Tri-typing of hepatitis B-related acute-on-chronic liver failure defined by the World Gastroenterology Organization

Tang, Xiaoting1; Qi, Tingting1; Li, Beiling1; Li, Hai2; Huang, Zuxiong3,4; Zhu, Zhibin5; Tu, Minghan6; Gao, Jie1; Zhu, Congyan1; Jiang, Xiuhua1; Yu, Xutong1; Lu, Guanting1; Xiong, Ming1; He, Qinjun1; Zhou, Fuyuan1; Wen, Weiqun1; Chen, Jinjun1; Hou, Jinlin1

2020-07

10.1111/jgh.15113

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY   影响因子和分区

0815-9319

1440-1746

Background and Aim Tri-typing of acute-on-chronic liver failure (ACLF), as proposed by the World Gastroenterology Organization (WGO), has not been validated in patients infected with hepatitis B virus (HBV). We aim to compare the three types of ACLF patients in clinic characteristics. Methods Hospitalized ACLF patients with chronic hepatitis B from five hepatology centers were retrospectively selected and grouped according to the WGO classification. For each group, we investigated laboratory tests, precipitating events, organ failure, and clinical outcome. Results Compared with type-B (n = 262, compensated cirrhosis) and type-C (n = 129, decompensated cirrhosis) ACLF, type-A patients (n = 195, non-cirrhosis) were associated with a younger age, the highest platelet counts, the highest aminotransferase levels, and the most active HBV replications. HBV reactivation were more predominant in type-A, while bacterial infections in type-B and type-C ACLF cases. Liver failure (97.4%) and coagulation failure (86.7%) were most common in type-A compared with type-B or type-C ACLF patients. Kidney failure was predominantly identified in type-C subjects (41.9%) and was highest (23/38, 60.5%) in grade 1 ACLF patients. Furthermore, type-C ACLF showed the highest 28-day (65.2%) and 90-day (75.3%) mortalities, compared with type-A (48.7% and 54.4%, respectively) and type-B (48.4% and 62.8%, respectively) ACLF cases. Compared with type-A (11.7%) ACLF patients, the increased mortality from 28 to 90 days was higher in type-B (31.6%) and type-C (37.5%). Conclusion Tri-typing of HBV-related ACLF in accordance with the WGO definition was able to distinguish clinical characteristics, including precipitating events, organ failure, and short-term prognosis in ACLF patients.

Acute-on-chronic liver failure Chronic hepatitis B virus infection Liver cirrhosis Prognosis

SCI

英语

其他

National Science and Technology Major Project[2018ZX10723203] ; National Natural Science Foundation of China[81270533][81470038] ; National Key Research and Development Programof China[2017YFC0908100] ; Key Scientific and Technological Program of Guangzhou City[201508020262] ; Department of Science and Technology of Guangdong Province[2014B020228003][2015B020226004] ; Clinical Research Program of Nanfang Hospital, Southern Medical University[2018CR037] ; Clinical Research Startup Program of Southern Medical University by High-level University Construction Funding of Guangdong Provincial Department of Education[LC2019ZD006] ; President Foundation of Nanfang Hospital, Southern Medical University[2019Z003]

Gastroenterology & Hepatology

Gastroenterology & Hepatology

WOS:000544593000001

WILEY

CLINICAL MEDICINE

Web of Science

1.Southern Med Univ, Nanfang Hosp, Hepatol Unit, Dept Infect Dis, Guangzhou, Peoples R China
2.Shanghai Jiao Tong Univ, Ren Ji Hosp, Sch Med, Dept Gastroenterol, Shanghai, Peoples R China
3.Fujian Med Univ, Dept Hepatol, Mengchao Hepatobiliary Hosp, Fuzhou, Peoples R China
4.Fujian Med Univ, Dept Hepatol, Affiliated Infect Dis Hosp, Fuzhou, Peoples R China
5.Southern Univ Sci & Technol, Natl Clin Res Ctr Infect Dis, Peoples Hosp Shenzhen 3, Affiliated Hosp 2, Shenzhen, Peoples R China
6.Ninth Hosp Nanchang, Dept Hepatol, Nanchang, Jiangxi, Peoples R China

Tang, Xiaoting,Qi, Tingting,Li, Beiling,et al. Tri-typing of hepatitis B-related acute-on-chronic liver failure defined by the World Gastroenterology Organization[J]. JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY,2020.

Tang, Xiaoting.,Qi, Tingting.,Li, Beiling.,Li, Hai.,Huang, Zuxiong.,...&Hou, Jinlin.(2020).Tri-typing of hepatitis B-related acute-on-chronic liver failure defined by the World Gastroenterology Organization.JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY.

Tang, Xiaoting,et al."Tri-typing of hepatitis B-related acute-on-chronic liver failure defined by the World Gastroenterology Organization".JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY (2020).