scholarly journals The Short-Term Efficacy of Tenofovir Alafenamide (TAF) in Acute-On-Chronic Liver Failure: A Single Center Experience

2021 ◽  
Author(s):  
Zhiqin Li ◽  
Yang Liu ◽  
Jianxia Dong ◽  
Jingya Yan ◽  
Yushu Hu ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Liver Failure ◽  
Virologic Response ◽  
Hbv Dna ◽  
Chronic Liver ◽  
Chronic Liver Failure ◽  
Single Center Experience ◽  
Primary Endpoints ◽  
Tenofovir Alafenamide ◽  
Dna Reduction

Abstract Background and aims: Entecavir (ETV) and tenofovir disoproxil fumarate (TDF) reduce hepatic events and death in patients with acute-on-chronic liver failure (ACLF), but the efficacy of Tenofovir alafenamide (TAF) is less well studied. We aimed to assess the effectiveness of TAF in hepatitis B virus (HBV) related ACLF.Methods: We analyzed 106 patients with HBV-ACLF received TAF (25mg/d), ETV(0.5mg/d) for 12 weeks. The primary endpoints were overall mortality and liver transplantation (LT) at week 12. Other determined factors of biochemical response, virologic response, mortality rate, and drug safety and side-effect were also evaluated.Results: At 4 weeks and 12 weeks, patients received TAF got significantly higher HBV-DNA reduction (P<0.001), higher rate of HBV-DNA undetectbility (P<0.001), lower HBV-DNA level (P<0.001). Lower CTP scores (P=0.003) at 4 weeks in TAF group, but CTP scores showed no difference in two groups at 12 weeks (P=1.143). Lower ALT levels in TAF group at week 4 and week 12 (P=0.023, P<0.0001). The mortality rate was lower in TAF group after 4 weeks treatment(P=0.038), but two group got similar mortality rate at week 8 and week 12. As for reason cause death in HBV-ACLF patients, we found that two group patients developed similar rates of liver-related complications (P>0.05).Conclusions: The antiviral efficacy of TAF was superior than ETV for the treatment of HBV-related ACLF. TAF therapy reduced 4-week mortality rate in patients with HBV-related ACLF.

scholarly journals Acute-on-Chronic Liver Failure in Pregnant Patients with Chronic Hepatitis B: A Retrospective Observational Case Series Study

2020 ◽  
Vol 2020 ◽  
pp. 1-8 ◽  
Author(s):  
Shiwei Wang ◽  
Haofeng Xiong ◽  
Changling Luo ◽  
Hong Zhao ◽  
Ying Fan ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Liver Failure ◽  
Pregnant Women ◽  
Antiviral Therapy ◽  
Chronic Hepatitis B ◽  
Hbv Dna ◽  
Chronic Liver ◽  
Chronic Liver Failure ◽  
Transfusion Therapy

Background and Aims. Acute-on-chronic liver failure (ACLF) is common in patients with end-stage liver disease and chronic hepatitis B (CHB) or hepatitis B virus- (HBV-) related cirrhosis. To date, no uniform definition and management strategy are available for ACLF. Although a considerable number of studies on ACLF has been published, there are few reports on ACLF in pregnant women with CHB. This study retrospectively reviewed five patients who were diagnosed with ACLF during pregnancy in the past 10 years. We aimed at investigating their clinical characteristics, treatment, biochemical test results, and maternal and fetal outcomes. Results. Asthenia, anorexia, and jaundice were the main initial clinical manifestations in these patients during the second or third trimester of pregnancy. All patients received antiviral therapy. None of the pregnant women died after treatment. Patient #4 was treated with an artificial liver support system, and patients #2 and #5 underwent transfusion therapy. The acute insult in all patients was HBV DNA reactivation. Except for patient #3, who chose an actively induced vaginal delivery because of intrauterine fetal demise, the remaining four patients underwent a preterm delivery via a cesarean section. The four neonates were alive, although all were small for gestational age. Conclusion. Asthenia, anorexia, and jaundice during mid-late pregnancy should be immediately investigated. Before and during the pregnancy, hepatologists or obstetricians should actively screen pregnant women with CHB for HBV DNA status and alanine aminotransferase levels. Reactivation of HBV replication in pregnant women with CHB may lead to ACLF, especially in multiparous women. Once ACLF is diagnosed, antiviral therapy should be considered as soon as possible to protect maternal and fetal health.

scholarly journals Prognostic Factors Related to the Mortality Rate of Acute-on-Chronic Liver Failure Patients

