The US Acute Liver Failure Study Group is given in the Appendix.
Clinical outcome and virological characteristics of hepatitis B-related acute liver failure in the United States
Article first published online: 17 FEB 2005
Journal of Viral Hepatitis
Volume 12, Issue 2, pages 192–198, March 2005
How to Cite
Wai, C.-T., Fontana, R. J., Polson, J., Hussain, M., Shakil, A. O., Han, S.-H., Davern, T. J., Lee, W. M., Lok, A. S.-F. and The US Acute Liver Failure Study Group (2005), Clinical outcome and virological characteristics of hepatitis B-related acute liver failure in the United States. Journal of Viral Hepatitis, 12: 192–198. doi: 10.1111/j.1365-2893.2005.00581.x
- Issue published online: 17 FEB 2005
- Article first published online: 17 FEB 2005
- Received March 2004; accepted for publication May 2004
- chronic hepatitis B;
- core promoter variants;
- HBV genotype;
- liver transplantation;
- precore variants
Summary. The role of hepatitis B virus (HBV) genotypes in the outcome of acute HBV infection is unclear. In this study, we aimed to evaluate the clinical and virological features of patients with hepatitis B-related acute liver failure (HBV-ALF) in the US. Clinical and laboratory features of consecutive patients with HBV-ALF from the US ALF Study Group were analysed. Prevalence of HBV genotypes, precore stop (G1896A) and core promoter dual (T1762A, A1764T) variants among patients with HBV-ALF were compared with a cohort of 530 patients with chronic HBV infection. Thirty-four HBV-ALF patients were studied: mean age 41 years, 56% men, 25 had detectable HBV-DNA. HBV genotypes A, B, C and D were found in 36, 24, 8 and 32% patients, respectively. Precore stop and core promoter dual variants were detected in 32 and 44% of patients, respectively. Twenty-three (68%) patients survived: 14 after liver transplant, nine without transplant. Older age was the only independent factor associated with poor outcome. Compared with patients with chronic HBV infection, patients with ALF were more likely to be non-Asians (88%vs 44%, P = 0.005) and to have genotype D (32%vs 10%, P < 0.01). A higher prevalence of HBV genotype D persisted even after matching for race and HBeAg status (32%vs 16%, P = 0.007). We concluded that HBV genotype D was more frequently found in patients with HBV-ALF than those with chronic HBV infection in the US. Further studies are needed to determine if HBV genotypes play a role in the outcome of acute HBV infection.