A novel integrated Model for End-Stage Liver Disease model predicts short-term prognosis of hepatitis B virus-related acute-on-chronic liver failure patients

2014 ◽  
Vol 45 (4) ◽  
pp. 405-414 ◽  
Author(s):  
Huadong Yan ◽  
Wei Wu ◽  
Ying Yang ◽  
Yihua Wu ◽  
Qiao Yang ◽  
...  
Keyword(s):  
Liver Disease ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Liver Failure ◽  
Disease Model ◽  
Chronic Liver Failure ◽  
Short Term ◽  
End Stage Liver Disease ◽  
B Virus ◽  
End Stage

scholarly journals Lower testosterone levels predict increasing severity and worse outcomes of hepatitis B virus-related acute-on-chronic liver failure in males

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yandi Huang ◽  
Dong Yan ◽  
Huafen Zhang ◽  
Bin Lou ◽  
Ren Yan ◽  
...  
Keyword(s):  
Liver Disease ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Liver Failure ◽  
Composite Outcome ◽  
Chronic Liver Failure ◽  
Testosterone Levels ◽  
Severity Scores ◽  
B Virus ◽  
Male Patients

Abstract Background Hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) is a serious liver disease with pathogenesis remaining unclear. This study aims to investigate the association between testosterone levels, stage (early, middle, or late, categorized according to clinical manifestation), severity scores, and clinical outcomes of HBV-ACLF. Methods This single-center observational study involved 160 male patients with HBV-ACLF, 151 chronic hepatitis B patients without liver failure (CHB) and 106 healthy controls (HC). Morning blood samples were collected and androgen levels analyzed by chemi-bioluminescent immunoassay. Time to death or liver transplantation within 90 days comprised the primary composite outcome. Results Serum levels of total testosterone (TT), free testosterone index (FTI), dehydroepiandrosterone sulfate and cortisol were significantly lower among HBV-ACLF than CHB and HC, while androstenedione was higher. Low TT, sex hormone binding globulin and FTI were associated with increased stage (of HBV-ACLF, ascites, and hepatic encephalopathy) and severity scores (Model for End-stage Liver Disease and Chinese Group on the Study of Severe Hepatitis B-ACLF scores). Low TT (< 142.39 ng/dL) was a risk factor for both the composite outcome and for death alone within 90 days. Multivariate analysis revealed TT to be an independent predictor for the composite outcome (hazard ratio 2.57, 95% CI 1.09–6.02; P = 0.030). Conclusion Low serum testosterone is common among male patients with HBV-ACLF and predictive of increased severity and worse outcome of the disease and may play an important role in the progression of HBV-ACLF.

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.

Southern-blot analysis and simultaneousIn Situ detection of hepatitis B virus–associated DNA and antigens in patients with end-stage liver disease

Hepatology ◽  
1993 ◽  
Vol 18 (5) ◽  
pp. 1032-1038 ◽  
Author(s):  
Kwang Hyub Han ◽  
F. Blaine Hollinger ◽  
Christine A. Noonan ◽  
Harvey Solomon ◽  
Goran B. G. Klintmalm ◽  
...  
Keyword(s):  
Liver Disease ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Southern Blot ◽  
Blot Analysis ◽  
Southern Blot Analysis ◽  
End Stage Liver Disease ◽  
B Virus ◽  
End Stage

scholarly journals Concomittant Liver Transplantation And  Low Anterior Resection in Patient with  Neuroendocrine Tumor and Chronic Hepatitis B Infection

2021 ◽  
Author(s):  
Adem Tuncer ◽  
Mehmet Zeki Öğüt ◽  
Sertac Usta ◽  
Sami Akbulut ◽  
Tevfik Tolga Sahin ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Disease ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Liver Failure ◽  
Neuroendocrine Tumor ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
B Virus ◽  
End Stage

Abstract Aim: The treatment of end-stage liver disease is liver transplantation. There are studies regarding liver transplantation in patients with colorectal cancer and neuroendocrine tumor liver metastasis indicating comparable results with patients who were transplanted for hepatocellular carcinoma. The aim of the present study is to present a case of a patient with Hepatitis B virus related chronic liver disease and rectal neuroendocrine tumor who underwent concomitant living donor liver transplantation and low anterior resection. Case report: The patients was a 62 years old male patient with hepatitis B virus related end-stage liver failure and a rectal neuroendocrine tumor determined during colonoscopy surveillance. Model for end stage liver disease score was 21 and had two episodes of life-threatening variceal bleeding. We performed living donor liver transplantation and low anterior resection to the patient. Currently patient is doing well 2 years after the operation. Conclusion: Our case is the first in literature showing concomitant liver transplantation for hepatitis B virus related liver failure and rectal resection for neuroendocrine tumor. These procedures can be performed synchronously provided that the etiology of liver failure is unrelated to neuroendocrine tumor and the primary tumor has favorable tumor biologic characteristics. We reviewed the English literature, we did not find any case who underwent rectal NET surgery and HBV-related liver transplantation in the same operation. We wanted to present this first case in the literature.

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