Survival and prognostic factors in hepatitis B virus-related acute-on-chronic liver failure

Table 1 Complications and laboratory tests in patients with hepatitis B virus-related acute-on-chronic liver failure (mean ± SD) n (%)

Complications and biochemical characteristics	Entecavir group	Lamivudine group	Non-antiviral group
No. of patients	77	64	49
Gender (M/F)	66/11	56/8	37/12
Age (yr)	45.90 ± 11.33	44.38 ± 10.39	47.20 ± 11
Ascites	64 (83.1)	53 (82.8)	35 (71.4)
HRS	7 (9.1)	6 (9.4)	3 (6.1)
HE	23 (29.9)	22 (34.4)	19 (38.8)
I-II	19 (24.7)	18 (28.1)	16 (32.7)
III-IV	4 (5.2)	4 (6.3)	3 (6.1)
SBP	23 (29.9)	21 (32.8)	19 (38.8)
Liver cirrhosis	48 (62.3)	38 (59.4)	34 (69.4)
Electrolyte disturbances	54 (70.1)	49 (76.6)	41 (83.7)
Alanine transaminase (U/L)	412.84 ± 605.62	271.14 ± 304.24	180.96 ± 222.50
Total bilirubin (μmol/L)	311.34 ± 120.99	340.81 ± 123.38	265.51 ± 121.88
Albumin (g/L)	37.25 ± 11.84	34.09 ± 10.90	35.76 ± 12.34
Prothrombin activity (%)	32.16 ± 9.21	31.36 ± 10.16	31.64 ± 10.59
International normalized ratio	2.46 ± 0.69	2.47 ± 0.61	2.58 ± 0.86
Creatinine (μmol/L)	97.78 ± 55.42	88.85 ± 25.08	96.94 ± 38.16
Sodium (mmol/L)	133.57 ± 13.37	133.52 ± 6.47	132.57 ± 5.61
HBeAg (+/-)	33/44	27/37	22/27
HBV DNA (IU/mL)	(1.00 ± 8.51) × 108	(4.00 ± 26.69) × 107	(4.41 ± 1.08) × 107
HBV DNA level (< 103/103-107/> 107)	4/61/11	3/52/10	4/39/6
MELD score	29.07 ± 4.02	28.69 ± 4.43	28.61 ± 3.49
MELD score (< 30/≥ 30)	47/30	41/23	34/15

HRS: Hepatorenal syndrome; HE: Hepatic encephalopathy; SBP: Spontaneous bacterial peritonitis; HBV: Hepatitis B virus; MELD: Model for end-stage liver disease.

Table 2 Factors affecting prognosis based on single-factor analysis

	Cases	Median time (mo)	1-yr survival rate (%)	χ2 value	P value
Age (yr)
20-45	88	6.7	69.9	9.047	0.003
> 45	102	2.5	46.5
Fundamental disease
Cirrhosis	120	2.6	49.1	8.026	0.005
No cirrhosis	69	8.4	71.8
Antiviral therapy
No	49	1.8	42.5	8.050	0.005
Yes	141	5.5	62.7
Electrolyte disturbances
No	46	11.8	84.1	14.397	< 0.001
Yes	144	2.6	49.3
HE grade
No	126	7.1	70.7	38.596	< 0.001
I-II	53	1.6	35.1
III-IV	11	1.5	9.1
SBP
No	127	6.0	64.3	5.345	0.021
Yes	63	2.5	44.3
HRS
No	174	5.7	60.9	18.403	< 0.001
Yes	16	0.9	20.8
PTA groups (%)
< 20	18	1.2	22.2	22.619	< 0.001
20-30	77	5.1	58.6
30-40	66	6.7	70.6
> 40	29	3.3	47.1

HE: Hepatic encephalopathy; SBP: Spontaneous bacterial peritonitis; HRS: Hepatorenal syndrome; PTA: Prothrombin activity.

Table 3 Results of multivariable Cox regression analysis

Variables	Relative risk ratio	95% CI	Wald value	P value
Age	1.322	0.792-2.208	1.139	0.286
Cirrhosis	1.144	0.648-2.021	0.215	0.643
Antiviral therapy	0.609	0.430-1.067	6.809	0.014
Electrolyte disturbances	2.062	1.282-6.433	6.571	0.010
HE	1.879	1.335-2.646	13.065	< 0.001
SBP	1.295	0.798-2.103	1.095	0.295
HRS	2.084	1.090-3.984	4.928	0.026
PTA	0.940	0.699-1.264	0.168	0.682

HE: Hepatic encephalopathy; SBP: Spontaneous bacterial peritonitis; HRS: Hepatorenal syndrome; PTA: Prothrombin activity.