Long‐term outcomes of patients with hepatitis B virus‐related acute on chronic liver failure: An observational cohort study

BACKGROUND AND AIMS The long-term outcomes of patients with hepatitis B virus-related acute on chronic liver failure (HBV-ACLF) remain unclear. The main aim of the study was to compare the 5-year survival rate and incidence rate of hepatocellular carcinoma (HCC) between patients with HBV-ACLF and HBV-cirrhosis. METHODS Clinical data of patients with ACLF, compensated cirrhosis and decompensated cirrhosis who survived more than 3 months after diagnosis were collected. The survival rate and cumulative incidence of HCC were compared. The Cox regression was used to evaluate risk factors for outcomes. RESULTS A total of 814 patients were included in the analysis, including 122 (14.99%) patients with ACLF, 450 (55.28%) patients with compensated cirrhosis and 242 (29.73%) patients with decompensated cirrhosis. The 5-year survival rate of patients with ACLF (97.2%) was higher than patients with decompensated cirrhosis (86.0%), but was lower than patients with compensated cirrhosis (99.1%). The 5-year HCC incidence rate was the highest in the decompensated cirrhosis group (14.6%, P