Deficiency, incapacity and social disadvantage of patients with chronic hepatitis B: a case-control study

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Jihene BERGAOUI
Imed Latiri
Helmi Ben Saad

Abstract

Introduction. Studies examining impairment, disability and social disadvantage of patients with chronic viral hepatitis B (CHB) are scarce and present conflicting conclusions.
Objective. To assess the deficiency, incapacity and social disadvantage of patients with CHB.
Methods. This is a project of a case-control study with two age-matched groups. Cases (n=27) will be untreated patients with a CHB. Controls (n=27) will be healthy participants. The following data will be collected: deficiency [anthropometric, biochemical (renal and hepatic functions, lipid balance, and inflammatory markers), haematological, virological, handgrip-strength, and spirometric data], incapacity [6-min walk distance, number of stops, oxy-haemoglobin saturation, dyspnoea (visual analogue scale), heart-rate, and blood-pressure] and social disadvantage [“chronic liver disease” and physical-activity questionnaires]. Each spirometric data < lower-limit-of-normal will be considered abnormal. A handgrip-strength <26 kg (male) or <16 kg (female) will be considered low. The signs of walking intolerance will be: stop during the walk, 6-min walk distance ≤ lower-limit-of-normal, dyspnoea at the end of the walk> 5/10, drop in oxy-haemoglobin saturation >5 points, heart-rate at the end of the walk ≤60%. A total physical-activity score <9.42 will classify the participant as sedentary.
Expected results. Compared with controls, cases will have a marked alteration of submaximal aerobic data. These alterations will worsen quality-of-life and may be related to muscle and/or spirometric abnormalities, and supported by systemic inflammation and high viral load.

Keywords:

