Plasma Apolipoprotein A-V Predicts Long-term Survival in Chronic Hepatitis B Patients with Acute-on-Chronic Liver Failure

Abstract

Hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) is a life-threatening condition, and the lipid metabolism disorder is common in the development of this disease. This prospective observational study aimed to define the characteristics of plasma apolipoprotein A-V (apoA-V) in long-term outcome prediction of HBV-ACLF, and a total of 330 HBV-ACLF patients were included and followed for more than 12 months. In this cohort, the 4-week, 12-week, 24-week and 48-week cumulative mortality of HBV-ACLF was 18.2%(60/330), 50.9%(168/330), 59.7%(197/330) and 63.3%(209/330), respectively. As compared to survivors, the non-survivors had significantly lower concentrations of plasma apoA-V on admission. Plasma apoA-V concentrations were positively correlated with prothrombin time activity (PTA), and negatively correlated with interleukin-10, tumor necrosis factor-α, and iMELD scores. Though plasma apoA-V, PTA, total bilirubin(TBil) and blood urea nitrogen(BUN) were all independent factors to predict one-year outcomes of HBV-ACLF, plasma apoA-V had the highest prediction accuracy. And its optimal cutoff value for one-year survival prediction was 480.00 ng/mL, which had a positive predictive value of 84.68% and a negative predictive value of 92.23%. In summary, plasma apoA-V decreases significantly in non-survivors of HBV-ACLF, and it may be regarded as a new predictive marker for the prognosis of patients with HBV-ACLF.

Correlation of Small Dense Low Density Lipoprotein, Tumour Necrosis Factor - alpha with Liver Enzymes in Chronic Hepatitis B Patients

“…Our findings also revealed a significant positive correlation with between sdLDL and hepatic aminotransferases. This agrees with findings of previous studies that reported significant rise in AST and ALT in proportion to raised LDL and triglycerides levels in patients with HBV infection [13, [34][35][36].…”

Effect of Hepatitis B Virus (HBV) Infection on Lipid Profile in Ghanaian Patients

“…19 HDL and major apolipoproteins, apoAI and apoAII, were also reduced in patients suffering from cirrhosis or HCC due to chronic HBV infection. 17,19 The current study showed increased levels of TG, LDL and VLDL in the HBV infected patients compared to the control groups, and is consistent with findings reported by Nonogaki et al 20…”

“…19 HDL and major apolipoproteins, apoAI and apoAII, were also reduced in patients suffering from cirrhosis or HCC due to chronic HBV infection. 17,19 The current study showed increased levels of TG, LDL and VLDL in the HBV infected patients compared to the control groups, and is consistent with findings reported by Nonogaki et al 20 Elevated LDL is an indicator of increased risk to cardiovascular related complications. 21 The linear model from the statistical analysis suggested that 71% variation in CVDR can be explained by age, T. chol, TG, HDL and LDL.…”

Apolipoprotein A5 alleviates LPS/d-GalN-induced fulminant liver failure in mice by inhibiting TLR4-mediated NF-κB pathway

“…Additionally, ApoA5 may act as an early predictor for remnant liver growth after preoperative portal vein embolization and liver surgery as plasma TG influences the process of liver regeneration and ApoA5 controls and determines TG levels [13]. In our previous study, we also found ApoA5 predicted the prognosis of hepatitis B virus-associated acute-on-chronic liver failure (HBV-ACLF) [14]. Except for the potential of predicting the outcomes of HBV-ACLF, we speculated that ApoA5 may also be a potential target for clinical intervention based on the fact that disorder of lipid metabolism can produce abundant toxic metabolites in the liver to induce and aggravate liver injury.…”