Longitudinal health-related quality of life and associated factors in autoimmune liver diseases.

INTRODUCTION AND

OBJECTIVES

Autoimmune liver diseases (AILD), including autoimmune hepatitis (AIH), primary biliary cholangitis (PBC), and primary sclerosing cholangitis (PSC), can significantly influence patients' health-related quality of life (HRQOL). Understanding longitudinal HRQOL trends and associated factors may help identify patients at risk for poor HRQOL long-term. This longitudinal, single-center observational study aimed to assess longitudinal changes in HRQOL and identify baseline factors associated with HRQOL over time among patients with AILD.

PATIENTS AND

METHODS

Adult patients with AIH, PBC, and/or PSC enrolled in a single-center prospective autoimmune liver registry were included. HRQOL was assessed using the Chronic Liver Disease Questionnaire (CLDQ). Linear mixed-effects models evaluated longitudinal changes in HRQOL and identified baseline demographic and clinical factors associated with HRQOL.

RESULTS

A total of 252 patients (mean follow-up=35.3 ± 23.5 months) were included. At baseline, CLDQ total scores indicated relatively preserved HRQOL (mean=5.47 ± 1.04) and showed a small but statistically significant increase over time (β=0.0018, p=0.03). The emotional and worry domains demonstrated modest improvement, whereas other domains remained stable. Male sex was associated with higher HRQOL (β=0.33, p=0.04), while the presence of other autoimmune diseases (β=-0.34, p=0.01), coexisting metabolic-associated steatotic liver disease (β=-0.39, p=0.04), and ascites (β=-1.24, p=0.002) were associated with poorer HRQOL over time.

CONCLUSIONS

While HRQOL among patients with AILD remained largely stable over time, patients with other autoimmune and liver conditions experience lower HRQOL. These findings underscore the importance of identifying high-risk patients and providing tailored strategies to maintain and improve long-term HRQOL in this population.