Introduction: Hepatitis B or C virus infection is one of the most common liver infections leading to altered health-related quality of life (HRQoL) in patients. The goal of this study was to assess the quality of life of patients infected with hepatitis B or C virus and to determine the factors that might be associated with worse outcomes. Methods: A cross-sectional study was conducted in patients aged 18 years and over followed on an outpatient basis at the teaching hospital Hassan II in Fez for hepatitis B or C. These patients were asked to complete the SF-12 questionnaire file which is the short form of the quality measurement scale of life SF-36. Sociodemographic, clinical and economic information was collected. A descriptive analysis was carried out, then a univariate analysis in search of factors associated with quality of life, and finally a multivariate analysis by linear regression was carried out adjusting for possible confounding factors. Results: A total of 94 patients whose mean age was 55.69 ± 13.25 years met the inclusion criteria. The physical quality of life was altered with an average of 41.98 ± 12.67. Hepatitis C virus infection (β = -6.802; 95% CI = (-12.05; -1.55)), cirrhosis (β = -6.947, 95% CI = (-12.04; -1.84)) and lack of employment (β = -8.48, 95% CI = (-13.18; -3.77)) were the factors associated with poor quality of life. The mental quality of life (MCS) was also altered with an average of 46.32 ± 12.84. In multivariate analysis we found that participants with hepatitis C (β = 7.444, 95% CI = (2.14; 12.74)), unemployed (β = 6.697, 95% CI (2.28; 11.11)) and having received treatment (β = 8.295, 95% CI (2.95; 13.63) had a better mental quality of life, while alcoholics had an impaired mental quality of life (β = -8.105, 95% CI (-15.28; -0.92)). Conclusion: Quality of life is altered in patients with chronic hepatitis regardless of type.
Cite this paper
Jho, D. B. , Hakima, A. , Harch, I. E. , Benmaamar, S. , Hind, B. , Nassiba, B. , Saliou, B. M. , Passy, C. , Otmani, N. , Abkari, M. E. , Berraho, M. A. , Tachfouti, N. and Fakir, S. E. (2022). Quality of Life and Associated Factors in Patients Infected with Hepatitis B and C Virus in a Moroccan Region: A Cross-Sectional Study. Open Access Library Journal, 9, e8781. doi: http://dx.doi.org/10.4236/oalib.1108781.
Bristol-Myers, S. (2006) Hépatite B: Mieux la connaître pour mieux la traiter. Journal de Pédiatrie et de Puériculture, 19, 340-343.
https://doi.org/10.1016/j.jpp.2006.10.009
Sbai, A., Baha, W., Ougabrai, H., Allalia, T., Dersi, N., Lazaar, F., Ennaji, M.M., Benjouad, A., El Malki, A., Hassar, M. and Benani, A. (2012) Prévalence de l’infection par le virus de l’hépatite B et l’évaluation des facteurs de risque au Maroc. Pathologie Biologie, 60, 65-69. https://doi.org/10.1016/j.patbio.2011.06.001
Benouda, A., Boujdiya, Z., Ahid, S., Abouqal, R. and Adnaoui, M. (2009) Prévalence de l’infection par le virus de l’hépatite C au Maroc et évaluation des tests sérologiques de dépistage pour la prédiction de la virémie. Pathologie Biologie, 57, 368-372.
https://doi.org/10.1016/j.patbio.2008.07.006
Testa, M.A. and Simonson, D.C. (1996) Assessment of Quality-of-Life Outcomes. The New England Journal of Medicine, 334, 835-840.
https://doi.org/10.1056/NEJM199603283341306
Diener, E. and Suh, E. (1997) Measuring Quality of Life: Economic, Social, and Subjective Indicators. Social Indicators Research, 40, 189-216.
https://doi.org/10.1023/A:1006859511756
Foster, G.R., Goldin, R.D. and Thomas, H.C. (1998) Chronic Hepatitis C Virus Infection Causes a Significant Reduction in Quality of Life in the Absence of Cirrhosis. Hepatology, 27, 209-212. https://doi.org/10.1002/hep.510270132
Dan, A.A., Kallman, J.B., Srivastava, R., Younoszai, Z., Kim, A. and Younossi, Z.M. (2008) Impact of Chronic Liver Disease and Cirrhosis on Health Utilities Using SF-6D and the Health Utility Index. Liver Transplantation, 14, 321-326.
