RISK FACTORS ASSOCIATED WITH PROGRESSION TO ACUTE-ON-CHRONIC LIVER FAILURE IN SEVERE ACUTE EXACERBATION OF CHRONIC HEPATITIS B

Nguyen Thi Thu Hai 1 , Bui Huu Hoang 2 , Le Hong Quan 3 , , Nguyen Lam Vinh Phuc 4
1 Tam Anh General Hospital, Ho Chi Minh City, Vietnam
2 University of Medicine and Pharmacy at Ho Chi Minh City image/svg+xml
3 Xuyen A General Hospital, Ho Chi Minh City, Vietnam
4 Nam Sai Gon General Hospital, Ho Chi Minh City, Vietnam
* Corresponding author:

Article Information

Metrics
Downloads: 9 Views: 13
DOI
10.63947/bvtn.v1i5.14
Published
2025-11-01
Issue Vol. 1 No. 5 (2025): Thong Nhat Hospital’s 50-Year Journey - Comprehensive Healthcare and Healthy Aging
Section
Original Research
Categories
Research

Download Article

PDF (Vietnamese)

How to Cite

1.
Thi Thu Hai N, Huu Hoang B, Hong Quan L, Lam Vinh Phuc N. RISK FACTORS ASSOCIATED WITH PROGRESSION TO ACUTE-ON-CHRONIC LIVER FAILURE IN SEVERE ACUTE EXACERBATION OF CHRONIC HEPATITIS B. JHA [Internet]. Vietnam; 2025 Nov. 1 [cited 2025 Nov. 5];1(5):93–99. https://tcsuckhoelaohoa.vn/bvtn/article/view/136 doi: 10.63947/bvtn.v1i5.14
Loading citation...
Crossref
Scopus
Google Scholar
Europe PMC

Abstract

Hepatitis B virus (HBV) infection is a prevalent and serious infectious disease. Severe acute exacerbation of chronic hepatitis B occurs in 40-50% of patients with chronic hepatitis B, which can progress to acute-on-chronic liver failure (ACLF) when their liver damage worsens. Early diagnosis and treatment play an important role in the survival of patients with ACLF. To investigate risk factors associated with the progression of ACLF in severe acute exacerbation of chronic hepatitis B. A retrospective, cross-sectional study with longitudinal follow-up was conducted on 69 patients with severe acute exacerbation of chronic hepatitis B, conducted at the Department of Gastroenterology, The University of Medicine Center of Ho Chi Minh City from January 2022 to December 2023. Of the 69 patients, 30 (43.5%) progressed to ACLF. Univariate analysis identified a history of compensated cirrhosis (OR = 9.04; 95% CI: 3.0–27.2), spider angiomas (OR = 4.43; 95% CI: 1.54–12.75), palmar erythema (OR = 5.07; 95% CI: 1.75–14.64), lower serum sodium (OR = 1.18; 95% CI: 1.02–1.37), higher total bilirubin (OR = 1.06; 95% CI: 1.01–1.12), and lower serum albumin (OR = 1.29; 95% CI: 1.13–1.47) as significant risk factors for ACLF progression in severe acute exacerbation of chronic HBV. Risk factors associated with the progression of ACLF in severe acute exacerbation of chronic hepatitis B are a history of compensated cirrhosis, spider angiomas, palmar erythema, serum sodium, total bilirubin, and serum albumin. Serum albumin is an independent risk factor.

 

Keywords

acute-on-chronic liver failure severe acute exacerbation of chronic hepatitis B chronic hepatitis B

References

  1. Cam Huong NT, Van Luu N, Nam NH, Ghula S, Atieh Qarawi AT, Mai Truc PT, et al. Prevalence of hepatitis B virus infection in health checkup participants: a cross-sectional study at University Medical Center, Ho Chi Minh City, Vietnam. Hosp Pract (1995). 2023;51(3):163-7. Epub 20230605. doi: 10.1080/21548331.2023.2221132. PubMed PMID: 37262352. DOI: https://doi.org/10.1080/21548331.2023.2221132
  2. Wong VW, Wong GL, Yiu KK, Chim AM, Chu SH, Chan HY, et al. Entecavir treatment in patients with severe acute exacerbation of chronic hepatitis B. J Hepatol. 2011;54(2):236-42. Epub 20100907. doi: 10.1016/j.jhep.2010.06.043. PubMed PMID: 21030105. DOI: https://doi.org/10.1016/j.jhep.2010.06.043
  3. Sarin SK, Choudhury A, Sharma MK, Maiwall R, Al Mahtab M, Rahman S, et al. Acute-on-chronic liver failure: consensus recommendations of the Asian Pacific association for the study of the liver (APASL): an update. Hepatol Int. 2019;13(4):353-90. Epub 20190606. doi: 10.1007/s12072-019-09946-3. PubMed PMID: 31172417; PubMed Central PMCID: PMC6728300.
  4. Li J, Liang X, You S, Feng T, Zhou X, Zhu B, et al. Development and validation of a new prognostic score for hepatitis B virus-related acute-on-chronic liver failure. J Hepatol. 2021;75(5):1104-15. Epub 20210604. doi: 10.1016/j.jhep.2021.05.026. PubMed PMID: 34090929. DOI: https://doi.org/10.1016/j.jhep.2021.05.026
  5. Barosa R, Roque Ramos L, Patita M, Nunes G, Fonseca J. CLIF-C ACLF score is a better mortality predictor than MELD, MELD-Na and CTP in patients with Acute on chronic liver failure admitted to the ward. Rev Esp Enferm Dig. 2017;109(6):399-405. doi: 10.17235/reed.2017.4701/2016. PubMed PMID: 28467096. DOI: https://doi.org/10.17235/reed.2017.4701/2016
  6. Yuan L, Zeng BM, Liu LL, Ren Y, Yang YQ, Chu J, et al. Risk factors for progression to acute-on-chronic liver failure during severe acute exacerbation of chronic hepatitis B virus infection. World J Gastroenterol. 2019;25(19):2327-37. doi: 10.3748/wjg.v25.i19.2327. PubMed PMID: 31148904; PubMed Central PMCID: PMC6529889. DOI: https://doi.org/10.3748/wjg.v25.i19.2327
  7. Ren Y, Liu L, Li Y, Yang F, He Y, Zhu Y, et al. Development and validation of a scoring system to predict progression to acute-on-chronic liver failure in patients with acute exacerbation of chronic hepatitis B. Hepatol Res. 2018;48(9):692-700. Epub 20180309. doi: 10.1111/hepr.13062. PubMed PMID: 29336092. DOI: https://doi.org/10.1111/hepr.13062

License

© 2025 The Author(s). Published by Journal of Health and Aging.

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.