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

INTRODUCTION

Studies examining impairment, disability and social disadvantage of patients with chronic viral hepatitis B (CHB) are scarce and present conflicting conclusions.

AIM

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.

[Not Available]

Zusammenfassung. Lungenkranke mit COPD, einer der häufigsten Todesursachen in der Schweiz, leiden darunter, dass ihre Krankheit in der Bevölkerung zu wenig bekannt ist oder als selbst verschuldete «Raucherlunge» bezeichnet wird. Auch die Luftverschmutzung durch Feinstaub sollte als Ursache bekämpft werden. Dank Früherkennung mit Fragebogen und Lungenfunktionsmessung können die kosteneffizientesten Massnahmen wie Raucherentwöhnung, Inhalationstherapie und selbständiges Körpertraining eine Verbesserung der Lebensqualität bewirken. Mit pulmonalen Rehabilitationsprogrammen kann die Mitarbeit der Patienten, insbesondere zur Vermeidung von teuren COPD-Exazerbationen, verbessert werden.

[Spirometry in the GP-Office]

Spirometry is an important diagnostic tool, which, with correct implementation, detects possible obstructive or restrictive lung diseases. However, it is important to note that only part of the lung function is measured by spirometry. For instance, total lung volume and residual volume, both useful in detecting pulmonary emphysema, are not measured. Therefore, in case of pathological spirometry or suspected restrictive lung disease, further tests such as body plethysmography with diffusion measurement should be carried out.