Quality of life in patients with hypersensitivity pneumonitis in real clinical practice

Background. Hypersensitivity pneumonitis (HP) is an immune-mediated interstitial lung disease that often progresses to pulmonary fibrosis, negatively affecting patients' quality of life (QOL).

Aim. To assess QOL in patients with different HP phenotypes using the K-BILD and EQ-5D-5L questionnaires and identify clinical and functional factors affecting QOL.

Materials and methods. The study included 105 HP patients [33 non-fibrotic (nfHP), 72 fibrotic (fHP), 32 with usual interstitial pneumonia (UIP) pattern on high-resolution computed tomography]. QOL, clinical data, respiratory function, echocardiography, dyspnea (mMRC scale), cough (VAS scale, LCQ), 6MWT results, and high-resolution computed tomography changes over 12 months were assessed. Statistical analysis involved nonparametric methods, correlation, linear, and multiple regression.

Results. fHP and nfHP patients showed significant differences. fHP patients had a longer disease duration, more severe symptoms, lower lung function, and worse QOL. Those with fHP+UIP had worse lung function and more disease progression but similar QOL to fHP patients without UIP. For K-BILD, cough severity (LCQ), 6MWT distance, and forced vital capacity most affected QOL. For EQ-5D-5L, the 6MWT distance was the key factor.

Conclusion. fHP patients experience a more severe disease course than nfHP patients. UIP pattern correlates with a more aggressive clinical progression. K-BILD and EQ-5D-5L are reliable tools for assessing QOL in HP. The greatest influence on QOL is exerted by the severity of cough, forced vital capacity and exercise tolerance.