Artificial liver treatment improves survival in patients with hepatitis B virus‐related acute‐on‐chronic liver failure: A case‐control matched analysis

Abstract

Aim The artificial liver support system (ALSS) is recognized as a bridge to liver transplantation in hepatitis B virus‐related acute‐on‐chronic liver failure (HBV‐ACLF) patients. However, patient survival remains unknown. We aim to assess the effects of ALSS on survival in HBV‐ACLF patients. Methods The clinical data of HBV‐ACLF patients receiving standard medical treatment (SMT) plus ALSS (ALSS group, n = 507) or only SMT (SMT group, n = 417) were collected for survival assessment. The main end‐points were cumulative survival rates at days 21, 28, and 90. Four different rigorous analyses were carried out to reduce bias and confounding. Results In the entire cohort, the cumulative survival rates at days 21, 28, and 90 were significantly higher in patients who underwent ALSS treatment (73.3% vs. 59.6%, 69.2% vs. 56.6%, 56.5% vs. 49.1%, respectively, P < 0.01) than in those who underwent SMT only. In the 276‐pair case–control matched cohort, a significantly higher survival rate was also observed in the ALSS group than in the SMT group on days 21, 28, and 90 (72.5% vs. 60.3%, 68.3% vs. 57.4%, 55.9% vs. 48.5%, respectively, P < 0.05), especially in patients with ACLF‐1 and ‐2. By a multivariable‐adjusted analysis, ALSS treatment was associated with a significantly lower risk of mortality, especially for ACLF‐2 at days 21, 28, and 90. These findings were also confirmed through propensity score matching and inverse probability treatment weighting analysis. Conclusions ALSS treatment can improve short‐term survival and is associated with a significantly lower risk of short‐term mortality in patients with HBV‐ACLF, especially ACLF‐2.

Traditional Chinese medicine enema for acute chronic liver failure

“…Therefore, these 2 most effective methods have not been carried out in all patients. [ 18 , 19 ] A growing body of research have shown that TCM enema can improve the clinical efficacy and quality of life of HBV-ACLF patients. Intestinal endotoxemia is the main pathogenesis of hepatocyte necrosis, so that reducing intestinal endotoxemia and avoiding intestinal infection is the key to the treatment of the disease.…”

Прогнозування Акушерських Ускладнень У Жінок З Вперше Виявленою Реплікативною Активністю Гепатиту В

“…Не дивлячись на досягнення медицини та постійне впровадження нових медичних технологій у практику з метою контролю над інфекційними процесами, вірусні гепатити є суттєвою причиною підвищення захворюваності та смертності [1][2][3][4]. На сьогодні у світі 1 млрд інфікованих та 350 млн чоловік носіїв вірусу ГВ, які є постійним резервуаром та джерелом інфекції [5].…”

Dynamic evaluation of hepatocellular carcinoma prediction models in patients with chronic hepatitis B receiving nucleotide/nucleoside analogue treatment

“…Recent advances in nucleoside/nucleotide analogue (NA) therapy have enabled viral suppression, hepatitis B surface antigen reduction, and improvement of treatment adherence in chronic hepatitis B [1][2][3][4][5] leading to reduce the development of hepatocellular carcinoma (HCC) and liver-related death. [6][7][8] However, despite good suppression of hepatitis B virus (HBV) by NA, there are still cases of HCC development. Therefore, identification of high-risk patients of hepatocarcinogenesis is an important clinical issue, even in patients receiving NA treatment, and the utility of HCC prediction models such as REACH-B, PAGE-B and modified PAGE-B (mPAGE-B) has been reported.…”

“…Recent advances in nucleoside/nucleotide analogue (NA) therapy have enabled viral suppression, hepatitis B surface antigen reduction, and improvement of treatment adherence in chronic hepatitis B 1–5 leading to reduce the development of hepatocellular carcinoma (HCC) and liver‐related death 6–8 . However, despite good suppression of hepatitis B virus (HBV) by NA, there are still cases of HCC development.…”