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Clinical outcome and virological characteristics of hepatitis B-related acute liver failure in the United States.
- Source :
-
Journal of viral hepatitis [J Viral Hepat] 2005 Mar; Vol. 12 (2), pp. 192-8. - Publication Year :
- 2005
-
Abstract
- 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.
- Subjects :
- Adult
Age Distribution
Cohort Studies
Female
Humans
Incidence
Liver Failure, Acute therapy
Liver Function Tests
Male
Middle Aged
Probability
Risk Assessment
Severity of Illness Index
Sex Distribution
Survival Analysis
United States epidemiology
Hepatitis B virus isolation & purification
Hepatitis B, Chronic complications
Hepatitis B, Chronic diagnosis
Liver Failure, Acute epidemiology
Liver Failure, Acute etiology
Subjects
Details
- Language :
- English
- ISSN :
- 1352-0504
- Volume :
- 12
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of viral hepatitis
- Publication Type :
- Academic Journal
- Accession number :
- 15720535
- Full Text :
- https://doi.org/10.1111/j.1365-2893.2005.00581.x