Public Release Type:
Journal
Publication Year: 2014
Authors:
Cloonan YK,
Ling S,
Murray KF,
Rodriguez-Baez N,
Rosenthal P,
Schwarzenberg SJ,
Schwarz KB,
Teckman J
Studies:
Hepatitis B Research Network
Background Health-related quality of life (HRQOL) is impaired in adults with HBV; we assessed HRQOL in children enrolled in the multicenter HBRN Pediatric Cohort Study. Methods The Child Health Questionnaire (CHQ), a validated generic pediatric HRQOL instrument measuring health in physical, psychological and social domains, was completed for HBsAg+ children ≥5y. CHQ-PF50 was completed by parents/caregivers with children 5-10y; children >10y completed CHQ-CF87. Categorical demographic and disease-related characteristics were described using frequency and percent. For each CHQ scale, median scaled score and interquartile range (25th-75th percentiles) were calculated. Results are presented separately by 1) sex, 2) HBV phenotype, and 3) whether children were living with biologic or adoptive parents. Results 197 of 224 children enrolled had CHQ collected; 36% were <10y, 33% were male, and 59% were adopted. Of 193 with phenotype data, 41% were immune tolerant, 22% immune active, 12% inactive carrier, 24% indeterminate. CHQ scales with the lowest median scores were: General Health Perceptions (PF50 70.8, CF87 66.0), Behavior (PF50 80.8, CF87 78.8), and Mental Health (PF50 80.0, CF87 80.5). The median score for PF50 Emotional Impact on Parent was 83.3. All other scales had a median score of at least 85.0. When evaluated separately by sex, phenotype and adoption status, similar patterns were observed across groups, with the four scales listed above having the lowest median scores. For gender, median score differential >15 points was seen for PF50 Emotional Impact on Parent (male 58.3, female 83.3) and PF50 Family Activities (male 81.3, female 100.0). Median psychosocial summary T-scores were lower in males (47.4) than females (54.7), with a differential of <1 for the physical summary. For phenotype, median score differential >20 points was seen for PF50 Emotional Impact on Parent (45.8 immune active, 83.3 immune tolerant) and CF87 Family Activity (70.8 indeterminate, 91.7 immune tolerant). Median psychosocial summary T-scores ranged from 46.1 (immune active) to 58.2 (inactive carrier), with a differential of <2 across phenotypes for the physical summary. For adoption status, median scores did not differ on any CHQ scales. Median T-score differential of <3 were observed for both the psychosocial and physical summary measures. Conclusions In a large cohort of HBsAg+ children, parents of young boys experience a greater impact on parental emotional health and family activity than parents of young girls. Greater viral activity impacts parent and family CHQ across all age groups. Children living with adoptive and biologic parents do not differ with respect to HRQOL.