Acute-on-chronic liver failure in chronic hepatitis B

Authors

  • Wai-Kay Seto,

    1. Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong
    Search for more papers by this author
  • Ching-Lung Lai,

    1. Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong
    2. State Key Laboratory for Liver Research, University of Hong Kong, Queen Mary Hospital, Hong Kong
    Search for more papers by this author
  • Man-Fung Yuen

    1. Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong
    2. State Key Laboratory for Liver Research, University of Hong Kong, Queen Mary Hospital, Hong Kong
    Search for more papers by this author

  • Conflicts of Interest: None of the authors has a conflict of interest.

  • Role of the funding source: None of the authors has anything to disclose.

  • The authors declare they have participated in the preparation of the manuscript and have seen and approved the final version.

Professor Man-Fung Yuen, Department of Medicine, University of Hong Kong, Queen Mary Hospital, Pokfulam Road, Hong Kong. Email: mfyuen@hkucc.hku.hk

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.

Ancillary