The Prognostic Value of Serum HBV-RNA during Hepatitis B Virus Infection is Related to Acute-on-Chronic Liver Failure.

IF 2.7 4区 医学 Q2 Medicine Canadian Journal of Gastroenterology and Hepatology Pub Date : 2022-09-13 eCollection Date: 2022-01-01 DOI:10.1155/2022/8422242
Keli Qian, Ying Xue, Hang Sun, Ting Lu, Yixuan Wang, Xiaofeng Shi
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Abstract

Background: Serum HBV-RNA levels can predict antiviral response in chronic hepatitis B (CHB) patients; however, its role in HBV-related ACLF (HBV-ACLF) remains unclear. Here, we determined its implications for HBV-ACLF.

Methods: Baseline serum HBV-RNA levels were retrospectively detected in HBV-ACLF and CHB patients. The association of serum HBV-RNA level with clinical outcomes was evaluated by performing multiple logistic regression. A nomogram was developed to formulate an algorithm incorporating serum HBV-RNA for predicting the survival of HBV-ACLF patients. After being discharged from the hospital, the HBV-ACLF patients were followed up for 36 weeks.

Results: In this study, 82 HBV-ACLF patients and 33 CHB patients were included. Serum HBV-RNA levels were significantly higher in CHB patients than in HBV-ACLF patients (4.15 ± 2.63 log10 copies/mL VS 5.37 ± 2.02 log10 copies/mL) (P < 0.05). Among the HBV-ACLF cases, patients with poor outcomes had lower serum HBV-RNA levels, but the difference was not significant. The area under the receiver operating characteristic curve of the serum HBV-RNA inclusive model was 0.745, superior to 0.66 from MELD scores (P < 0.05). During the follow-up for four weeks, the serum HBV-RNA levels, especially in the survival group, were found to be lower than the baseline levels.

Conclusions: Serum HBV-RNA levels were associated with disease severity and might predict the long-term clinical outcome of HBV-ACLF patients.

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乙型肝炎病毒感染期间血清HBV-RNA的预后价值与急性-慢性肝衰竭有关
背景:血清HBV-RNA水平可以预测慢性乙型肝炎(CHB)患者的抗病毒反应;然而,其在hbv相关ACLF (HBV-ACLF)中的作用尚不清楚。在这里,我们确定了它对HBV-ACLF的影响。方法:回顾性检测HBV-ACLF和CHB患者血清HBV-RNA基线水平。通过多重逻辑回归评估血清HBV-RNA水平与临床结果的关系。我们开发了一个nomogram来制定一种结合血清HBV-RNA预测HBV-ACLF患者生存的算法。出院后,对HBV-ACLF患者随访36周。结果:本研究共纳入82例HBV-ACLF患者和33例CHB患者。CHB患者血清HBV-RNA水平显著高于HBV-ACLF患者(4.15±2.63 log10 copies/mL VS 5.37±2.02 log10 copies/mL) (P < 0.05)。在HBV-ACLF病例中,预后较差的患者血清HBV-RNA水平较低,但差异不显著。血清HBV-RNA包容性模型的受试者工作特征曲线下面积为0.745,优于MELD评分的0.66 (P < 0.05)。在为期四周的随访期间,血清HBV-RNA水平,特别是在生存组,被发现低于基线水平。结论:血清HBV-RNA水平与疾病严重程度相关,并可能预测HBV-ACLF患者的长期临床预后。
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来源期刊
CiteScore
4.80
自引率
0.00%
发文量
0
审稿时长
37 weeks
期刊介绍: Canadian Journal of Gastroenterology and Hepatology is a peer-reviewed, open access journal that publishes original research articles, review articles, and clinical studies in all areas of gastroenterology and liver disease - medicine and surgery. The Canadian Journal of Gastroenterology and Hepatology is sponsored by the Canadian Association of Gastroenterology and the Canadian Association for the Study of the Liver.
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