Hepatitis B Virus Reactivation Increased the Risk of Developing Hepatic Failure and Mortality in Cirrhosis With Acute Exacerbation
Background and AimsHepatitis B virus (HBV) reactivation is a serious condition and has been extensively described in chemotherapeutic immunosuppressive population. However, little is known about HBV reactivation in immunocompetent patients with chronic hepatitis B (CHB). In this study, we evaluated...
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Frontiers Media S.A.
2022-07-01
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| Series: | Frontiers in Microbiology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmicb.2022.910549/full |
| _version_ | 1828775130935853056 |
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| author | Ying Zhu Hai Li Xianbo Wang Xin Zheng Yan Huang Jinjun Chen Zhongji Meng Yanhang Gao Zhiping Qian Feng Liu Xiaobo Lu Yu Shi Jia Shang Huadong Yan Yubao Zheng Liang Qiao Yan Zhang Xiaomei Xiang Xiaomei Xiang Yunjie Dan Yunjie Dan Shuning Sun Yixin Hou Qun Zhang Yan Xiong Sumeng Li Jun Chen Zebing Huang Beiling Li Xiuhua Jiang Sen Luo Yuanyuan Chen Na Gao Chunyan Liu Liujuan Ji Wei Yuan Jing Li Tao Li Rongjiong Zheng Xinyi Zhou Haotang Ren Yi Zhou Yi Zhou Baoyan Xu Baoyan Xu Rentao Yu Wenting Tan Wenting Tan Guohong Deng Guohong Deng |
| author_facet | Ying Zhu Hai Li Xianbo Wang Xin Zheng Yan Huang Jinjun Chen Zhongji Meng Yanhang Gao Zhiping Qian Feng Liu Xiaobo Lu Yu Shi Jia Shang Huadong Yan Yubao Zheng Liang Qiao Yan Zhang Xiaomei Xiang Xiaomei Xiang Yunjie Dan Yunjie Dan Shuning Sun Yixin Hou Qun Zhang Yan Xiong Sumeng Li Jun Chen Zebing Huang Beiling Li Xiuhua Jiang Sen Luo Yuanyuan Chen Na Gao Chunyan Liu Liujuan Ji Wei Yuan Jing Li Tao Li Rongjiong Zheng Xinyi Zhou Haotang Ren Yi Zhou Yi Zhou Baoyan Xu Baoyan Xu Rentao Yu Wenting Tan Wenting Tan Guohong Deng Guohong Deng |
| author_sort | Ying Zhu |
| collection | DOAJ |
| description | Background and AimsHepatitis B virus (HBV) reactivation is a serious condition and has been extensively described in chemotherapeutic immunosuppressive population. However, little is known about HBV reactivation in immunocompetent patients with chronic hepatitis B (CHB). In this study, we evaluated the prevalence and the clinical significance of HBV reactivation in CHB patients with acute exacerbations.MethodPatients were screened from two prospective multicenter observational cohorts (CATCH-LIFE cohort). A total of 1,020 CHB patients with previous antiviral treatment history were included to assess the prevalence, risk factors, clinical characteristics of HBV reactivation, and its influence on the progression of chronic liver disease.ResultsThe prevalence of HBV reactivation was 51.9% in CHB patients with acute exacerbations who had antiviral treatment history in our study. Among the 529 patients with HBV reactivation, 70.9% of them were triggered by discontinued antiviral treatment and 5.9% by nucleos(t)ide analogs (NUCs) resistance. The prevalence of antiviral treatment disruption and NUCs resistance in patients with HBV reactivation is much higher than that in the patients without (70.9% vs. 0.2%, and 5.9% vs. 0, respectively, both p < 0.001). Stratified and interaction analysis showed that HBV reactivation was correlated with high short-term mortality in cirrhosis subgroup (HR = 2.1, p < 0.001). Cirrhotic patients with HBV reactivation had a significantly higher proportion of developing hepatic failure (45.0% vs. 20.3%, p < 0.001), acute-on-chronic liver failure (ACLF; 31.4% vs. 21.8%, p = 0.005), and short-term death (14.0% vs. 5.9% for 28-day, and 23.3% vs. 12.4% for 90-day, both p < 0.001) than those without. HBV reactivation is an independent risk factor of 90-day mortality for cirrhosis patients (OR = 1.70, p = 0.005), as well as hepatic encephalopathy, ascites, and bacterial infection.ConclusionThis study clearly demonstrated that there was a high prevalence of HBV reactivation in CHB patients, which was mainly triggered by discontinued antiviral treatment. The HBV reactivation strongly increased the risk of developing hepatic failure, ACLF and short-term death in HBV-related cirrhotic patients, which may suggest that HBV reactivation would be a new challenge in achieving the WHO target of 65% reduction in mortality from hepatitis B by 2030. |
| first_indexed | 2024-12-11T15:34:59Z |
| format | Article |
| id | doaj.art-bd22f5a89da74d5095bdb8c8480a7e4c |
| institution | Directory Open Access Journal |
| issn | 1664-302X |
| language | English |
| last_indexed | 2024-12-11T15:34:59Z |
| publishDate | 2022-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Microbiology |
