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EARLY FACTORS RESPONSIBLE FOR PROGRESSION OF HEPATITIS B TO LIVER FAILURE

Dr. Ayesha Zahoor, Dr. Kanwal Shahzadi, Dr. Shaiza Sharif

Abstract: Retrospective study was conducted on 293 patients with hepatitis B infection and were divided into acute liver failure and non-acute liver failure ALF(13) and non-ALF(280) group. 13 patients out of 293 developed ALF, out of which 3 died and 7 survived. Variables like age, anti-HBc IgM titers≥10 S/CO, HBeAg negativity, and serum bilirubin at the time of enrollment was higher in ALF group as compared to non-ALF group. PT and APTT values were lower in ALF group. At discharge, ALF patients had lower TB normalization rates and early clearance of HBsAg, HBeAg and HBVDNA than non-ALF patients. In multivariate analysis, two independent predictor factors for prediction of ALF progression at time of enrollment were TB≥5×upper limit of normal (ULN) and HBeAg negative status, with 84.6% sensitivity, 85.7% specificity, a most likely ratio of 5.91 and an area under the receiver operating characteristics curve (AUROC) of 0.850. Lower levels of peak PTA (<20%) and higher levels of peak hepatic encephalopathy (HE) grade (III-IV) was observed in those who died than those who survived. Key Words: hepatitis B, hepatic failure, factors.

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