Photo Credit: Myboxpra

The following is a summary of “Alpha-fetoprotein and APRI as predictive markers for patients with Type C hepatitis B-related acute-on-chronic liver failure: a retrospective study,” published in the June 2024 issue of Gastroenterology by Li et al.

Type C hepatitis B-related acute-on-chronic liver failure (HBV-ACLF), a severe liver condition with variable presentations, necessitates unique prognostic markers.

Researchers conducted a retrospective study to develop a scoring system based on liver function and fibrosis markers to predict outcomes in patients with type C HBV-ACLF.

They conducted a 90-day observation on patients with type C HBV-ACLF. They gathered Demographic details, clinical assessments, and lab findings of the participants. Univariate and multivariate logistic regressions were executed to pinpoint autonomous prognostic factors and devise an innovative prognostic scoring system. A receiver operating characteristic (ROC) curve was utilized to scrutinize the model’s performance.

The results showed 224 patients with type C HBV-ACLF with a 90-day OS rate of 47.77%. Age, total bilirubin (TBil), international normalized ratio (INR), alpha-fetoprotein (AFP), white blood cell (WBC), serum sodium (Na), and aspartate aminotransferase/platelet ratio index (APRI) emerged as autonomous prognostic factors. A fresh prognostic model (named the A3Twin score) was devised following logistic regression analysis. The AUC of the ROC was 0.851 [95% CI (0.801-0.901)], with a sensitivity of 78.8% and specificity of 71.8%, markedly surpassing those of the MELD, IMELD, MELD-Na, TACIA, and COSSH‐ACLF II scores (all P<0.001). Patients with lower A3Twin scores (<-9.07) exhibited prolonged survival.

Investigators concluded a new scoring system using seven standard lab tests that accurately predicted short-term mortality in patients with type C HBV-ACLF, potentially aiding clinical decision-making.

Source: bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-024-03276-x