Relation of liver fibrosis indicators and prognosis in hepatitis B-related acute on chronic liver failure

Objective To study the relation of liver fibrosis indicators and prognosis in hepatitis B virus-related acute on chronic liver failure (HBV-ACLF) .Methods One-hundred-eighty-five cases of HBV-ACLF diagnosed and treated between October 2008 and October 2010 were classified according to prognosis: improved group (n=116) and ineffective group (n=69) .Serum markers of liver fibrosis, virus replication, and liver function were measured to analyze their relation with prognosis.Results There was no difference in sex, HBV genotype, positivity rate of HBV e antigen, HBV DNA load, or levels of alanine aminotransferase, albumin, cholinesterase, hyaluronic acid, type IV collagen, or human procollagen peptide III between the improved and ineffective groups.However, the improved group showed higher average age (years: 43.3±10.1 vs.ineffective group: 48.7±10.1, P=0.006) , level of total bilirubin (TBil;μmol/L: 295.9±99.6 vs.355.4±136.8, P=0.009) , prothrombin activity (PTA;%: 34.5±7.9 vs.ineffective group: 30.4 ±7.6 P=0.0007) , alpha-fetoprotein (AFP;ng/L: 85 (range: 9-4760) vs.ineffective group: 26 (4-529) , P<0.001) , and laminin (LN;μg/L: 657 (45-1616) vs.306 (29-1724) , P<0.001.Conclusion LN, AFP, TBil and PTA levels and age may be effective prognostic markers for HBV-ACLF patients.