Author:
Wang Lu,Xu Wenxiong,Li Xuejun,Chen Dabiao,Zhang Yeqiong,Chen Yuanli,Wang Juan,Luo Qiumin,Xie Chan,Peng Liang
Abstract
Abstract
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.
Trial Registration The trial was registered at ClinicalTrials.gov (CT.gov identifier: NCT04231565) on May 13, 2020: https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S0009OZY&selectaction=Edit&uid=U00036P1&ts=2&cx=27seqt
Funder
the National major science and technology project for the prevention and treatment of AIDS and viral hepatitis
Guangzhou Municipal Science and Technology Project
Sun Yat-Sen University Clinical Research 5010 Program
Research project on degree and postgraduate education reform in Guangdong province
Young teacher training program of Sun Yat-Sen university
Natural Science Foundation of China
the Five-Year Plan of Third Affiliated Hospital of Sun Yat-Sen University
Publisher
Springer Science and Business Media LLC
Subject
Gastroenterology,General Medicine
Cited by
5 articles.
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