Analysis Of Factors Related To The Progression Of Chronic Hepatitis B Plus Acute Liver Failure

Objective:To explore the effects of HBV-DNA load,HBs Ag level and infection factors on the progression of chronic hepatitis B plus acute liver failure(HBV-ACLF).Methods:A total of 35 patients with chronic hepatitis B and acute liver failure were diagnosed in Hunan Provincial people’s Hospital from September 2019 to January 2011.the age,sex,HBV-DNA,HBs Ag,BR,LFT,CF and other data were collected to analyze the relationship between HBV-DNA,HBs Ag,BR,CF and liver function.According to the HBV-DNA load,the patients with chronic hepatitis B plus acute liver failure were divided into high expression group according to greater than2000IU/ml,and low expression group when less than or equal to 2000IU/ml.According to the grouping,the differences of PT,INR,WBC,NEUT,LYM,MONO,TBIL,AST,ALT and ALB between the two groups were compared.Then,according to the expression of HBs Ag,the patients with chronic hepatitis B plus acute liver failure were divided into high expression group according to HBs Ag > 1400IU/ml,and low and high expression group when less than 1400IU/ml.According to the grouping,the differences of HBs Ag,PT,INR,TBIL,AST,ALT and ALB between the two groups were compared.To analyze the influence of infection factors on chronic hepatitis B plus acute liver failure.Results :1.Baseline characteristics: A total of 22 patients were enrolled in the HBV-DNA high replication group,including 20 males and 2 females,with an average age of53.4±13.2 years.Among them,63% were compli cated with hepatic encephalopathy,45% with gastrointestinal bleeding,and 82% with infection;In the HBV-DNA low replication group,there were 13 patients,9 males and4 females,with an average age of 53.3±13.7 years old.Among them,69% were complicated with hepatic encephalopathy,54% with gastrointestinal bleeding,and62% with infection.2.There was no correlation between HBV-DNA and TBil or Alb in patients with overall hepatitis B liver failure.HBV-DNA was positively correlated with INR.The higher HBV-DNA was,the greater INR was,the worse coagulation function was,and the worse liver function was reflected.There was a positive correlation between HBV-DNA and HBs Ag.The more HBV-DNA was replicated,the higher HBs Ag expression was.3.There was no correlation between HBs Ag and TBil or Alb in the overall hepatitis B failure patients;HBs Ag is positively correlated with INR.The more HBs Ag expression,the higher INR ratio,indicating the worse coagulation function.4.The mean values of TBbil,HBs Ag and INR in the high HBV-DNA load group were higher than those in the low HBV-DNA load group(all P values were less than0.05),suggesting that the higher the HBV-DNA,the more severe the liver function was impaired and the worse the blood coagulation function was.5.TBil and INR in the high HBs Ag expression group were higher than those in the low HBs Ag expression group(all P values were less than 0.05),indicating that the higher HBs Ag,the more severe liver function impairment and the worse coagulation function of the patients.6.There was a positive correlation between total PCT and NEUT and TBIL(P <0.05).The higher TBIL,the higher NEUT and PCT,indicating the worse liver function,and infection factors played an important role in promoting chronic hepatitis B plus acute liver failure.Conclusion:1.HBV-DNA load and HBs Ag level are risk factors for the progression of chronic hepatitis B plus acute liver failure.2.In this study,PCT and NEUT were closely related to the progression of HBV-ACLF,indicating that infectious factors were the risk factors for HBV-ACLF.