Progress in HBV Related Liver Failure Treatment in China: A Large, Multicenter, Retrospective Cohort Study

Background & Aims: HBV related liver failure is a complicated syndrome with a high short-term mortality rate. We collected clinical data from a representative sample of the China population from a number of centers, to explore how treatment of HBV related liver failure in the past decade has developed. Methods: Cohort I data were from 2007 to 2011 and cohort II data were from 2012 to 2016. Patients with HBV related liver failure were enrolled retrospectively. Patients of both cohorts were assigned to standard medical therapy (SMT) group (cohort I-SMT; cohort II-SMT) and artificial liver support system (ALS) group (cohort I-ALS; cohort II-ALS). Propensity score matching analysis was used to eliminate the baseline differences between these groups. The short-term (28/56 days) survival rates were compared between the two cohorts. Results: The short-term (28/56 days) survival rate was higher in ALS group than SMT group (60.0%vs 54.8%; 47.5% vs 42.8%, p < 0.05, respectively). The short-term (28/56 days) survival rates were higher in cohort II than cohort I (63.2% vs 54.4%; 51.1% vs 41.2%, p < 0.001, respectively). After propensity score matching, the short-term (28/56 days) survival rates were higher in cohort II than cohort I for both SMT treatment (60.7% vs 53%; 50% vs 39.8%, p < 0.05) and ALS treatment (66.1% vs 56.5%; 53% vs 44.4%, p < 0.05). The short-term (28/56 days) survival rate was higher treated with nucleos(t)ide analogues than without nucleos(t)ide analogues. Conclusions: By analyzing nationwide data from China, we found that treatment for HBV related liver failure has progress in the past decade and that antiviral and ALS treatment can significantly reduce mortality. Funding Statement: This project was funded in part by the Science & Technology Key Program of Zhejiang China, No.#2017C03051. Declaration of Interests: The authors stated: None declared. Ethics Approval Statement: The study was performed in accordance with the Declaration of Helsinki, approved by the Clinical Research Ethics Committee of the First Affiliated Hospital, Zhejiang University School of Medicine, China. Appropriate approvals were obtained from patients or their legal surrogates before enrollment.