Quality of life of hepatitis B and C patients after liver transplantation

Abstract

Liver transplantation is an accepted treatment for end-stage liver disease due to hepatitis C (HCV), but remains controversial for patients with hepatitis B(HBV). Recently, the use of aggressive hepatitis B immunoglobulin (HBIg) to maintain hepatitis B surface antibody (anti-HBs) titers greater than 500 IU/L has been reported to improve outcome of transplantation for hepatitis B. The aim of this study was to compare the quality of life of patients transplanted for HBV using this regimen of HBIg immunoprophylaxis (group 1) to patients transplanted for HCV (group 2). The State-Trait Anxiety Inventory (STAI), Sickness Impact Profile (SIP), and a work survey were administered to two groups of patients. The STAI measured anxiety while the SIP evaluated physical and psychosocial function. Lower scores indicated less anxiety and dysfunction. Questions regarding hours worked prior to illness and hours worked after transplantation were administered to both groups. Group 1 included a majority of patients who were hepatitis B e antigen (HBeAg) positive prior to transplantation. Survey response was 13:16 (81%) for group 1; and 17:24 (72%) for group 2. Group 1 revealed significantly lower scores than group 2 on the STAI and the overall SIP score. Group 1 reported working similar hours after transplantation as prior to illness while group 2 did not. Thus, patients transplanted for HBV and treated with aggressive HBIg immunoprophylaxis attained a higher quality of life than patients transplanted for HCV.