Virology, liver, handgrip strength, spirometry, field test, quality of life

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References

  1. 1. Dienstag JL. Hepatitis B as an immune complex disease. Semin Liver Dis. 1981;1(1):45-57. 2. Galant LH, Forgiarini Junior LA, Dias AS, Marroni CA. Functional status, respiratory muscle strength, and quality of life in patients with cirrhosis. Rev Bras Fisioter. 2012;16(1):30-4. 3. Faustini Pereira JL, Galant LH, Rossi D, Telles da Rosa LH, Garcia E, de Mello Brandao AB, et al. Functional capacity, respiratory muscle strength, and oxygen consumption predict mortality in patients with cirrhosis. Can J Gastroenterol Hepatol. 2016;2016:6940374. 4. Maruyama S, Koda M, Murawaki Y. Myocardial perfusion defects in patients with chronic hepatitis B infection. J Gastroenterol Hepatol. 2014;29(4):794-9. 5. Sehonou J, Kpossou AR, Amanda TO, Sokpon CNM, Vignon RK, Vigan J. Hepatitis B and renal failure: prevalence and associated factors in National university hospital center of Cotonou. Pan Afr Med J. 2018;31(121):121. 6. Hafeez M, Sarfraz T, Khan RG, Rafe A, Rasool G, Ahmed KN. Hepatitis B leading to megaloblastic anemia and catastrophic peripheral thrombocytopenia. J Coll Physicians Surg Pak. 2016;26(12):992-4. 7. Hong YS, Chang Y, Ryu S, Cainzos-Achirica M, Kwon MJ, Zhang Y, et al. Hepatitis B and C virus infection and diabetes mellitus: A cohort study. Sci Rep. 2017;7(1):4606. 8. Liang TJ. Hepatitis B: the virus and disease. Hepatology. 2009;49(5 Suppl):S13-21. 9. International classification of functioning, disability and health (ICF). Available from http://www.who.int/classifications/icf/en/ (Last visit: July 25th 2021) 10. Goh LY, Card T, Fogarty AW, McKeever TM. The association of exposure to hepatitis B and C viruses with lung function and respiratory disease: a population based study from the NHANES III database. Respir Med. 2014;108(12):1733-40. 11. Teuber G, Teupe C, Dietrich CF, Caspary WF, Buhl R, Zeuzem S. Pulmonary dysfunction in non-cirrhotic patients with chronic viral hepatitis. Eur J Intern Med. 2002;13(5):311-8. 12. Bohannon RW. Muscle strength: clinical and prognostic value of hand-grip dynamometry. Curr Opin Clin Nutr Metab Care. 2015;18(5):465-70. 13. Beseler MR, Rubio C, Duarte E, Hervas D, Guevara MC, Giner-Pascual M, et al. Clinical effectiveness of grip strength in predicting ambulation of elderly inpatients. Clin Interv Aging. 2014;9:1873-7. 14. Leong DP, Teo KK, Rangarajan S, Lopez-Jaramillo P, Avezum A, Jr., Orlandini A, et al. Prognostic value of grip strength: findings from the Prospective Urban Rural Epidemiology (PURE) study. Lancet. 2015;386(9990):266-73. 15. Sharma P, Rauf A, Matin A, Agarwal R, Tyagi P, Arora A. Handgrip strength as an important bed side tool to assess malnutrition in patient with liver disease. J Clin Exp Hepatol. 2017;7(1):16-22. 16. Hiraoka A, Tamura R, Oka M, Izumoto H, Ueki H, Tsuruta M, et al. Prediction of risk of falls based on handgrip strength in chronic liver disease patients living independently. Hepatol Res. 2019;49(7):823-9. 17. Itoh S, Shirabe K, Yoshizumi T, Takeishi K, Harimoto N, Ikegami T, et al. Skeletal muscle mass assessed by computed tomography correlates to muscle strength and physical performance at a liver-related hospital experience. Hepatol Res. 2016;46(4):292-7. 18. Nagamatsu A, Kawaguchi T, Hirota K, Koya S, Tomita M, Hashida R, et al. Slow walking speed overlapped with low handgrip strength in chronic liver disease patients with hepatocellular carcinoma. Hepatol Res. 2019;49(12):1427-40. 19. Lee K. Relationship between handgrip strength and nonalcoholic fatty liver disease: Nationwide surveys. Metab Syndr Relat Disord. 2018;16(9):497-503. 20. Alameri HF, Sanai FM, Al Dukhayil M, Azzam NA, Al-Swat KA, Hersi AS, et al. Six minute walk test to assess functional capacity in chronic liver disease patients. World J Gastroenterol. 2007;13(29):3996-4001. 21. Galant LH, Forgiarini LA, Jr., Dias AS. The aerobic capacity and muscle strength are correlated in candidates for liver transplantation. Arq Gastroenterol. 2011;48(1):86-8. 22. Ben Saad H, Prefaut C, Tabka Z, Mtir AH, Chemit M, Hassaoune R, et al. 6-minute walk distance in healthy North Africans older than 40 years: influence of parity. Respir Med. 2009;103(1):74-84. 23. Cramm JM, Adams SA, Walters BH, Tsiachristas A, Bal R, Huijsman R, et al. The role of disease management programs in the health behavior of chronically ill patients. Patient Educ Couns. 2014;95(1):137-42. 24. Karacaer Z, Cakir B, Erdem H, Ugurlu K, Durmus G, Ince NK, et al. Quality of life and related factors among chronic hepatitis B-infected patients: a multi-center study, Turkey. Health Qual Life Outcomes. 2016;14(1):153. 