Posaconazole demonstrates efficacy as prophylaxis against IFI in high-risk neutropenic Chinese patients and is well tolerated during long-term use (ClinicalTrials. gov number, NCT00811928).
Serum miR-29 levels are negatively correlated with liver fibrotic stages and necroinflammation grades in patients with chronic HBV infection. miR-29 appears to be a novel biomarkers for predicting disease progression in these patients.
Objective
To investigate retrospectively the efficacy of steroids in patients with acute‐on‐chronic liver failure (ACLF) precipitated by hepatitis B.
Methods
Patients with ACLF precipitated by hepatitis B were included and categorized according to treatment modalities (steroid vs. control). Survival and clinical characteristics, including patients’ age, baseline ACLF grade, the model for end‐stage liver disease (MELD) score, and occurrence of infection were compared between the two groups. Survival analyses of subgroups classified by their age, ACLF grade and MELD score were performed. Cox regression analyses were conducted to identify factors associated with 60‐day cumulative and transplant‐free mortality.
Results
From 2007 to 2016, 293 patients with hepatitis B‐precipitated ACLF were recruited, among whom 162 received at least five consecutive doses of corticosteroids. By day 60 transplant‐free survival was 62.6% in the control group compared with 53.7% in the steroid group (P = 0.126). Steroid treatment failed to show a survival benefit in the survival analysis among the subgroup. Within 60 days, pulmonary and overall infections occurred with higher frequency in the steroid‐treated group than in the controls (P = 0.003 and < 0.001, respectively). In the univariate analysis, age, baseline MELD score >20, CLIF consortium (CLIF‐C) ACLF grade 2‐3, pulmonary infection and overall infection were associated with 60‐day mortality. In the multivariate analysis, older age, baseline MELD score >20 and CLIF‐C ACLF grade 2‐3 were independent risk factors of 60‐day mortality.
Conclusion
Steroid treatment did not improve transplant‐free survival in patients with ACLF precipitated by hepatitis B.
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