These authors contributed equally to this work.
Invasive fungal infections secondary to acute-on-chronic liver failure: a retrospective study
Article first published online: 1 FEB 2013
© 2013 Blackwell Verlag GmbH
Volume 56, Issue 4, pages 429–433, July 2013
How to Cite
Lin, L. N., Zhu, Y., Che, F. B., Gu, J. L. and Chen, J. H. (2013), Invasive fungal infections secondary to acute-on-chronic liver failure: a retrospective study. Mycoses, 56: 429–433. doi: 10.1111/myc.12044
- Issue published online: 14 JUN 2013
- Article first published online: 1 FEB 2013
- Submitted for publication 2 August 2012 Revised 26 December 2012 Accepted for publication 28 December 2012
- Acute-on-chronic liver failure;
- invasive fungal infections;
- risk factors;
- Candida albicans
Although the consequences of invasive fungal infections (IFIs) secondary to chronic hepatitis B infections secondary IFIs are serious, the incidence and main pathogenic factors of IFIs in acute-on-chronic liver failure (ACLF) patients remain unclear. This study included 1200 hepatitis B patients who were treated in the Department of Infectious Diseases, Shanghai Changzheng Hospital from January 2006 to January 2009. Patients with ACLF were screened according to the diagnostic guidelines for liver failure. Patients with ACLF and secondary IFI were the disease group, and patients with ACLF without secondary IFI were the controls. The incidence of IFI, mortality, and possible IFI causes in two groups were evaluated retrospectively. Sixty patients with ACLF had secondary IFI, of which 14 were confirmed cases and 46 were suspected cases. The incidence of IFI was 47.62% for ACLF patients. Logistic regression analysis showed that the level of hepatitis B viral (HBV) DNA was an important risk factor for secondary IFI in ACLF patients. Receiver operating characteristic curve analysis suggested that when the number of HBV DNA copies was higher than 3.16 × 103 copies ml−1, the possibility of secondary IFI in ACLF patients increased significantly, while white blood cell levels showed protective effects for these patients. The incidence of IFI is high in ACLF patients and high hepatitis B virus DNA levels may be an independent risk factor of secondary IFI in these patients.