2021 ◽  
Vol Volume 14 ◽  
pp. 2573-2580
Author(s):  
Jian Zhang ◽  
Junfeng Li ◽  
Yu Chen ◽  
Mei Ding ◽  
Zhongping Duan
Keyword(s):  
Prognostic Factors ◽  
Mortality Rate ◽  
Liver Failure ◽  
Chronic Liver ◽  
Chronic Liver Failure

scholarly journals Acute-On-Chronic Liver Failure: The Role of Prognostic Scores in a Single-Center Experience

2020 ◽  
Vol 26 ◽  
Author(s):  
Grzegorz Niewiński ◽  
Szymon Morawiec ◽  
Maciej K. Janik ◽  
Michał Grąt ◽  
Agata Graczyńska ◽  
...  
Keyword(s):  
Liver Failure ◽  
Chronic Liver ◽  
Prognostic Scores ◽  
Single Center ◽  
Chronic Liver Failure ◽  
Single Center Experience

scholarly journals Chronic Liver Failure after Treatment with Infliximab for Ankylosing Spondylitis in a Patient with Hepatitis B

2013 ◽  
Vol 2 (2) ◽  
pp. 84-87
Author(s):  
Yun-ru Li ◽  
Feng-xin Chen ◽  
Xue-fei Duan ◽  
Xue-song Gao ◽  
Xiao-ling Fan
Keyword(s):  
Ankylosing Spondylitis ◽  
Liver Failure ◽  
Total Bilirubin ◽  
Chinese Herb ◽  
Hbv Dna ◽  
Chronic Liver ◽  
Chronic Liver Failure ◽  
Serum Aminotransferase ◽  
Herb Medicine ◽  
Chinese Herb Medicine

Abstract A 50-year-old man with ankylosing spondylitis was treated successfully with infliximab, who was also a HBV carrier for about twenty five years. After injection with infliximab for four times, he developed jaundice and HBV DNA was detectable in serum. Serum aminotransferase and total bilirubin levels were higher than normal. Then he was hospitalized and treated with entacavir and Chinese herb medicine. But his liver damage aggravated and was diagnosed as acute on chronic liver failure. Finally, liver transplantation was carried out and he was cured successfully.

scholarly journals Low Platelet to White Blood Cell Ratio Indicates Poor Prognosis for Acute-On-Chronic Liver Failure

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Yusheng Jie ◽  
Jiao Gong ◽  
Cuicui Xiao ◽  
Shuguang Zhu ◽  
Wenying Zhou ◽  
...  
Keyword(s):  
Liver Disease ◽  
Mortality Rate ◽  
Blood Cell ◽  
Liver Failure ◽  
White Blood Cell ◽  
Chronic Liver ◽  
Healthy Controls ◽  
Chronic Liver Failure ◽  
Time Activity ◽  
Cell Ratio

Background. Platelet to white blood cell ratio (PWR) was an independent prognostic predictor for outcomes in some diseases. However, the prognostic role of PWR is still unclear in patients with hepatitis B related acute-on-chronic liver failure (ACLF). In this study, we evaluated the clinical performances of PWR in predicting prognosis in HBV-related ACLF. Methods. A total of 530 subjects were recruited, including 97 healthy controls and 433 with HBV-related ACLF. Liver function, prothrombin time activity (PTA), international normalized ratio (INR), HBV DNA measurement, and routine hematological testing were performed at admission. Results. At baseline, PWR in patients with HBV-related ACLF (14.03 ± 7.17) was significantly decreased compared to those in healthy controls (39.16 ± 9.80). Reduced PWR values were clinically associated with the severity of liver disease and the increased mortality rate. Furthermore, PWR may be an inexpensive, easily accessible, and significant independent prognostic index for mortality on multivariate analysis (HR = 0.660, 95% CI: 0.438–0.996, p=0.048) as well as model for end-stage liver disease (MELD) score. Conclusions. The PWR values were markedly decreased in ACLF patients compared with healthy controls and associated with severe liver disease. Moreover, PWR was an independent prognostic indicator for the mortality rate in patients with ACLF. This investigation highlights that PWR comprised a useful biomarker for prediction of liver severity.

Sa1546 THE MORTALITY RATE OF ACUTE ON CHRONIC LIVER FAILURE IN SETTING OF ACUTE HEPATITIS A INFECTION, A RETROSPECTIVE STUDY FROM A TERTIARY MEDICAL CENTER.

2020 ◽  
Vol 158 (6) ◽  
pp. S-1328-S-1329
Author(s):  
Karim Benrajab ◽  
Elica Shokri ◽  
Saad Emhmed Ali ◽  
Leon Su ◽  
Abimbola Chris-Olaiya ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Mortality Rate ◽  
Liver Failure ◽  
Acute Hepatitis ◽  
Hepatitis A ◽  
Medical Center ◽  
Chronic Liver ◽  
Chronic Liver Failure ◽  
Acute Hepatitis A
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