Acute-on-chronic liver failure in chronic hepatitis B

J Gastroenterol Hepatol. 2012 Apr;27(4):662-9. doi: 10.1111/j.1440-1746.2011.06971.x.

Abstract

Acute-on-chronic liver failure (ACLF) in chronic hepatitis B (CHB) is most commonly caused by acute severe exacerbation of CHB. The pathophysiology of ACLF in CHB is still poorly understood. Despite the identification of important predisposing factors and prognostic markers, ACLF in CHB remains a disease associated with high mortality. The majority of studies using nucleoside analog therapy did not show any significant improvement in survival, although larger prospective studies are needed. Liver transplantation is the definitive treatment for ACLF in CHB. The challenge ahead would be prognosticating cases with favorable or unfavorable outcomes in order to streamline patients for early transplantation or for medical therapy.

Publication types

  • Review

MeSH terms

  • Disease Progression
  • End Stage Liver Disease / etiology*
  • End Stage Liver Disease / therapy*
  • Hepatitis B, Chronic / complications*
  • Hepatitis B, Chronic / virology
  • Humans
  • Liver Failure, Acute / etiology*
  • Liver Failure, Acute / therapy*
  • Prognosis