Risk Factors And Prognosis Of ACLF Due To Recurrent CHB After NAs Withdrawal

OBJECTIVE To study the risk factors and prognosis of ACLF due to recurrent CHB after NAs withdrawal.METHODS Investigated and analyzed22hospitalized cases of acute on chronic liver failure in The1Affiliated Hospital of Zhe Jiang University, which due to recurrent CHB after NAs withdrawal, during January2010to December2011.RESULTS The HBeAg before initial treatment and after recurrence have no significant influence to the prognosis (P>0.05).9Patients have cirrhosis,7of them died. The mortality is77.78%. Cirrhosis has significant influence to the prognosis (P<0.05), increasing the mortality. MELD scores have great association with the prognosis, based on Log-rank test (P<0.05). TB, PTA, HBV DNA and the exist of ascites or hepatic encephalopathy have significant influence to the prognosis, based on Logistic regression analysis (P<0.05).And PTA has significant influence to the prognosis, based on Cox regression analysis (P<0.05). CONCLUSIONS Recurrent CHB after NAs withdrawal is one of challenges in CHB treatment. Recurrence of CHB may lead to liver failure, even death. Therefore, we should educate patients who will take NAs to treat CHB, make them know the important of standardized treatment and the serious consequences due to inappropriate drug withdrawal. Prolong treatment time properly, so that the recurrence will be reduced. Patients with cirrhosis should take NAs for a long term, even for a life time. MELD score and PTA have great association with the prognosis. They are effective methods to estimate patients’condition in time.