Interferon-α2b improves short-term survival in patients transplanted for chronic liver failure caused by hepatitis B

Background and Aims. The value of hepatocyte regeneration in predicting the outcomes of hepatitis B-related acute-on-chronic liver failure (HBV-ACLF) is not fully assessed. The present study was aimed at establishing a novel scoring system to predict patients’ outcomes within 3 months by applying serological indicators of hepatic regeneration and liver injury. Methods. Patients with chronic hepatitis B who had a rapid deterioration were investigated. Patients were observed for 90 days, and the endpoint of follow-up was death or liver transplantation. Serum parameters were estimated on the diagnosis of acute-on-chronic liver failure (ACLF). Cox proportional hazard regression was used to identify independent prognostic factors and create a novel prognostic scoring system, and a receiver operating characteristic (ROC) curve was used to analyze the performance of the model. Results. A total of 308 patients with HBV-ACLF were incorporated and divided into the training cohort (n=206) and testing cohort (n=102) randomly. Creatine (Cre), age, total bilirubin (TBil), alpha-fetoprotein (AFP), and international normalized ratio (INR) were found to be independent prognostic factors. According to the results of Cox regression analysis, a new prognostic model (we named it the TACIA score) was calculated. The areas under ROC (AUROC) for the new model were 0.861 and 0.763 in the training and testing cohorts, respectively, and patients with lower TACIA scores (<4.34) would survive longer (P<0.001). Conclusions. A pertinent prognostic scoring system for patients with HBV-ACLF was established in our study, and the novel model could predict patients’ short-term survival effectively.

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Short-term survival advantage after plasma exchange in the treatment of acute on chronic liver failure or acute liver failure

Clinical Intensive Care ◽

10.3109/09563070400003714 ◽

2004 ◽

Vol 15 (2-3) ◽

pp. 93-99 ◽

Cited By ~ 1

Author(s):

Y-M Hung ◽

G-C Hung ◽

P-I Hsu ◽

S-Y Hung ◽

K-J Chou ◽

...

Keyword(s):

Liver Failure ◽

Acute Liver Failure ◽

Plasma Exchange ◽

Chronic Liver ◽

Survival Advantage ◽

Chronic Liver Failure ◽

Short Term ◽

Term Survival ◽

Short Term Survival

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Predictive Value of Age-Bilirubin-International Normalized Ratio-Creatinine Score in Short-Term Survival of Acute-on-Chronic Hepatitis B Liver Failure

Cellular Physiology and Biochemistry ◽

10.1159/000495904 ◽

2018 ◽

Vol 51 (5) ◽

pp. 2484-2495 ◽

Cited By ~ 2

Author(s):

Liang Chen ◽

Jun Zheng ◽

Jianye Cai ◽

Yusheng Jie ◽

Yingcai Zhang ◽

...

Keyword(s):

Risk Factors ◽

Chronic Hepatitis ◽

Hepatitis B ◽

Liver Failure ◽

International Normalized Ratio ◽

Meld Score ◽

Short Term ◽

Term Survival ◽

Training Cohort ◽

Short Term Survival

Background/Aims: The age-bilirubin-international normalized ratio-creatinine (ABIC) score, which is a predictive model commonly used for alcoholic hepatitis, has not yet been studied in acute-on-chronic hepatitis B liver failure (HBV-ACLF). We aimed to investigate the predictive value of the ABIC score in patients with HBV-ACLF. Methods: This retrospective study involved 398 patients diagnosed with HBV-ACLF, who were divided into a training cohort of 305 patients and a validation cohort of 93 patients. Univariate and multivariate Cox regression models were used to determine risk factors for mortality. Area under the receiver operating characteristic curve (AUC) was calculated to estimate and compare the predictive values of different prognostic scores. Results: The ABIC score was significantly higher in the death group of the training cohort than in its survival group. Independent risk factors for mortality identified by multivariate Cox analysis included blood urea nitrogen, ABIC score, and Chronic Liver Failure Consortium Organ Failure (CLIF-C OF) score. For predicting 1- and 3-month mortality, AUC was higher for the ABIC score than for the Model for End-stage Liver Diseases (MELD) score (0.732 vs. 0.653, P < 0.05, 0.695 vs. 0.619, P < 0.05, respectively), CLIF-C OF score (0.693, P=0.353, 0.656, P=0.341, respectively), and Child-Pugh score (0.675, P=0.189, 0.656, P=0.300, Respectively). Patients with ABIC score > 9.44 had reduced 1- and 3-month survival rates. Conclusion: ABIC score is superior to MELD score in predicting short-term survival in HBV-ACLF patients. ABIC score > 9.44 predicts high short-term mortality risk in HBV-ACLF patients.

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Increased IL-17-producing CD8+ T cell frequency predicts short-term mortality in patients with hepatitis B virus-related acute-on-chronic liver failure

Therapeutics and Clinical Risk Management ◽

10.2147/tcrm.s184809 ◽

2018 ◽

Vol Volume 14 ◽

pp. 2127-2136 ◽

Cited By ~ 5

Author(s):

Geng-lin Zhang ◽

Ting Zhang ◽

Qi-yi Zhao ◽

Chan Xie ◽

Chao-shuang Lin ◽

...

Keyword(s):

Hepatitis B Virus ◽

Hepatitis B ◽

Liver Failure ◽

Chronic Liver ◽

Chronic Liver Failure ◽

Short Term ◽

Cell Frequency ◽

B Virus ◽

Short Term Mortality

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

Disease Markers ◽

10.1155/2020/8814841 ◽

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.

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