Brief Article
Copyright ©2011 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Aug 7, 2011; 17(29): 3448-3452
Published online Aug 7, 2011. doi: 10.3748/wjg.v17.i29.3448
Survival and prognostic factors in hepatitis B virus-related acute-on-chronic liver failure
Kun Huang, Jin-Hua Hu, Hui-Fen Wang, Wei-Ping He, Jing Chen, Xue-Zhang Duan, Ai-Min Zhang, Xiao-Yan Liu
Kun Huang, Jin-Hua Hu, Liver Failure Treatment and Research Center, 302 Military Hospital, Peking University Health Science Center, Beijing 100191, China
Jin-Hua Hu, Hui-Fen Wang, Wei-Ping He, Jing Chen, Xue-Zhang Duan, Ai-Min Zhang, Xiao-Yan Liu, Liver Failure Treatment and Research Center, 302 Military Hospital, Beijing 100039, China
Author contributions: Huang K analyzed the data; Huang K and Hu JH wrote the paper; Hu JH and Wang HF designed the study; Huang K, He WP, Chen J, Duan XZ, Zhang AM and Liu XY collected the data and performed the study.
Supported by National 11th Five-Year Special Major Project for Infectious Diseases (No. 2008zx10002-005-6); Collaborative Project between US and China on Major Liver Diseases (No. 2009DFA32450); The Capital Medical Research and Development (No. 20072026); the Army Medical and Health Scientific Research Fund of China, No. 06H057
Correspondence to: Jin-Hua Hu, Associate Professor, Liver Failure Treatment and Research Center, 302 Military Hospital, Beijing 100039, China. hjh@medmail.com.cn
Telephone: +86-10-66933434 Fax: +86-10-63879339
Received: October 7, 2010
Revised: November 8, 2010
Accepted: November 15, 2010
Published online: August 7, 2011
Abstract

AIM: To investigate the survival rates and prognostic factors in patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF).

METHODS: Clinical data in hospitalized patients with HBV-ACLF admitted from 2006 to 2009 were retrospectively analyzed. Their general conditions and survival were analyzed by survival analysis and Cox regression analysis.

RESULTS: A total of 190 patients were included in this study. The overall 1-year survival rate was 57.6%. Patients not treated with antiviral drugs had a significantly higher mortality [relative risk (RR) = 0.609, P = 0.014]. The highest risk of death in patients with ACLF was associated with hepatorenal syndrome (HRS) (RR = 2.084, P =0.026), while other significant factors were electrolyte disturbances (RR = 2.062, P = 0.010), and hepatic encephalopathy (HE) (RR = 1.879, P < 0.001).

CONCLUSION: Antiviral therapy has a strong effect on the prognosis of the patients with HBV-ACLF by improving their 1-year survival rate. HRS, electrolyte disturbances, and HE also affect patient survival.

Keywords: Hepatitis B virus; Acute-on-chronic liver failure; Antiviral therapy; Nucleosides; Survival analysis