, was administered at a single visit to assess HBV/HCV knowledge, community disease awareness, treatment quality, and healthcare barriers. We developed the India Hepatitis Knowledge Index (IHKI), where a higher IHKI score (range 0-10) indicates increased hepatitis knowledge. Multivariate regression models evaluated demographic and disease factors.
  
  
  RESULTS
  The overall mean IHKI score was 5.6 out of 10, with higher scores among patients with HBV (5.9) than HCV (5.3); p < 0.001. In HBV patients lower IHKI was associated with shorter disease duration, government clinic attendance (p < 0.0001), fewer personal experiences with HBV (p < 0.0001), and residing in northern India. Among HCV patients, lower IHKI was associated with shorter disease duration, community (p < 0.0001) and government clinic attendance (p < 0.0001), and fewer personal experiences with HCV (p < 0.0001). Among HBV patients, IHKI was independently associated with disease severity as assessed by MELD score, albumin, and APRI. This association was strongest for HBV patients with elevated ALT and HBV DNA >2000 IU/ml. Among HCV patients, IHKI results had no significant associations with disease severity.
  
  
  CONCLUSIONS
  The association of IHKI with disease underscores the need to understand connections between hepatitis knowledge and progression and may guide efforts to address patient education and awareness of chronic viral hepatitis in India.
authors.affiliation: University of California Berkeley School of Public Health, Berkeley, CA, USA. tamayo@berkeley.edu.
authors.forename: Aracely
authors.initials: A
authors.lastname: Tamayo
authors.affiliation: Jaslok Hospital and Research Centre and Breach Candy Hospital, Mumbai, India.
authors.forename: Samir R
authors.initials: SR
authors.lastname: Shah
authors.affiliation: Seth GS Medical College and KEM Hospital, Mumbai, India.
authors.forename: Shobna
authors.initials: S
authors.lastname: Bhatia
authors.affiliation: Institute of Post Graduate Medical Education and Research, Kolkata, India.
authors.forename: Abhijit
authors.initials: A
authors.lastname: Chowdhury
authors.affiliation: Asian Institute of Gastroenterology, Hyderabad, India.
authors.forename: Padaki N
authors.initials: PN
authors.lastname: Rao
authors.affiliation: Gilead Sciences, Inc., Foster City, CA, USA.
authors.forename: Phillip
authors.initials: P
authors.lastname: Dinh
authors.affiliation: Gilead Sciences, Inc., Foster City, CA, USA.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Knox
authors.affiliation: Gilead Sciences, Inc., Foster City, CA, USA.
authors.forename: Anuj
authors.initials: A
authors.lastname: Gaggar
authors.affiliation: Gilead Sciences, Inc., Foster City, CA, USA.
authors.forename: G Mani
authors.initials: GM
authors.lastname: Subramanian
authors.affiliation: VGM Hospital, Coimbatore, Tamil Nadu, India.
authors.forename: Viswanathan G
authors.initials: VG
authors.lastname: Mohan
authors.affiliation: Dayanand Medical College and Hospital, Ludhiana, India.
authors.forename: Ajit
authors.initials: A
authors.lastname: Sood
authors.affiliation: Liver Clinic, Surat, India.
authors.forename: Rajiv
authors.initials: R
authors.lastname: Mehta
authors.affiliation: Institute of Liver and Biliary Sciences, New Delhi, India.
authors.forename: Shiv K
authors.initials: SK
authors.lastname: Sarin
mesh_terms: D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D019694:Hepatitis B, Chronic / Q000453:epidemiology / Q000523:psychology*; D019698:Hepatitis C, Chronic / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D007194:India; D012044:Regression Analysis; D012307:Risk Factors
keywords: Disease knowledge; Hepatitis B virus; Hepatitis C virus; India