Prognostic factors in severe exacerbation of chronic hepatitis B

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Abstract

Forty-seven patients with severe hepatitis B exacerbation were compared with patients who had mild exacerbation (n = 96) or no exacerbation (n = 96). Seventeen patients (36.2%) died or underwent liver transplantation. Preexisting cirrhosis and a prothrombin time (PT) of >30 s were associated with adverse outcome in 60.9% and 87.5% of patients, respectively. The rate of adverse outcome increased to 92.3% when albumin levels of ≤35 g/L and bilirubin levels of >200 μM were present. Other factors associated with adverse outcomes included peak bilirubin level, peak PT, time to reach peak PT, and the presence of encephalopathy and/or ascites. There was no difference in the frequency of precore mutations in patients with severe or mild exacerbation or without exacerbation. A significantly lower prevalence of core promoter mutants was found in patients with severe exacerbation (50%), compared with those who had mild exacerbation (81.3%; P = .004). Patients with severe exacerbation of hepatitis B with poor prognostic factors should be considered for early liver transplantation.

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APA

Yuen, M. F., Sablon, E., Hui, C. K., Li, T. M., Yuan, H. J., Wong, D. K. H., … Lai, C. L. (2003). Prognostic factors in severe exacerbation of chronic hepatitis B. Clinical Infectious Diseases, 36(8), 979–984. https://doi.org/10.1086/374226

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