Impact of Fatigue on Patient‐Reported Outcomes and Work Productivity in Chronic Hepatitis B and C: Insights From a Multinational Registry Study

Fatigue in chronic viral hepatitis may be associated with decreased health-related quality of life and other patient-reported outcomes (PROs). We evaluated the relationship between fatigue and PROs in patients with chronic hepatitis B (CHB) and chronic hepatitis C (CHC). Patients with CHB and CHC enrolled in the Global Liver Registry completed PRO instruments: FACIT-F, CLDQ (for CHB), CLDQ-HCV (for CHC), and WPAI:SHP. Fatigue was defined as FACIT-F Fatigue Scale (FS) score < 30 (scale range: 0-52). Among 2888 patients from 14 countries, 1561 had CHB (mean age 47 ± 13 years; 60% male; 13% advanced fibrosis; 13% depression; 17% fatigue) and 1327 had CHC (50 ± 13 years; 47% male; 21% advanced fibrosis; 18% depression; 28% fatigue). CHB-fatigue was associated with younger age, female, obesity, anxiety, depression (all p < 0.01) and worse PRO scores: CLDQ (scale 1-7): 4.1 ± 0.9 vs. 5.8 ± 0.9; FACIT score (range 0-108): 67.6 ± 14.5 vs. 87.7 ± 13.7; work productivity impairment (range 0-1): 0.33 ± 0.29 vs. 0.11 ± 0.22 (all p < 0.0001). Multivariable analysis confirmed the association of fatigue with lower PRO scores, impairment up to -23% (p < 0.01). CHC-fatigue was associated with female sex, obesity, type 2 diabetes, anxiety, depression (all p < 0.05) and worse PRO scores: CLDQ-HCV: 3.8 ± 1.0 vs. 5.5 ± 1.0; FACIT: 61.8 ± 14.1 vs. 85.6 ± 14.5; work productivity impairment: 0.49 ± 0.32 vs. 0.17 ± 0.25 (all p < 0.0001). In multivariable models, fatigue remained associated with reduced PRO scores, impairment up to -33% (p < 0.01). Almost one in five patients with chronic viral hepatitis report significant fatigue, which is associated with substantial PRO and work productivity impairment. Routine assessment for and management of fatigue in CHC or CHB care is essential.

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Journal
Journal of Viral Hepatitis
Published
2026-05-17
DOI
https://doi.org/10.1111/jvh.70188
Primary Topic
Hepatitis C virus research
Type
article
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article

Impact of Fatigue on Patient‐Reported Outcomes and Work Productivity in Chronic Hepatitis B and C: Insights From a Multinational Registry Study

María Buti Ferret, Ashwani K. Singal, Stuart C. Gordon, Yuichiro Eguchi et al.
Journal of Viral Hepatitis
Hepatitis C virus research
article

Impact of Fatigue on Patient‐Reported Outcomes and Work Productivity in Chronic Hepatitis B and C: Insights From a Multinational Registry Study

María Buti Ferret, Ashwani K. Singal, Stuart C. Gordon, Yuichiro Eguchi, Linda Henry, M Gomez Fernandez, Maria Stepanova, Çağlayan Keklikkıran, S.A. Roberts, Fatema Nader, Georgios Papatheodoridis, Gamal Esmat, W K Chan, Vasily Isakov, Saleh Alqahtani, Yusuf Yilmaz, Ajay Duseja, Zobair M. Younossi, Khalid Alswat, Jian Gao Fan, Mohamed El‐Kassas, Saeed Hamid, Jacob George, Nahum Méndez‐Sánchez, Aijaz Ahmed, Ming‐Lung Yu, Brian Lam, Manuel Romero Gomez
article en

Abstract

Fatigue in chronic viral hepatitis may be associated with decreased health-related quality of life and other patient-reported outcomes (PROs). We evaluated the relationship between fatigue and PROs in patients with chronic hepatitis B (CHB) and chronic hepatitis C (CHC). Patients with CHB and CHC enrolled in the Global Liver Registry completed PRO instruments: FACIT-F, CLDQ (for CHB), CLDQ-HCV (for CHC), and WPAI:SHP. Fatigue was defined as FACIT-F Fatigue Scale (FS) score < 30 (scale range: 0-52). Among 2888 patients from 14 countries, 1561 had CHB (mean age 47 ± 13 years; 60% male; 13% advanced fibrosis; 13% depression; 17% fatigue) and 1327 had CHC (50 ± 13 years; 47% male; 21% advanced fibrosis; 18% depression; 28% fatigue). CHB-fatigue was associated with younger age, female, obesity, anxiety, depression (all p < 0.01) and worse PRO scores: CLDQ (scale 1-7): 4.1 ± 0.9 vs. 5.8 ± 0.9; FACIT score (range 0-108): 67.6 ± 14.5 vs. 87.7 ± 13.7; work productivity impairment (range 0-1): 0.33 ± 0.29 vs. 0.11 ± 0.22 (all p < 0.0001). Multivariable analysis confirmed the association of fatigue with lower PRO scores, impairment up to -23% (p < 0.01). CHC-fatigue was associated with female sex, obesity, type 2 diabetes, anxiety, depression (all p < 0.05) and worse PRO scores: CLDQ-HCV: 3.8 ± 1.0 vs. 5.5 ± 1.0; FACIT: 61.8 ± 14.1 vs. 85.6 ± 14.5; work productivity impairment: 0.49 ± 0.32 vs. 0.17 ± 0.25 (all p < 0.0001). In multivariable models, fatigue remained associated with reduced PRO scores, impairment up to -33% (p < 0.01). Almost one in five patients with chronic viral hepatitis report significant fatigue, which is associated with substantial PRO and work productivity impairment. Routine assessment for and management of fatigue in CHC or CHB care is essential.

Journal of Viral HepatitisVol. 33(6)
Aga Khan University (PK), Hebron University (PS), The University of Sydney (AU), University of Louisville (US), Cairo University (EG), Applied Science Private University (JO), Kaohsiung Medical University (TW), Henry Ford Health System (US), Recep Tayyip Erdoğan University (TR), Palo Alto University (US), National and Kapodistrian University of Athens (GR), Inova Fairfax Hospital (US), King Faisal Specialist Hospital & Research Centre (SA), XinHua Hospital (CN), The Alfred Hospital (AU), King Saud University (SA), Federal Research Centre of Nutrition and Biotechnology (RU), UNSW Sydney (AU), University of Malaya (MY), Monash Alfred Psychiatry Research centre (AU), Center for Outcomes Research in Liver Diseases (US), Vall d'Hebron Hospital Universitari (ES), Global Health Council (US), Hospital Universitario Virgen del Rocío (ES), Universidad de Ciencias Médicas de la Habana (CU), Post Graduate Institute of Medical Education and Research (IN), Helwan University (EG), Universidad Nacional Autónoma de México (MX), Stanford University (US)
Decent work and economic growth
Openalex Percentile: Top 7%
Hepatitis C virus research
DOISourceOpenAlex
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