Long-term prognosis of patients with hepatitis B virus-related acute-on-chronic liver failure: a retrospective study

被引：10

作者：

Wang, Lu ^{[1
,2
]}

Xu, Wenxiong ^{[1
,2
,3
]}

Li, Xuejun ^{[1
,2
]}

Chen, Dabiao ^{[1
,2
]}

Zhang, Yeqiong ^{[1
,2
]}

Chen, Yuanli ^{[1
]}

Wang, Juan ^{[1
]}

Luo, Qiumin ^{[1
,2
]}

Xie, Chan ^{[1
,2
,3
]}

Peng, Liang ^{[1
,2
,3
]}

机构：

[1] Sun Yat Sen Univ, Affiliated Hosp 3, Dept Infect Dis, 600 Tianhe Rd, Guangzhou, Guangdong, Peoples R China

[2] Sun Yat Sen Univ, Affiliated Hosp 3, Guangdong Key Lab Liver Dis Res, Guangzhou, Guangdong, Peoples R China

[3] Sun Yat Sen Univ, Key Lab Trop Dis Control, Minist Educ, Guangzhou, Peoples R China

来源：

BMC GASTROENTEROLOGY | 2022年 / 22卷 / 01期

关键词：

Acute-on-chronic liver failure; HBV; Aetiology; Prognosis; Risk factors;

D O I：

10.1186/s12876-022-02239-4

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background The long-term prognosis of patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) is not well characterised. We assessed long-term outcomes and the associated risk factors of HBV-ACLF patients in southern China. Methods We retrospectively analysed 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 616 (52.3%) patients with cirrhosis and 561 (47.7%) patients without cirrhosis were included. In 973 (83%) patients, the disease was associated only with HBV, while 204 (17%) patients had two or more aetiological factors. The proportion of patients receiving antiviral treatment for HBV was low (20.3%). Further analyses indicated that patients without cirrhosis had a significantly lower 90-day liver transplantation-free mortality and higher 5-year survival rate than those with cirrhosis (59.5% vs. 27.6%; 62% vs. 36%; P < 0.05). Remarkably, self-withdrawal of nucleos(t)ide analog (NA) was an independent risk factor for short-term prognosis. Age, cirrhosis at admission, and platelet level were closely related to long-term prognosis of HBV-ACLF patients. Conclusion The proportion of HBV-ACLF patients receiving antiviral treatment is very low in south China. Cirrhosis at admission has a significant effect on both short-term and long-term prognosis. No significant improvement in the short-term prognosis of HBV-ACLF patients was observed compared with previous studies. More comprehensive access to antiviral treatment and long-term surveillance of HBV patients are key imperatives to reduce the incidence of HBV-ACLF and improve the prognosis.

引用

页数：9