Prognostic analysis of acute-on-chronic liver failure after withdrawal of nucleos(t)ide analogues for antiviral treatment of chronic hepatitis B
10.3760/cma.j.issn.1007-3418.2016.04.003
- VernacularTitle:核苷(酸)类药物治疗慢性乙型肝炎停药后复发相关肝衰竭预后分析
- Author:
Shuhua OU
1
;
Yongpeng CHEN
;
Ronglong JIANG
;
Jie PENG
Author Information
1. 南方医科大学附属小榄医院感染内科
- Keywords:
Hepatitis B,chronic;
Liver failure,acute;
Nucleos(t)ide analogues
- From:
Chinese Journal of Hepatology
2016;24(4):252-257
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the prognostic factors for acute-on-chronic liver failure (ACLF) after the withdrawal of nucleos(t)ide analogues (NAs) for the antiviral treatment of chronic hepatitis B (CHB).Methods The clinical data of 67 hospitalized patients with ACLF after withdrawal of NAs for the antiviral treatment of CHB were analyzed retrospectively.Results The HBeAg status before initial treatment and after recurrence,course of the antiviral treatment,duration from the withdrawal of NAs to recurrence,and type of NAs before and after withdrawal were not associated with the prognosis of ACLF.The Cox univariate regression analysis showed that serum bilirubin,international normalization ratio,serum creatinine,model of end-stage of liver disease (MELD) score,hepatic encephalopathy,and concurrent infection were associated with the 12-week death.The Cox multivariate regression analysis showed that MELD score and hepatic encephalopathy were independent predictors for 12-week death.The area under the receiver operating characteristic curve for the MELD score to predict 12-week death was 0.906,with an optimal cutoff value of 32,a sensitivity of 82.9％,a specificity of 88.5％,a positive predictive value of 91.9％,and a negative predictive value of 76.7％.Conclusion MELD score and hepatic encephalopathy are closely associated with the prognosis of patients with ACLF after withdrawal of NAs for the antiviral treatment of CHB.
