OBJECTIVES: Chronic hepatitis B (CHB) is a viral infection that can lead to fatal liver diseases such as cirrhosis and hepatocellular carcinoma. We conducted a targeted literature review to describe the impact of CHB on health-related quality of life (HRQoL).

METHODS: Searches were conducted in Biosis, Derwent Drug, Embase, PubMed, Medline, Clinicaltrials.gov, Google, and Google Scholar from the beginning of database inception through October 2017. Search strings contained MESH terms and key words such as "Hepatitis B, Chronic”, “Quality of Life”, and "patient reported outcome", and were limited to English and humans.

RESULTS: 29 published studies were included. Most studies were cross-sectional. The SF-36, EQ-5D, and Chronic Liver Disease Questionnaire (CLDQ) were frequently used. The majority of the measures identified were not CHB-specific. Compared to the general population, patients with CHB reported worse HRQoL, particularly in aspects such as physical and emotional functioning, fatigue, worry, depression, and stigma. Patients with CHB reported similar or better HRQoL compared to those with other liver diseases such as hepatitis C and non-alcoholic fatty liver disease. CHB patients with impaired liver functions such as cirrhosis, hepatocellular carcinoma, and liver failure had worse scores on SF-36, EQ-5D, and CLDQ than those without impaired liver function. Declines in physical and emotional functioning in patients during peginterferon alpha-2a treatment were observed, but functioning returned to baseline levels at post-treatment follow up, while patients treated with nucleos(t)ide analogs reported improvements in physical functioning and general health status. Virologic response (i.e., reduction in hepatitis B virus DNA level) was associated with HRQoL improvements in patients who received antiviral therapy.

CONCLUSIONS: CHB has a negative impact on HRQoL. Prospective, interventional studies evaluating the effect of currently available treatments and novel curative regimens on HRQoL in CHB are needed.