| spelling | doaj.art-bd22f5a89da74d5095bdb8c8480a7e4c2022-12-22T00:59:58ZengFrontiers Media S.A.Frontiers in Microbiology1664-302X2022-07-011310.3389/fmicb.2022.910549910549Hepatitis B Virus Reactivation Increased the Risk of Developing Hepatic Failure and Mortality in Cirrhosis With Acute ExacerbationYing Zhu0Hai Li1Xianbo Wang2Xin Zheng3Yan Huang4Jinjun Chen5Zhongji Meng6Yanhang Gao7Zhiping Qian8Feng Liu9Xiaobo Lu10Yu Shi11Jia Shang12Huadong Yan13Yubao Zheng14Liang Qiao15Yan Zhang16Xiaomei Xiang17Xiaomei Xiang18Yunjie Dan19Yunjie Dan20Shuning Sun21Yixin Hou22Qun Zhang23Yan Xiong24Sumeng Li25Jun Chen26Zebing Huang27Beiling Li28Xiuhua Jiang29Sen Luo30Yuanyuan Chen31Na Gao32Chunyan Liu33Liujuan Ji34Wei Yuan35Jing Li36Tao Li37Rongjiong Zheng38Xinyi Zhou39Haotang Ren40Yi Zhou41Yi Zhou42Baoyan Xu43Baoyan Xu44Rentao Yu45Wenting Tan46Wenting Tan47Guohong Deng48Guohong Deng49Department of Infectious Diseases, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaDepartment of Gastroenterology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaCenter of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, ChinaDepartment of Infectious Diseases, Institute of Infection and Immunology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Infectious Diseases, Hunan Key Laboratory of Viral Hepatitis, Xiangya Hospital, Central South University, Changsha, ChinaHepatology Unit, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, ChinaDepartment of Infectious Diseases, Hubei Clinical Research Center for Precise Diagnosis and Therapy of Liver Cancer, Taihe Hospital, Hubei University of Medicine, Shiyan, ChinaDepartment of Hepatology, The First Hospital of Jilin University, Changchun, ChinaDepartment of Liver Intensive Care Unit, Shanghai Public Health Clinical Centre, Fudan University, Shanghai, China0Department of Infectious Diseases and Hepatology, The Second Hospital of Shandong University, Jinan, China1Infectious Disease Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China2State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Disease, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China3Department of Infectious Diseases, Henan Provincial People’s Hospital, Zhengzhou, China4Department of Hepatology, Hwamei Hospital, Ningbo No.2 Hospital, University of Chinese Academy of Sciences, Ningbo, China5Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, ChinaDepartment of Gastroenterology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Gastroenterology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Infectious Diseases, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China6Chongqing Key Laboratory for Research of Infectious Disease, Chongqing, ChinaDepartment of Infectious Diseases, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China6Chongqing Key Laboratory for Research of Infectious Disease, Chongqing, ChinaDepartment of Infectious Diseases, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaCenter of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, ChinaCenter of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, ChinaDepartment of Infectious Diseases, Institute of Infection and Immunology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Infectious Diseases, Institute of Infection and Immunology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Infectious Diseases, Hunan Key Laboratory of Viral Hepatitis, Xiangya Hospital, Central South University, Changsha, ChinaDepartment of Infectious Diseases, Hunan Key Laboratory of Viral Hepatitis, Xiangya Hospital, Central South University, Changsha, ChinaHepatology Unit, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, ChinaHepatology Unit, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, ChinaDepartment of Infectious Diseases, Hubei Clinical Research Center for Precise Diagnosis and Therapy of Liver Cancer, Taihe Hospital, Hubei University of Medicine, Shiyan, ChinaDepartment of Infectious Diseases, Hubei Clinical Research Center for Precise Diagnosis and Therapy of Liver Cancer, Taihe Hospital, Hubei University of Medicine, Shiyan, ChinaDepartment of Hepatology, The First Hospital of Jilin University, Changchun, ChinaDepartment of Hepatology, The First Hospital of Jilin University, Changchun, ChinaDepartment of Liver Intensive Care Unit, Shanghai Public Health Clinical Centre, Fudan University, Shanghai, ChinaDepartment of Liver Intensive Care Unit, Shanghai Public Health Clinical Centre, Fudan University, Shanghai, China0Department of Infectious Diseases and Hepatology, The Second Hospital of Shandong University, Jinan, China0Department of Infectious Diseases and Hepatology, The Second Hospital of Shandong University, Jinan, China1Infectious Disease Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China1Infectious Disease Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China2State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Disease, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, ChinaDepartment of Infectious Diseases, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China6Chongqing Key Laboratory for Research of Infectious Disease, Chongqing, ChinaDepartment of Infectious Diseases, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China6Chongqing Key Laboratory for