Quality of life and self-reported stigma following hepatitis B surface antigen loss: A multi-site study by the Canadian Hepatitis B Network

Abstract Background: Chronic hepatitis B (CHB) imposes adverse health outcomes but may also cause psychosocial and quality-of-life (QOL) challenges. Hepatitis B surface antigen (HBsAg) loss, whether spontaneous or due to treatment (ie, a functional cure), is associated with improved clinical outcomes, but the impact of HBsAg clearance on patient-reported outcome measures (PROMs) is poorly understood. Methods: Two surveys (hepatitis B self-stigma and hepatitis B–related QOL [HBQOL]) were administered to adults with a history of CHB with documented HBsAg clearance from six Canadian hepatology clinics. Results: Eighty-four participants were enrolled (median age: 60 years; 53.6% male). Nearly three quarters (72.6%) of patients reported never feeling self-stigma. HBQOL scores improved across all six domains ( p < 0.001 for each), with the largest relative gains in psychological well-being (60% reduction), transmission concerns (55%), and stigma (53%). Conclusions: HBsAg loss was associated with significant improvements in patient-reported stigma and QOL. These findings highlight the importance of incorporating PROMs into hepatitis B virus clinical care to better capture treatment experiences.