Nucleoside analogues improve the short-term and long-term prognosis of patients with hepatitis B virus-related acute-on-chronic liver failure

2011 ◽  
Vol 12 (3) ◽  
pp. 159-164 ◽  
Author(s):  
Tianyan Chen ◽  
Yingli He ◽  
Xiaojing Liu ◽  
Zhi Yan ◽  
Ke Wang ◽  
...  
Keyword(s):  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Liver Failure ◽  
Chronic Liver ◽  
Nucleoside Analogues ◽  
Chronic Liver Failure ◽  
Short Term ◽  
B Virus ◽  
Long Term Prognosis

scholarly journals Serum Clusterin: A Potential Marker for Assessing the Clinical Severity and Short-Term Prognosis of Hepatitis B Virus-Related Acute-on-Chronic Liver Failure

2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Huimin Liu ◽  
Yuxin Li ◽  
Fangyuan Gao ◽  
Peipei Meng ◽  
Hao Yu ◽  
...  
Keyword(s):  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Liver Failure ◽  
Chronic Liver ◽  
Clinical Severity ◽  
Chronic Liver Failure ◽  
Short Term ◽  
Potential Biomarker ◽  
B Virus ◽  
Normal Controls

Background. Acute-on-chronic liver failure (ACLF) is a clinical syndrome characterized by acute deterioration of liver function and high short-term mortality. Clusterin, with biological functions similar to small heat shock proteins, can protect cells from apoptosis induced by various stressors. The aim of this study was to detect the level of serum clusterin in hepatitis B virus- (HBV-) related ACLF and to assess the predictive value of clusterin for the short-term prognosis of HBV-ACLF. Methods. We detected serum clusterin by ELISA in 108 HBV-ACLF patients, 63 HBV-non-ACLF patients, and 44 normal controls. Results. Serum clusterin was markedly lower in HBV-ACLF patients (median, 51.09 μg/mL) than in HBV-non-ACLF patients (median, 188.56 μg/mL) and normal controls (median, 213.45 μg/mL; all P < 0.05 ). Nonsurviving HBV-ACLF patients who died within 90 days had much lower clusterin levels than did surviving patients, especially those who died within 28 days (nonsurvival group vs. survival group: 39.82 ± 19.34 vs. 72.26 ± 43.52 , P < 0.001 ; survival time ≤ 28 vs. survival time > 28 : median 28.39 vs. 43.22, P = 0.013 ). The results showed that for identifying HBV-ACLF, the sensitivity of clusterin (93.7%) was similar to the sensitivities of the international normalized ratio (INR; 94.4%) and total bilirubin (TBIL; 94.8%), but its specificity (90.7%) was higher than that of prothrombin activity (PTA; 65.8%) and TBIL (69.8%) and was similar to INR (88.9%). As the concentration of clusterin increased, the mortality of HBV-ACLF patients decreased significantly from 59.3% to 7.0%. Clusterin had better ability for predicting the prognosis of HBV-ACLF patients than did the model for end-stage liver disease (MELD) score and the chronic liver failure consortium (CLIF-C) ACLF score (MELD vs. clusterin: P = 0.012 ; CLIF-C ACLF vs. clusterin: P = 0.031 ). Conclusion. Serum clusterin is a potential biomarker for HBV-ACLF which can be used to assess clinical severity and the short-term prognosis of patients with this disease and may help clinicians identify HBV-ACLF with greater specificity and improved prognostic accuracy than existing prognostic markers.

scholarly journals The scoring systems in predicting short-term outcomes in patients with hepatitis B virus-related acute-on-chronic liver failure

2020 ◽  
Vol 9 (5) ◽  
pp. 3048-3058 ◽  
Author(s):  
Hui Li ◽  
Jun Zheng ◽  
Liang Chen ◽  
Jianye Cai ◽  
Min Zhang ◽  
...  
Keyword(s):  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Liver Failure ◽  
Scoring Systems ◽  
Chronic Liver ◽  
Chronic Liver Failure ◽  
Short Term ◽  
B Virus

Development of diagnostic criteria and a prognostic score for hepatitis B virus-related acute-on-chronic liver failure

Gut ◽  
2017 ◽  
Vol 67 (12) ◽  
pp. 2181-2191 ◽  
Author(s):  
Tianzhou Wu ◽  
Jiang Li ◽  
Li Shao ◽  
Jiaojiao Xin ◽  
Longyan Jiang ◽  
...  
Keyword(s):  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Liver Failure ◽  
Diagnostic Criteria ◽  
Prognostic Score ◽  
Chronic Liver ◽  
Chronic Liver Failure ◽  
Short Term ◽  
Hospitalised Patients ◽  
B Virus