25. Bondini S, Kallman J, Dan A, Younoszai Z, Ramsey L, Nader F, et al. Health-related quality of life in patients with chronic hepatitis B. Liver Int. 2007;27(8):1119-25. 26. Younossi ZM, Guyatt G, Kiwi M, Boparai N, King D. Development of a disease specific questionnaire to measure health related quality of life in patients with chronic liver disease. Gut. 1999;45(2):295-300. 27. Yi YH, Kim YJ, Lee SY, Cho BM, Cho YH, Lee JG. Health behaviors of Korean adults with hepatitis B: Findings of the 2016 Korean national health and nutrition examination survey. World J Gastroenterol. 2018;24(28):3163-70. 27. Younossi ZM, Stepanova M, Younossi I, Racila A. Development and validation of a hepatitis B-specific health-related quality-of-life instrument: CLDQ-HBV. J Viral Hepat. 2021;28(3):484-492. 29. Newsom JT, Huguet N, McCarthy MJ, Ramage-Morin P, Kaplan MS, Bernier J, et al. Health behavior change following chronic illness in middle and later life. J Gerontol B Psychol Sci Soc Sci. 2012;67(3):279-88. 30. Celli BR, Decramer M, Wedzicha JA, Wilson KC, Agusti A, Criner GJ, et al. An official American thoracic society/European respiratory society statement: research questions in COPD. Eur Respir J. 2015;45(4):879-905. 31. Haskell WL, Lee IM, Pate RR, Powell KE, Blair SN, Franklin BA, et al. Physical activity and public health: updated recommendation for adults from the American college of sports medicine and the American heart association. Med Sci Sports Exerc. 2007;39(8):1423-34. 32. Voorrips LE, Ravelli AC, Dongelmans PC, Deurenberg P, Van Staveren WA. A physical activity questionnaire for the elderly. Med Sci Sports Exerc. 1991;23(8):974-9. 33. Berk PD, Popper H. Fulminant hepatic failure. Am J Gastroenterol. 1978;69(3 Pt 2):349-400. 34. Singh SJ, Puhan MA, Andrianopoulos V, Hernandes NA, Mitchell KE, Hill CJ, et al. An official systematic review of the European respiratory society/American thoracic society: measurement properties of field walking tests in chronic respiratory disease. Eur Respir J. 2014;44(6):1447-78. 35. Serhier Z, Bendahhou K, Ben Abdelaziz A, Bennani MO. Methodological sheet n°1: How to calculate the size of a sample for an observational study? Tunis Med. 2020 Jan;98(1):1-7. 36. Abdelghani A, Ben Saad H, Ben Hassen I, Ghannouchi I, Ghrairi H, Bougmiza I, et al. Evaluation of the deficiency and the submaximal exercise capacity in obstructive sleep apnoea patients. Rev Mal Respir. 2010;27(3):266-74. 37. Heneghan C, Alonso-Coello P, Garcia-Alamino JM, Perera R, Meats E, Glasziou P. Self-monitoring of oral anticoagulation: a systematic review and meta-analysis. Lancet. 2006;367(9508):404-11. 38. Haeckel R. Simplified determinations of the "true" creatinine concentration in serum and urine. J Clin Chem Clin Biochem. 1980;18(7):385-94. 39. Colombet I, Pouchot J, Kronz V, Hanras X, Capron L, Durieux P, et al. Agreement between erythrocyte sedimentation rate and C-reactive protein in hospital practice. Am J Med. 2010;123(9):863 e7-13. 40. Blood tests: normal values. MSD Manual. Professional version. Available from: https://www.msdmanuals.com/professional/resources/normal-laboratory-values/blood-tests-normal-values (Last visit: July 25th 2021). 41. Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972;18(6):499-502. 42. Cadenas-Sanchez C, Sanchez-Delgado G, Martinez-Tellez B, Mora-Gonzalez J, Lof M, Espana-Romero V, et al. Reliability and validity of different models of TKK hand dynamometers. Am J Occup Ther. 2016;70(4):7004300010. 43. Studenski SA, Peters KW, Alley DE, Cawthon PM, McLean RR, Harris TB, et al. The FNIH sarcopenia project: rationale, study description, conference recommendations, and final estimates. J Gerontol A Biol Sci Med Sci. 2014;69(5):547-58. 44. Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, et al. Standardisation of spirometry. Eur Respir J. 2005;26(2):319-38. 45. Kammoun R, Ben Saad H. From deficiency to handicap in the respiratory field: lung function tests (LFT) norms and quality of life (QOL) questionnaires validated for the Tunisian population. Tunis Med. 2020;98(5):378-95. 46. Ben Saad H. Interpretation of respiratory functional explorations of deficiency and incapacity in adult. Tunis Med. 2020;98(11):797-815. 47. Tanaka H, Monahan KD, Seals DR. Age-predicted maximal heart rate revisited. J Am Coll Cardiol. 2001;37(1):153-6. 48. Mahler DA, Wells CK. Evaluation of clinical methods for rating dyspnea. Chest. 1988;93(3):580-6. 49. Bourahli M-K, Bougrida M, Martani M, Mehdioui H, Ben Saad H. 6-Min walk-test data in healthy North-African subjects aged 16-40years. Egypt J Chest Dis Tuberc. 2016;65(1):349-60. 50. Ben Saad H, Tfifha M, Harrabi I, Tabka Z, Guenard H, Hayot M, et al. Factors influencing pulmonary function in Tunisian women aged 45 years and more. Rev Mal Respir. 2006;23(4 Pt 1):324-38.