Introduction to Acute Exacerbation of Chronic Hepatitis B (AECHB)

Ning, Qin; Guo, Wei; Li, Weina; Wang, Xiaojing; Ma, Ke

doi:10.1007/978-94-024-1606-0_1

Cited by 1 publication

(1 citation statement)

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“…Acute-on-chronic liver failure (ACLF) is a prevalent kind of liver failure in which patients acquire acute or subacute liver failure as a result of chronic liver disease [ 1 ]. Meanwhile, patients with acute-on-chronic liver failure are more susceptible to fungal infections, particularly the rising incidence of invasive pulmonary aspergillosis (IPA), which has been reported to be as high as 5.0–8.3% [ 2 – 4 ], with a significant increase in short-term mortality (73.5–100%) [ 2 , 3 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of voriconazole in the treatment of invasive pulmonary aspergillosis in patients with liver failure: study protocol for a randomized controlled clinical trial

Yu,

Xu,

Zheng

et al. 2023

Trials

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Background Acute-on-chronic liver failure (ACLF) is a common clinical type of liver failure, and patients with acute-on-chronic liver failure are prone to fungal infections, especially the increasing incidence of invasive pulmonary aspergillosis (IPA). Voriconazole is recommended as the first-line antifungal agent in the treatment of invasive aspergillosis; however, no recommendation has been given for patients with severe liver cirrhosis (Child–Pugh C) and liver failure. This trial aims to examine the therapeutic effects and safety of voriconazole in the treatment of IPA in patients with liver failure. Methods This study is a non-double-blind randomized controlled trial. The 96 eligible acute-on-chronic liver failure patients complicated with invasive pulmonary aspergillosis will be randomly assigned to receive either the optimized voriconazole regimen or the recommended voriconazole regimen for patients with mild to moderate liver cirrhosis (Child–Pugh A and B), at a 1:1 ratio, with an 8-week follow-up period. The antifungal efficacy of voriconazole will be the primary outcome measure. Plasma voriconazole trough concentration, the laboratory examination (CRP, PCT, ESR, etc.), chest CT, adverse events, and mortality at week 4 and 8 will be the secondary outcome measures. Discussion This trial aims to demonstrate the efficacy and safety of voriconazole in the treatment of IPA in patients with liver failure, which is expected to provide a reference for scientific optimization of voriconazole regimens and a realistic basis for the standardized treatment of acute-on-chronic liver failure patients complicated with invasive pulmonary aspergillosis. Trial registration The trial was registered with the Chinese Clinical Trial Registry, ChiCTR2100048259. Registered on 5 July 2021.

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