https://doi.org/10.1002/lt.21376
Ong, S., Mak, B., Aung, M., Li, S.C. and Lim, S.G. (2008) Health-Related Quality of Life in Chronic Hepatitis B Patients. Hepatology, 47, 1108-1117.
https://doi.org/10.1002/hep.22138
Ware, J.E. and Sherbourne, C.D. (1992) The MOS 36-Items Short-Form Health Survey (SF36). I. Conceptual Framework and Item Selection. Medical Care, 30, 473-474. https://doi.org/10.1097/00005650-199206000-00002
Obtel, M., El Rhazi, K., Elhold, S., Benjelloune, M., Gnatiuc, L. and Nejjari, C. (2013) Cross-Cultural Adaptation of the 12-Item Short-Form Survey Instrument in a Moroccan Representative Survey. Southern African Journal of Epidemiology and Infection, 28, 166-171. https://doi.org/10.1080/10158782.2013.11441540
Ware Jr., J., Kosinski, M. and Keller, S.D. (1996) A 12-Item Short-Form Health Survey: Construction of Scales and Preliminary Test of Reliability and Validity. Medical Care, 34, 220-233. https://doi.org/10.1097/00005650-199603000-00003
Martin, L.M., Sheridan, M.J. and Younossi, Z.M. (2002) The Impact of Liver Disease on Health-Related Quality of Life: A Review of the Literature. Current Gastroenterology Reports, 4, 79-83. https://doi.org/10.1007/s11894-002-0041-z
Gutteling, J.J., de Man, R.A., van der Plas, S.M., Schalm, S.W., Busschbach, J.J. and Darlington, A.S. (2006) Determinants of Quality of Life in Chronic Liver Patients. Alimentary Pharmacology & Therapeutics, 23, 1629-1635.
https://doi.org/10.1111/j.1365-2036.2006.02934.x
Bonkovski, H.L. and Woolley, J.M. (1999) Reduction of Health-Related Quality of Life Chronic Hepatitis C and Improvement with Interferon Therapy. Hepatology, 29, 264-270. https://doi.org/10.1002/hep.510290124
Kang, S.C., Hwang, S.J., Lee, S.H., Chang, F.Y. and Lee, S.D. (2005) Health-Related Quality of Life and Impact of Antiviral Treatment in Chinese Patients with Chronic Hepatitis C in Taiwan. World Journal of Gastroenterology, 11, 7494-7498.
https://doi.org/10.3748/wjg.v11.i47.7494
Younossi, Z.M., Kiwi, M.L., Boparai, N., Price, L.L. and Guyatt, G. (2000) Cholestatic Liver Diseases and Health-Related Quality of Life. American Journal of Gastroenterology, 95, 497-502. https://doi.org/10.1111/j.1572-0241.2000.01774.x
Bao, Z., Qiu, D., Ma, X., Fan, Z., Zhang, G., Huang, Y., et al. (2007) Assessment of Health-Related Quality of Life in Chinese Patients with Minimal Hepatic Encephalopathy. World Journal of Gastroenterology, 13, 3003-3008.
https://doi.org/10.3748/wjg.v13.i21.3003
Kallman, J., O’Neil, M.M., Larive, B., Boparai, N., Calabrese, L. and Younossi, Z.M. (2007) Fatigue and Health-Related Quality of Life (HRQL) in Chronic Hepatitis C Virus Infection. Digestive Diseases and Sciences, 52, 2531-2539.
https://doi.org/10.1007/s10620-006-9708-x
Svirtlih, N., Pavic, S., Terzic, D., Delic, D., Simonovic, J., Gvozdenovic, E. and Boricic, I. (2008) Reduced Quality of Life in Patients with Chronic Viral Liver Disease as Assessed by SF12 Questionnaire. Journal of Gastrointestinal and Liver Diseases, 17, 405-409.