ObjectiveThe definition of acute-on-chronic liver failure (ACLF) based on cirrhosis, irrespective of aetiology, remains controversial. This study aimed to clarify the clinicopathological characteristics of patients with hepatitis B virus-related ACLF (HBV-ACLF) in a prospective study and develop new diagnostic criteria and a prognostic score for such patients.DesignThe clinical data from 1322 hospitalised patients with acute decompensation of cirrhosis or severe liver injury due to chronic hepatitis B (CHB) at 13 liver centres in China were used to develop new diagnostic and prognostic criteria.ResultsOf the patients assessed using the Chronic Liver Failure Consortium criteria with the exception of cirrhosis, 391 patients with ACLF were identified: 92 with non-cirrhotic HBV-ACLF, 271 with cirrhotic HBV-ACLF and 28 with ACLF with cirrhosis caused by non-HBV aetiologies (non-HBV-ACLF). The short-term (28/90 days) mortality of the patients with HBV-ACLF were significantly higher than those of the patients with non-HBV-ACLF. Total bilirubin (TB) ≥12 mg/dL and an international normalised ratio (INR) ≥1.5 was proposed as an additional diagnostic indicator of HBV-ACLF, and 19.3% of patients with an HBV aetiology were additionally diagnosed with ACLF. The new prognostic score (0.741×INR+0.523×HBV-SOFA+0.026×age+0.003×TB) for short-term mortality was superior to five other scores based on both discovery and external validation studies.ConclusionsRegardless of the presence of cirrhosis, patients with CHB, TB ≥12 mg/dL and INR ≥1.5 should be diagnosed with ACLF. The new criteria diagnosed nearly 20% more patients with an HBV aetiology with ACLF, thus increasing their opportunity to receive timely intensive management.

scholarly journals Prognostic factors of the short-term outcomes of patients with hepatitis B virus-associated acute-on-chronic liver failure

Clinics ◽  
2017 ◽  
Vol 72 (11) ◽  
pp. 686-692 ◽  
Author(s):  
Q Lei ◽  
K Ao ◽  
Y Zhang ◽  
D Ma ◽  
D Ding ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Liver Failure ◽  
Chronic Liver ◽  
Chronic Liver Failure ◽  
Short Term ◽  
B Virus

scholarly journals Long-Term Prognosis of Patients with Hepatitis B Virus-Related Acute-on-Chronic Liver Failure: A Retrospective Study

2021 ◽  
Author(s):  
Lu Wang ◽  
Wenxiong Xu ◽  
Xuejun Li ◽  
Dabiao Chen ◽  
Yeqiong Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Antiviral Treatment ◽  
Chronic Liver Failure ◽  
Short Term ◽  
B Virus ◽  
Cirrhotic Patients ◽  
Long Term Prognosis

Abstract Introduction and Objectives: The long-term prognosis of patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) is not well characterized. We sought to assess the short-term and long-term outcomes and the associated risk factors of HBV-ACLF patients in south China.Patients and Methods: We retrospectively analyzed clinical data, adverse events, and clinical endpoint events of HBV-ACLF patients treated at our department between January 2014 and December 2018. Results: A total of 1177 HBV-ACLF patients were included in the study, including 616 (52.3%) cirrhotic patients and 561 (47.7%) non-cirrhotic patients. 973 (83%) patients were associated only with HBV, and 204 (17%) patients had two or more etiologies. The leading cause of simple HBV-ACLF patients was lack of antiviral treatment and the proportion of patients receiving antiviral treatment for HBV was low (20%). Further analyses indicated non-cirrhotic patients had a significantly lower 90-day transplantation‐free mortality and greater 5‐year survival rate than cirrhotic patients (59.5% vs. 27.6%, 62% vs. 36%, P＜0.05). Age, hepatic encephalopathy, liver cirrhosis, nucleoside (acid) analogues (NAs) withdrawal, total bilirubin, and prothrombin time were independent risk factors for 90-day mortality in HBV-ACLF patients. Cirrhosis at admission (AOR=3.675, 95% CI: 2.408–6.594) was a strong independent risk factor for long-term prognosis. Conclusion: The proportion of HBV-ACLF patients receiving antiviral treatment was extremely low in south China. HBV combined with acute hepatitis E, or DILI had no significant effect on the short-term mortality rate in HBV-ACLF patients. Remarkably, the effect of withdrawal of NAs and cirrhosis on short-term outcomes cannot be ignored. No significant improvement in the short-term prognosis of HBV-ACLF patients was observed compared with previous studies. Trial Registration: The trial is registered at ClinicalTrials.gov (CT.gov identifier: NCT04231565). Registered 13 May 2020https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S0009OZY&selectaction=Edit&uid=U00036P1&ts=2&cx=27seqt

scholarly journals Different models in predicting the short-term prognosis of patients with hepatitis B virus-related acute-on-chronic liver failure

2012 ◽  
Vol 11 (3) ◽  
pp. 311-319 ◽  
Author(s):  
Wen-Bin Yang ◽  
En-Qiang Chen ◽  
Hong-Xia Bi ◽  
Lang Bai ◽  
Xue-Bin Chen ◽  
...  
Keyword(s):  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Liver Failure ◽  
Chronic Liver ◽  
Chronic Liver Failure ◽  
Short Term ◽  
B Virus
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