Online Program

Health-Related Quality of Life in Children with Chronic Hepatitis B in the United States and Canada: Pediatric Cohort of the Hepatitis B Research Network

Monday, November 2, 2015

Hsinghua Sylvia Lin, PhD student, Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA
Sarah Jane Schwarzenberg, MD, University of Minnesota Masonic Children’s Hospital, Minneapolis, MN
Yona Keich Cloonan, PhD, Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA
Simon C. Ling, MD, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
Donna M. Evon, PhD, MS, MA, Department of Medicine, University of North Carolina at Chapel Hill, NC
Karen F. Murray, MD, Department of Pediatrics, University of Washington, Seattle, WA
Norberto Rodriguez-Baez, MD, Department of Pediatrics at UT Southwestern Medical Center, Dallas, TX
Philip Rosenthal, MD, Department of Pediatrics, UCSF, San Francisco, CA
Jeffrey Teckman, MD, Department of Pediatrics, Saint Louis University, Saint Louis, MO
Kathleen B. Schwarz, MD, Department of Pediatrics, Johns Hopkins Medical Institutions, Baltimore, MD
Purpose: To determine if disease-related clinical factors are associated with health-related quality of life (HRQoL) among children with chronic hepatitis B (HBV) using the validated Child Health Questionnaire-Child Report Form 87 (CHQ-CF87).

Methods: As of January 2015, 185 children aged 10-<18 years completed the CHQ-CF87, including 10 subdomains (4 physical, 5 psychosocial, 1 family). Each subdomain is based on a 0-100 scale; higher scores reflect better HRQoL. Clinical factors included serum alanine transaminase (ALT), HBV e antigen (HBeAg(+)/(-)), and log10HBV DNA (IU/ml). Covariates with p-value< 0.1 were retained in multivariable linear models.

Results: Mean age was 14 years, 54% female, 71% Asian, and 50% adopted. Multivariable analyses included age, sex, race, adoption status, maternal education, past HBV treatment, ALT, and HBeAg status. HBV DNA was not included in multivariable models due to high correlation with HBeAg status. Children with HBeAg(-) had impairment in every subdomain, especially in physical functioning (β=-4.3;95%CI: -7.9,-0.7), social role limitation physical health (β=-5.2;95%CI:-9.1,-1.4), and social role limitation behavior problems (β=-8.7;95%CI:-15.1,-2.4). With every doubling in ALT, all subdomain scores decreased, with the greatest decrease in general health perceptions (β=-2.5;95%CI:-4.8,-0.3) and behavior (β=-2.5;95%CI:-4.5,-0.6).

Conclusions: Among children with chronic HBV, higher serum ALT level and HBeAg(-) were associated with lower HRQoL scores across multiple subdomains. Future studies are needed to better understand the association of other disease-related factors with HRQoL, independent of family and sociodemographic factors. The impaired HRQoL reported by children may be an important marker for risk of poor therapy adherence or later mental health issues.

Learning Areas:

Administer health education strategies, interventions and programs
Assessment of individual and community needs for health education
Chronic disease management and prevention
Clinical medicine applied in public health
Social and behavioral sciences

Learning Objectives:
Evaluate if disease-related clinical factors are associated with health-related quality of life among children with chronic hepatitis B.

Keyword(s): Adolescents, Chronic Disease Management and Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a graduate student researcher for the Hepatitis B Research Network and I did all the statistical analyses and the poster for this paper I submitted. Among my scientific interests has been the epidemiology studies for child health.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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