Research of Infectious Disease, Chongqing, ChinaDepartment of Infectious Diseases, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaDepartment of Infectious Diseases, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China6Chongqing Key Laboratory for Research of Infectious Disease, Chongqing, ChinaDepartment of Infectious Diseases, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China6Chongqing Key Laboratory for Research of Infectious Disease, Chongqing, ChinaBackground and AimsHepatitis B virus (HBV) reactivation is a serious condition and has been extensively described in chemotherapeutic immunosuppressive population. However, little is known about HBV reactivation in immunocompetent patients with chronic hepatitis B (CHB). In this study, we evaluated the prevalence and the clinical significance of HBV reactivation in CHB patients with acute exacerbations.MethodPatients were screened from two prospective multicenter observational cohorts (CATCH-LIFE cohort). A total of 1,020 CHB patients with previous antiviral treatment history were included to assess the prevalence, risk factors, clinical characteristics of HBV reactivation, and its influence on the progression of chronic liver disease.ResultsThe prevalence of HBV reactivation was 51.9% in CHB patients with acute exacerbations who had antiviral treatment history in our study. Among the 529 patients with HBV reactivation, 70.9% of them were triggered by discontinued antiviral treatment and 5.9% by nucleos(t)ide analogs (NUCs) resistance. The prevalence of antiviral treatment disruption and NUCs resistance in patients with HBV reactivation is much higher than that in the patients without (70.9% vs. 0.2%, and 5.9% vs. 0, respectively, both p < 0.001). Stratified and interaction analysis showed that HBV reactivation was correlated with high short-term mortality in cirrhosis subgroup (HR = 2.1, p < 0.001). Cirrhotic patients with HBV reactivation had a significantly higher proportion of developing hepatic failure (45.0% vs. 20.3%, p < 0.001), acute-on-chronic liver failure (ACLF; 31.4% vs. 21.8%, p = 0.005), and short-term death (14.0% vs. 5.9% for 28-day, and 23.3% vs. 12.4% for 90-day, both p < 0.001) than those without. HBV reactivation is an independent risk factor of 90-day mortality for cirrhosis patients (OR = 1.70, p = 0.005), as well as hepatic encephalopathy, ascites, and bacterial infection.ConclusionThis study clearly demonstrated that there was a high prevalence of HBV reactivation in CHB patients, which was mainly triggered by discontinued antiviral treatment. The HBV reactivation strongly increased the risk of developing hepatic failure, ACLF and short-term death in HBV-related cirrhotic patients, which may suggest that HBV reactivation would be a new challenge in achieving the WHO target of 65% reduction in mortality from hepatitis B by 2030.https://www.frontiersin.org/articles/10.3389/fmicb.2022.910549/fullacute-on-chronic liver failurecohort studyHepatitis B virus reactivationcirrhosismortality |
| spellingShingle | Ying Zhu Hai Li Xianbo Wang Xin Zheng Yan Huang Jinjun Chen Zhongji Meng Yanhang Gao Zhiping Qian Feng Liu Xiaobo Lu Yu Shi Jia Shang Huadong Yan Yubao Zheng Liang Qiao Yan Zhang Xiaomei Xiang Xiaomei Xiang Yunjie Dan Yunjie Dan Shuning Sun Yixin Hou Qun Zhang Yan Xiong Sumeng Li Jun Chen Zebing Huang Beiling Li Xiuhua Jiang Sen Luo Yuanyuan Chen Na Gao Chunyan Liu Liujuan Ji Wei Yuan Jing Li Tao Li Rongjiong Zheng Xinyi Zhou Haotang Ren Yi Zhou Yi Zhou Baoyan Xu Baoyan Xu Rentao Yu Wenting Tan Wenting Tan Guohong Deng Guohong Deng Hepatitis B Virus Reactivation Increased the Risk of Developing Hepatic Failure and Mortality in Cirrhosis With Acute Exacerbation Frontiers in Microbiology acute-on-chronic liver failure cohort study Hepatitis B virus reactivation cirrhosis mortality |
| title | Hepatitis B Virus Reactivation Increased the Risk of Developing Hepatic Failure and Mortality in Cirrhosis With Acute Exacerbation |
| title_full | Hepatitis B Virus Reactivation Increased the Risk of Developing Hepatic Failure and Mortality in Cirrhosis With Acute Exacerbation |
| title_fullStr | Hepatitis B Virus Reactivation Increased the Risk of Developing Hepatic Failure and Mortality in Cirrhosis With Acute Exacerbation |
| title_full_unstemmed | Hepatitis B Virus Reactivation Increased the Risk of Developing Hepatic Failure and Mortality in Cirrhosis With Acute Exacerbation |
| title_short | Hepatitis B Virus Reactivation Increased the Risk of Developing Hepatic Failure and Mortality in Cirrhosis With Acute Exacerbation |
| title_sort | hepatitis b virus reactivation increased the risk of developing hepatic failure and mortality in cirrhosis with acute exacerbation |
| topic | acute-on-chronic liver failure cohort study Hepatitis B virus reactivation cirrhosis mortality |
| url | https://www.frontiersin.org/articles/10.3389/fmicb.2022.910549/full |
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