Document Type

Conference Proceeding

Publication Date

10-2023

Publication Title

Hepatology

Abstract

Background: Pruritus—itching—is common with liver disease, but its prevalence and severity among US patients with chronic hepatitis B and C (HBV, HCV) are not well-documented. A subset of patients from the Chronic Hepatitis Cohort Study (CHeCS) were surveyed to examine pruritus prevalence, persistence, and management, and the impact on patients’ quality of life (QoL). Methods: The validated Pruritus Numeric Rating Scale (NRS) was used to assess pruritus intensity; patients who reported a score ≥ 3 in the last 30 days were invited to participate in a 6-month study using the validated SF-36 questionnaire. A general regression model (univariate followed by multivariable modeling) was used to analyze associations between pruritus intensity and eight dimensions of QoL. Results: Among 1654 patients (HBV =358, HCV = 1296, HBV/HCV =6), pruritus prevalence was significantly higher among patients with HCV than those with HBV (44% vs 35%; p< 0.05 excluding HBV/HCV). A total of 123 patients (21 HBV and 102 HCV) with pruritus agreed to participate in a 6-month questionnaire-based study; 72% were ≥ 60 years, 50% were men, 25% were Black, 22% had compensated cirrhosis, 15% had decompensated cirrhosis, and 66% had BMI >25. Mean NRS was 4.9–5.3. QoL responses for social functioning and emotional well-being were relatively high (70–72 points), but responses for energy/fatigue were lower (50–51 points). Rates of antiviral treatment were higher in HCV patients (92%, SVR rate 99%) and 71% in patients with HBV patients (with 43% receiving ongoing treatment). Multivariable analyses showed no significant effect of either hepatitis type or antiviral treatments on itch. Antihistamine treatment was associated with severe itch. Higher NRS was associated with significantly reduced QoL across all eight dimensions analyzed (Table 1; negative coefficients indicate worse QoL, positive values indicate improvement). The strongest association was between increased itching and the

impact of pain on QoL; for each additional point in the NRS, QoL changed by -3.33 units (95%CI -4.46, -2.20). There was a similar effect on the role of physical limitations on QoL (-3.20, 95%CI -5.34, -1.07). Each unit increase in NRS was also associated with a 2 to 3-unit decline in reported QoL for the remaining dimensions of emotional well-being, general health, physical function, energy/ fatigue, social functioning, and the impact of emotional health. Conclusion: Pruritus affects a large proportion of viral hepatitis patients, regardless of antiviral treatment status. Improved treatment options are needed to address the significant negative impact of itch on their

Volume

78

Issue

S1

First Page

S699

Comments

American Association for the Study of Liver Diseases AASLD, The Liver Meeting, November 10-14, 2023, Boston, MA

Last Page

S700

DOI

10.1097/HEP.0000000000000580

Download

Share

COinS