QUALITY OF LIFE & COST EFFECTIVENESS ANALYSIS OF MANAGEMENT FOR PATIENTS WITH CHRONIC HEPATITIS B VIRUS INFECTION

Abstract

Viral hepatitis caused by either B or C virus is the most common cause of chronic liver disease, it can lead to cirrhosis and increased the risk of hepatocellular carcinoma (I-ICC) approximately 300 folds compared with the general population. Assessment of the effect of chronic viral hepatitis on quality of life (QOL) of patients with chronic viral hepatitis, was conducted through a case control study in Ahmed Maher educational hospital. 200 patients were eligible for inclusion criteria, which are laboratory evidence of chronic viral hepatitis with clinical evidence of absence of cirrhosis and other chronic disease, for each case studied, a matched control were taken for comparison. The results showed marked significant reduction in QOL total score and in all QOL domains except for sexual functions, when compared with controls. Gender variation showed significant reduction of male quality of life more than females and higher educational levels showed more decrease in QOL score. There was no significant relation between the reduction in QOL and the symptomatology of the patients. Disability adjusted life years (DALYs) lost from the expected life years was calculated for patients with chronic HB V infection depending on data obtained from experts opinion using the method proposed by the decision making project (DDM,1993). DALYs lost was estimated to be 3.38 years as a result ofHBV infection. Years of life lost were mainly from premature death while disability was responsible for about 15% of the years lost from life expectancy of patients. Cost effectiveness analysis of interferon therapy as a curative intervention in Ahmed Maher educational Hospital, reveals that in order to save one year of life expectancy it costs 8914 LE, which is considered to be more costy in comparison to preventive intervention.