# Clinical characteristics and prognosis of patients with HBV-ACLF versus ALD-ACLF: a retrospective comparative study

## TL;DR

This study compares the clinical features and outcomes of patients with two types of liver failure caused by hepatitis B and alcohol, finding similar prognoses but different risk factors.

## Contribution

The study identifies distinct risk factors for 90-day mortality in HBV-ACLF and ALD-ACLF patients, offering insights into their clinical management.

## Key findings

- ALD-ACLF patients had higher WBC, N, and M levels but lower ALT, AST, ALB, K, and Na compared to HBV-ACLF patients.
- TBIL and PT were independent mortality risk factors in HBV-ACLF, while WBC, TBIL, and PT were linked to mortality in ALD-ACLF.
- No significant differences in overall prognosis were observed between the two groups.

## Abstract

This study aims to investigate the differences in clinical characteristics and prognosis between patients with HBV-ACLF (Hepatitis B Virus-related Acute-on-Chronic Liver Failure) and those with ALD-ACLF (Alcohol-Associated Acute-on-Chronic Liver Failure), and to identify risk factors associated with 90-day mortality in both cohorts.

This study enrolled 56 patients with HBV-ACLF and 83 patients with ALD-ACLF to compare their clinical characteristics and conduct analyses of risk factors associated with 90-day prognosis.

Compared with the HBV-ACLF cohort, the ALD-ACLF group exhibited a higher proportion of male patients and a greater prevalence of ascites. Additionally, significant differences were observed in laboratory parameters, with ALD-ACLF patients showing higher levels of WBC (white blood cells), N (neutrophils), and M (monocytes) but lower levels of ALT (alanine aminotransferase), AST (aspartate aminotransferase), ALB (albumin), K (potassium), and Na (sodium) compared to HBV-ACLF patients (p < 0.05). In terms of prognostic factors, TBIL (total bilirubin) and PT (prothrombin time) were identified as independent risk factors for 90-day mortality in HBV-ACLF patients, while WBC, TBIL, and PT were associated with 90-day mortality in ALD-ACLF patients.

Patients with ALD-ACLF typically present with a higher prevalence of comorbidities, such as ascites and infections, compared to those with HBV-ACLF. However, no significant differences in prognosis were observed between the two cohorts. For HBV-ACLF patients, elevated TBIL and prolonged PT were identified as independent risk factors for 90-day mortality. In contrast, in addition to TBIL and PT, elevated white WBC was also associated with 90-day mortality in ALD-ACLF patients. These findings warrant further validation through multicenter studies with larger sample sizes.