Early warning and clinical outcome prediction of acute-on-chronic hepatitis B liver failure

World J Gastroenterol. 2015 Nov 14;21(42):11964-73. doi: 10.3748/wjg.v21.i42.11964.

Abstract

Hepatitis B virus (HBV) associated acute-on-chronic liver failure (ACLF) is an increasingly recognized fatal liver disease encompassing a severe acute exacerbation of liver function in patients with chronic hepatitis B (CHB). Despite the introduction of an artificial liver support system and antiviral therapy, the short-term prognosis of HBV-ACLF is still extremely poor unless emergency liver transplantation is performed. In such a situation, stopping or slowing the progression of CHB to ACLF at an early stage is the most effective way of reducing the morbidity and mortality of HBV-ACLF. It is well-known that the occurrence and progression of HBV-ACLF is associated with many factors, and the outcomes of HBV-ACLF patients can be significantly improved if timely and appropriate interventions are provided. In this review, we highlight recent developments in early warning and clinical outcome prediction in patients with HBV-ACLF and provide an outlook for future research in this field.

Keywords: Acute exacerbation; Acute-on-chronic liver failure; Chronic hepatitis B; Clinical outcome prediction; Early warning.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Acute-On-Chronic Liver Failure / diagnosis*
  • Acute-On-Chronic Liver Failure / mortality
  • Acute-On-Chronic Liver Failure / therapy
  • Acute-On-Chronic Liver Failure / virology*
  • Antiviral Agents / therapeutic use
  • Decision Support Techniques
  • Disease Progression
  • Early Diagnosis
  • Hepatitis B, Chronic / complications*
  • Hepatitis B, Chronic / diagnosis
  • Hepatitis B, Chronic / mortality
  • Hepatitis B, Chronic / therapy
  • Humans
  • Liver, Artificial
  • Predictive Value of Tests
  • Risk Factors
  • Time Factors
  • Treatment Outcome

Substances

  • Antiviral Agents