UNDERSTANDING THE HEALTH-RELATED QUALITY OF LIFE BURDEN IN CHRONIC HEPATITIS DELTA INFECTION: A SYSTEMATIC LITERATURE REVIEW
Author(s)
Robert Wong, MD, MS, FACG, FAASLD1, Arman Papadakis-Sali, MSc2, Pankaj Rai, MS3, Chong H Kim, MPH, MS, PhD4, Barinder Singh, RPh3, Marvin Rock, MPH, DrPH4, Robert G. Gish, MD5;
1Stanford School of Medicine, Division of Gastroenterology and Hepatology, Palo Alto, CA, USA, 2Gilead Sciences, Inc., Stockley Park, United Kingdom, 3Pharmacoevidence Private Limited, Mohali, India, 4Gilead Sciences, Inc., Foster City, CA, USA, 5University of Nevada, Reno School of Medicine, Kirk Kerkorian School of Medicine at UNLV, Las Vegas, NV, USA
1Stanford School of Medicine, Division of Gastroenterology and Hepatology, Palo Alto, CA, USA, 2Gilead Sciences, Inc., Stockley Park, United Kingdom, 3Pharmacoevidence Private Limited, Mohali, India, 4Gilead Sciences, Inc., Foster City, CA, USA, 5University of Nevada, Reno School of Medicine, Kirk Kerkorian School of Medicine at UNLV, Las Vegas, NV, USA
OBJECTIVES: Chronic hepatitis delta (CHD) progresses rapidly to advanced liver diseases and impairs health-related quality of life (HRQoL). This systematic literature review aims to identify and summarize the published HRQoL burden in adults with CHD.
METHODS: Embase, MEDLINE, and CENTRAL were searched from database inception to August 2025 to identify studies reporting HRQoL burden in CHD. The citations were screened in parallel by a human reviewer and an artificial intelligence tool using predefined eligibility criteria with conflicts resolved by a subject matter expert.
RESULTS: Ten studies (sample size: 10-168 patients) were included, utilizing various HRQoL instruments, including EQ-5D (VAS, n=4; Index, n=3), HQLQ, CLDQ, FACIT-F, WPAI (n=2 each), FSS, HBQoL, and PGI-S (n=1 each), where higher scores indicate better HRQoL, except for FSS, HBQoL, and WPAI instruments. Compared with patients with CHB monoinfection, patients with CHD reported lower EQ-5D scores (VAS: 64.30-71.50 vs 73.71-79.80; Index: 0.63-0.81 vs 0.70-0.88). EQ-5D scores in CHD patients further declined with disease progression from F0-F3 to F4 decompensated cirrhosis (DC; VAS: 78.70-40.20; Index: 0.90-0.40). HQLQ assessment suggested similar declines with increasing disease severity across all domains (F0-F3: 58.70-80.20; F4 DC: 25.30-28.30). Patients with compensated cirrhosis (CC) reported greater impairment in daily activities and emotional symptoms on the HQLQ scale, with reduced energy and poorer outlook on life, highlighting substantial physical and psychological burden. Additionally, fatigue severity measured using the FSS, increased from 3.90 (F0-F3) to 4.70 (F4 CC) and 6.20 (F4 DC), with scores ≥4 considered severe. This trend was consistent across other HRQoL measures. Notably, most patients with F4 DC (80.00%) and coexisting hepatocellular carcinoma (62.50%) reported receiving caregiver support.
CONCLUSIONS: CHD is associated with a substantial and progressive burden on HRQoL, affecting physical, emotional, and functional well-being, particularly with advancing disease. This review highlights the need for interventions to slow progression, manage symptoms, and improve patient health.
METHODS: Embase, MEDLINE, and CENTRAL were searched from database inception to August 2025 to identify studies reporting HRQoL burden in CHD. The citations were screened in parallel by a human reviewer and an artificial intelligence tool using predefined eligibility criteria with conflicts resolved by a subject matter expert.
RESULTS: Ten studies (sample size: 10-168 patients) were included, utilizing various HRQoL instruments, including EQ-5D (VAS, n=4; Index, n=3), HQLQ, CLDQ, FACIT-F, WPAI (n=2 each), FSS, HBQoL, and PGI-S (n=1 each), where higher scores indicate better HRQoL, except for FSS, HBQoL, and WPAI instruments. Compared with patients with CHB monoinfection, patients with CHD reported lower EQ-5D scores (VAS: 64.30-71.50 vs 73.71-79.80; Index: 0.63-0.81 vs 0.70-0.88). EQ-5D scores in CHD patients further declined with disease progression from F0-F3 to F4 decompensated cirrhosis (DC; VAS: 78.70-40.20; Index: 0.90-0.40). HQLQ assessment suggested similar declines with increasing disease severity across all domains (F0-F3: 58.70-80.20; F4 DC: 25.30-28.30). Patients with compensated cirrhosis (CC) reported greater impairment in daily activities and emotional symptoms on the HQLQ scale, with reduced energy and poorer outlook on life, highlighting substantial physical and psychological burden. Additionally, fatigue severity measured using the FSS, increased from 3.90 (F0-F3) to 4.70 (F4 CC) and 6.20 (F4 DC), with scores ≥4 considered severe. This trend was consistent across other HRQoL measures. Notably, most patients with F4 DC (80.00%) and coexisting hepatocellular carcinoma (62.50%) reported receiving caregiver support.
CONCLUSIONS: CHD is associated with a substantial and progressive burden on HRQoL, affecting physical, emotional, and functional well-being, particularly with advancing disease. This review highlights the need for interventions to slow progression, manage symptoms, and improve patient health.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
PCR127
Topic
Patient-Centered Research
Topic Subcategory
Health State Utilities, Patient-reported Outcomes & Quality of Life Outcomes
Disease
SDC: Infectious Disease (non-vaccine)