Work

The clinical value of combined assessment of inflammatory biomarkers and liver reserve function in predicting the 12-week prognosis of HBV-ACLF

Year: 2025

Type: article

Abstract: BACKGROUND: Hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) represents a serious clinical condition characterized by acute deterioration of liver function in patients with chronic liver disease. Prompt and precise prognostic assessment is key to guiding therapy and improving clinical outcomes. OBJECTIVE: To investigate the clinical value of combined assessment of inflammatory biomarkers and liver reserve function indicators in predicting the 12-week prognosis of patients with HBV-ACLF. METHODS: We analyzed clinical data from 150 HBV-ACLF patients admitted between July 2022 and December 2024. Patients were followed for 12 weeks and categorized into survival or death groups. Baseline data included inflammatory biomarkers [Neutrophil count (NEUT), Lymphocyte count (LYM), Monocyte count (MON), Platelet count (PLT), Procalcitonin (PCT)] and liver function indicators [Albumin (ALB), Alanine aminotransferase (ALT), Aspartate aminotransferase (AST), Total bilirubin (TBIL), International normalized ratio (INR)]. Pearson correlation analysis was performed for statistically significant indicators. The construction of the combined prediction model for 12-week prognosis of HBV-ACLF was performed using multivariate logistic regression analysis. The application value of combining inflammatory biomarkers with liver reserve function indicators in the 12-week prognostic assessment of HBV-ACLF was evaluated using ROC curve analysis. P-value <0.05 was considered statistically significant. RESULTS: Among the 150 patients with HBV-ACLF, 102 survived and 48 died. Compared to the survival group, patients in the death group were significantly older (P = 0.032) and included a lower proportion of males (P = 0.001). Among the laboratory indicators, the death group had significantly elevated NEUT, TBIL, INR, and PCT levels (P < 0.05), while LYM, PLT, and ALB levels were significantly decreased (P < 0.05). Pearson correlation analysis revealed that age (r = 0.175, P = 0.032), NEUT (r = 0.184, P = 0.024), TBIL (r = 0.272, P = 0.001), and PCT (r = 0.161, P = 0.049) were positively correlated with prognosis, while gender (r = -0.272, P = 0.001), LYM (r = -0.188, P = 0.021), PLT (r = -0.189, P = 0.021), and ALB (r = -0.197, P = 0.015) were negatively correlated. ROC curve analysis revealed that the AUCs for predicting the 12-week prognosis using NEUT, LYM, PLT, ALB, TBIL, and PCT alone were 0.615, 0.696, 0.616, 0.620, 0.671, and 0.608, respectively. When combined, the AUC significantly increased to 0.817 (P < 0.001), with a sensitivity of 79.17 % and a specificity of 76.47 %, indicating that combined indicators can more accurately predict the prognosis of patients with HBV-ACLF. CONCLUSION: The combined assessment of inflammatory biomarkers and liver reserve function indicators can provide a more comprehensive and accurate evaluation of the disease severity in patients with HBV-ACLF and holds significant clinical value in predicting their 12-week prognosis.

Source: Immunobiology

DOI: 10.1016/j.imbio.2025.153147

Authors: Ke Luo, Tianhuang Liu

Institution: Meizhou City People's Hospital

Language: English

Topic: Liver Disease and Transplantation

Subfield: Hepatology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,840