scholarly journals Etiologies and Outcomes of Acute Liver Failure in a Spanish Community

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Emilio Fábrega ◽  
Miguel Ángel Mieses ◽  
Alvaro Terán ◽  
Irene Moraleja ◽  
Fernando Casafont ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Hepatitis B ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Acute Hepatitis ◽  
Term Survival ◽  
Acetaminophen Overdose ◽  
Acute Hepatitis B ◽  
Toxic Reactions ◽  
Short Term Survival

Previous retrospective study (1992 to 2000) performed in Spain showed that drug toxicity, viral hepatitis, and indeterminate etiology were the most prevalent causes of acute liver failure (ALF). In the last decade, there is no information about ALF in our country. For these reasons we analyze retrospectively, in a ten-year period (2000 to 2010), the presumed causes, clinical characteristics, course, and outcome of ALF in a Spanish community. Causes of ALF were indeterminate in 4 patients (24%), acute hepatitis B infection in 4 patients (24%), drug or toxic reactions in 4 patients (24%), including one case of acetaminophen overdose, followed by miscellaneous causes. The overall short-term survival (6 weeks after admission) was 65%. Liver transplantation was performed in 11 patients with a survival of 82%. Despite fulfilling criteria, 2 patients were not transplanted because of contraindications; they both died. In summary, acute hepatitis B and indeterminate cause are still being the most frequent causes of ALF in our region, and patients with ALF have an excellent chance of survival after emergency liver transplantation. Acetaminophen overdose still represents a very rare cause of ALF in our community.

scholarly journals Acute HBV Related ALF- Successful Outcome with Oral Antiviral Treatment

2022 ◽  
Vol 5 (1) ◽  
pp. 01-03
Author(s):  
Parveen Malhotra ◽  
Vani Malhotra ◽  
Yogesh Sanwariya ◽  
Ajay Chugh ◽  
Isha Pahuja ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Hepatic Encephalopathy ◽  
Hepatitis B ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Acute Hepatitis ◽  
Antiviral Treatment ◽  
Stable Condition ◽  
Successful Outcome ◽  
Acute Hepatitis B

Case report: We present a young female of fourteen years who was admitted to the hospital with short duration of Icterus, malaise, vomiting and diagnosed to be having acute hepatitis B. She went into acute liver failure as evidenced by development of hepatic encephalopathy and coagulopathy. She was managed on lines of hepatic encephalopathy along with oral antiviral treatment. She recovered successfully and was discharged after two weeks in heamodynamically stable condition. After a gap of six months, she became Hepatitis B surface (HbsAg) & hepatitis B e-antigen (HbeAg) negative and Hepatitis B Virus DNA (HBV DNA) was undetectable with normal liver function tests. She is on regular follow up for last one year and is absolutely normal. Conclusion: Acute hepatitis B can go into acute liver failure in 1% of cases, treatment for which includes liver transplantation and oral antiviral treatment which is especially helpful in cases who cannot afford liver transplantation, as was in our case.

scholarly journals Role of humoral immunity against hepatitis B virus core antigen in the pathogenesis of acute liver failure

2018 ◽  
Vol 115 (48) ◽  
pp. E11369-E11378 ◽  
Author(s):  
Zhaochun Chen ◽  
Giacomo Diaz ◽  
Teresa Pollicino ◽  
Huaying Zhao ◽  
Ronald E. Engle ◽  
...  
Keyword(s):  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Acute Hepatitis ◽  
B Cell ◽  
Core Antigen ◽  
Cell Disease ◽  
B Virus ◽  
Acute Hepatitis B

Hepatitis B virus (HBV)-associated acute liver failure (ALF) is a dramatic clinical syndrome leading to death or liver transplantation in 80% of cases. Due to the extremely rapid clinical course, the difficulties in obtaining liver specimens, and the lack of an animal model, the pathogenesis of ALF remains largely unknown. Here, we performed a comprehensive genetic and functional characterization of the virus and the host in liver tissue from HBV-associated ALF and compared the results with those of classic acute hepatitis B in chimpanzees. In contrast with acute hepatitis B, HBV strains detected in ALF livers displayed highly mutated HBV core antigen (HBcAg), associated with increased HBcAg expression ex vivo, which was independent of viral replication levels. Combined gene and miRNA expression profiling revealed a dominant B cell disease signature, with extensive intrahepatic production of IgM and IgG in germline configuration exclusively targeting HBcAg with subnanomolar affinities, and complement deposition. Thus, HBV ALF appears to be an anomalous T cell-independent, HBV core-driven B cell disease, which results from the rare and unfortunate encounter between a host with an unusual B cell response and an infecting virus with a highly mutated core antigen.

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

2018 ◽  
Vol 51 (5) ◽  
pp. 2484-2495 ◽  
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.

scholarly journals Auxiliary partial orthotopic liver transplantation in acute liver failure due to hepatitis B

2002 ◽  
Vol 15 (7) ◽  
pp. 369-373 ◽  
Author(s):  
Sanjiv Saigal ◽  
Parthi Srinivasan ◽  
John Devlin ◽  
Bastiaan Boer ◽  
Buxton Thomas ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Hepatitis B ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Orthotopic Liver Transplantation

scholarly journals A case of acute hepatitis B on the patient of primary biliary cirrhosis who was registered for the brain-death donor liver transplantation

Kanzo ◽  
2014 ◽  
Vol 55 (3) ◽  
pp. 176-181 ◽  
Author(s):  
Mai Hirae ◽  
Takehisa Watanabe ◽  
Yoko Yoshimaru ◽  
Takeshi Kawasaki ◽  
Kazuhiro Izumi ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Primary Biliary Cirrhosis ◽  
Hepatitis B ◽  
Brain Death ◽  
Acute Hepatitis ◽  
Biliary Cirrhosis ◽  
Donor Liver ◽  
Donor Liver Transplantation ◽  
Acute Hepatitis B ◽  
The Brain
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