Younossi, Z.M., Guyatt, G., Kiwi, M., Boparai, N. and King, D. (1999) Development of a Disease Specific Questionnaire to Measure Health Related Quality of Life in Patients with Chronic Liver Disease. Gut, 45, 295-300.
https://doi.org/10.1136/gut.45.2.295
Younossi, Z.M., Boparai, N., Price, L.L., Kiwi, M.L., McCormick, M. and Guyatt, G. (2001) Health-Related Quality of Life in Chronic Liver Disease: The Impact of Type and Severity of Disease. American Journal of Gastroenterology, 96, 2199-2205.
https://doi.org/10.1111/j.1572-0241.2001.03956.x
Park, C.K., Park, S.Y., Kim, E.S., et al. (2003) Assessment of Quality of Life and Associated Factors in Patients with Chronic Viral Liver Disease. The Korean Journal of Hepatology, 9, 212-221.
Younossi, Z.M. (2001) Chronic Liver Disease and Health-Related Quality of Life. Gastroenterology, 120, 305-307. https://doi.org/10.1053/gast.2001.22073
Arguedas, M.R., DeLawrence, T.G. and McGuire, M.G. (2003) Influence of Hepatic Encephalopathy on Health-Related Quality of Life in Patients with Cirrhosis. Digestive Diseases and Sciences, 48, 1622-1626. https://doi.org/10.1023/A:1024784327783
Marchesini, G., Bianchi, G., Amodio, P., Salerno, F., Merli, M., Panella, C., Loguercio, C., Apolone, G., Niero, M., Abbiati, R.; Italian Study Group for Quality of Life in Cirrhosis (2001) Factors Associated with Poor Health-Related Quality of Life of Patients with Cirrhosis. Gastroenterology, 120, 170-178.
https://doi.org/10.1053/gast.2001.21193
Pojoga, C., Dumitrascu, D.L., Pascu, O., Grigorescu, M., Radu, C. and Damian, D. (2004) Impaired Health-Related Quality of Life in Romanian Patients with Chronic Viral Hepatitis before Antiviral Therapy. European Journal of Gastroenterology & Hepatology, 16, 27-31. https://doi.org/10.1097/00042737-200401000-00005
Ozkan, M., Corapçioglu, A., Balcioglu, I., Ertekin, E., Khan, S., Ozdemir, S., Karayün, D., Unsalver, B.O., Kocaman, N., Kaymakglu, S. and Köroglu, G. (2006) Psychiatric Morbidity and Its Effect on the Quality of Life of Patients with Chronic Hepatitis B and Hepatitis C. The International Journal of Psychiatry in Medicine, 36, 283-297. https://doi.org/10.2190/D37Y-X0JY-39MJ-PVXQ
Foster, G.R. (1999) Hepatitis C Virus Infection: Quality of Life and Side Effects of Treatment. Journal of Hepatology, 31, 250-254.
https://doi.org/10.1016/S0168-8278(99)80411-5
Ware Jr., J.E., Bayliss, M.S., Mannocchia, M. and Davis, G.L. (1999) Health-Related Quality of Life in Chronic Hepatitis C: Impact of Disease and Treatment Response. Hepatology, 30, 550-555. https://doi.org/10.1002/hep.510300203
Lam, E.T., Lam, C.L., Lai, C.L., Yuen, M.F., Fong, D.Y. and So, T.M. (2009) Health-Related Quality of Life of Southern Chinese with Chronic Hepatitis B Infection. Health and Quality of Life Outcomes, 7, Article No. 52.
https://doi.org/10.1186/1477-7525-7-52
Häuser, W., Holtmann, G. and Grandt, D. (2004) Determinants of Health-Related Quality of Life in Patients with Chronic Liver Diseases. Clinical Gastroenterology and Hepatology, 2, 157-163. https://doi.org/10.1016/S1542-3565(03)00315-X
Popovic, D.D., Kisic-Tepavcevic, D., Kovacevic, N., et al. (2018) Quality of Life in Patients with Chronic Liver Disease. Vojnosanitetski Pregled, 75, 453-460.
https://doi.org/10.2298/VSP160616339P
