Clinical and patient-reported outcome profile of patients with hepatitis B viral infection from the Global Liver Registry™

Zobair M. Younossi, Ming Lung Yu, Yusuf Yilmaz, Khalid Aida Alswat, Maria Buti, Marlen Ivon Castellanos Fernandez, Georgios Papatheodoridis, Saeed S. Hamid, Mohamed El-Kassas, Wah Kheong Chan, Ajay K. Duseja, Stuart C. Gordon, Yuichiro Eguchi, Vasily A. Isakov, Stuart K. Roberts, Jian Gao Fan, Ashwani K. Singal, Manuel Romero-Gómez, Aijaz Ahmed, Janus OngBrian P. Lam, Issah Younossi, Fatema Nader, Andrei Racila, Maria Stepanova, Saleh Alqahtani

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3 Citations (Scopus)


Chronic hepatitis B (CHB) infection is one of the most common causes of cirrhosis and liver cancer worldwide. Our aim was to assess clinical and patient-reported outcome (PRO) profile of CHB patients from different regions of the world using the Global Liver Registry. The CHB patients seen in real-world practices are being enrolled in the Global Liver Registry. Clinical and PRO (FACIT-F, CLDQ, WPAI) data were collected and compared to baseline data from CHB controls from clinical trials. The study included 1818 HBV subjects (48 ± 13 years, 58% male, 14% advanced fibrosis, 7% cirrhosis) from 15 countries in 6/7 Global Burden of Disease super-regions. The rates of advanced fibrosis varied (3–24%). The lowest PRO scores across multiple domains were in HBV subjects from the Middle East/North Africa (MENA), the highest – Southeast/East and South Asia. Subjects with advanced fibrosis had PRO impairment in 3 CLDQ domains, Activity of WPAI (p < 0.05). HBV subjects with superimposed fatty liver had more PRO impairments. In multivariate analysis adjusted for location, predictors of PRO impairment in CHB included female sex, advanced fibrosis, and non-hepatic comorbidities (p < 0.05). In comparison to Global Liver Registry patients, 242 controls from clinical trials had better PRO scores (Abdominal, Emotional, and Systemic scores of CLDQ, all domains of WPAI) (p < 0.05). In multivariate analysis with adjustment for location and clinicodemographic parameters, the associations of PROs with the enrollment setting (real-life Global Liver Registry vs. clinical trials) were no longer significant (all p > 0.10). The clinico-demographic portrait of CHB patients varies across regions of the world and enrollment settings. Advanced fibrosis and non-hepatic comorbidities are independently associated with PRO impairment in CHB patients.

Original languageEnglish
Pages (from-to)335-344
Number of pages10
JournalJournal of Viral Hepatitis
Issue number4
Publication statusPublished - Apr 2023


  • emotional well-being
  • fatigue
  • fatty liver
  • physical functioning
  • viral hepatitis
  • work productivity


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