Viral Hepatitis and Acute-on-Chronic Liver Failure

Talal Khushid Bhatti; Ashwani K Singal; Paul Y Kwo

doi:10.1016/j.cld.2023.03.006

Viral Hepatitis and Acute-on-Chronic Liver Failure

Clin Liver Dis. 2023 Aug;27(3):617-630. doi: 10.1016/j.cld.2023.03.006. Epub 2023 Apr 23.

Authors

Talal Khushid Bhatti¹, Ashwani K Singal², Paul Y Kwo³

Affiliations

¹ Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan.
² University of SD Sanford School of Medicine, Sioux Falls, SD, USA.
³ Stanford University School of Medicine, Palo Alto, CA, USA. Electronic address: pkwo@stanford.edu.

PMID: 37380286
DOI: 10.1016/j.cld.2023.03.006

Abstract

Acute-on-chronic liver failure (ACLF) is a potentially reversible syndrome that develops in patients with cirrhosis or with underlying chronic liver disease (CLD) and is characterized by acute decompensation, organ failure, and high short-term mortality. Hepatitis A and hepatitis E are major causes of ACLF. Hepatitis B may also cause ACLF through a flare of hepatitis B, acute infection, or reactivation. Besides supportive care, nucleoside/nucleotide analog therapy should also be initiated in this setting. Nonhepatotropic viruses may rarely also cause ACLF with the severe acute respiratory syndrome coronavirus 2 virus recently being identified with poorer outcomes in those with underlying CLD.

Keywords: Acute-on-chronic liver failure; EBV; Hepatitis A; Hepatitis B; Hepatitis C; Hepatitis D; Hepatitis E; SARS-CoV-2.

Publication types

Review

MeSH terms

Acute-On-Chronic Liver Failure* / etiology
Acute-On-Chronic Liver Failure* / therapy
COVID-19*
Hepatitis B*
Hepatitis E* / complications
Hepatitis E* / epidemiology
Humans
Liver Cirrhosis / complications