title: Entecavir treatment prevents disease progression in hepatitis B virus-related acute-on-chronic liver failure: establishment of a novel logistical regression model.
abstract: BACKGROUND
  Hepatitis B-related acute-on-chronic liver failure (ACLF) has a poor prognosis with very high mortality. Unfortunately, most prognostic predictive models of liver failure are complicated and offer suboptimal sensitivity. Experience in entecavir (ETV)-treated patients with hepatitis B virus (HBV)-ACLF is limited.
  
  
  OBJECTIVE
  This study was designed to evaluate the efficacy and safety of ETV in patients with HBV-ACLF and to develop a novel model (Tongji prognostic predictor model, TPPM) for prognostic prediction of HBV-ACLF patients.
  
  
  METHODS
  In this retrospective study, 248 patients with HBV-ACLF were enrolled. There were no significant differences in baseline clinical and virologic characteristics between patients treated with and without ETV.
  
  
  RESULTS
  The 1- and 3-month survival rates of patients in the ETV-treated group (n = 124) were 72.58 and 61.29%, respectively, significantly higher than that in NA-free group (n = 124), which were 53.23 and 45.97%, respectively. By Hosmor and Lemeshow test, TPPM for HBV-ACLF had a very good degree of fit with disease prognosis. Based on this unique group of patients, the TPPM scoring offered a better prediction value in both specificity and sensitivity for 3-month mortality of patients with HBV-ACLF compared with MELD scoring system with statistically significant difference. In the patients with HBV-ACLF, using a cutoff of 0.22 for 3-month predicted mortality by TPPM, the positive predictive value was 93.6% and negative predictive value 91.3%.
  
  
  CONCLUSIONS
  ETV treatment prevented disease progression and increased the survival of patients with HBV-ACLF. The established TPPM scoring system offers superior predictor value in both specificity and sensitivity for HBV-ACLF patients when compared with MELD.
authors.affiliation: Department of Infectious Disease, Tongji Hospital, Tongji Medical College, University of Science and Technology, No 1095, Jiefang Avenue, 430030, Wuhan, China.
authors.forename: Ke
authors.initials: K
authors.lastname: Ma
authors.affiliation: Department of Infectious Disease, Tongji Hospital, Tongji Medical College, University of Science and Technology, No 1095, Jiefang Avenue, 430030, Wuhan, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Guo
authors.affiliation: Department of Infectious Disease, Tongji Hospital, Tongji Medical College, University of Science and Technology, No 1095, Jiefang Avenue, 430030, Wuhan, China.
authors.forename: Meifang
authors.initials: M
authors.lastname: Han
authors.affiliation: Department of Infectious Disease, Tongji Hospital, Tongji Medical College, University of Science and Technology, No 1095, Jiefang Avenue, 430030, Wuhan, China.
authors.forename: Guang
authors.initials: G
authors.lastname: Chen
authors.affiliation: Department of Infectious Disease, Tongji Hospital, Tongji Medical College, University of Science and Technology, No 1095, Jiefang Avenue, 430030, Wuhan, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Chen
authors.affiliation: Department of Infectious Disease, Tongji Hospital, Tongji Medical College, University of Science and Technology, No 1095, Jiefang Avenue, 430030, Wuhan, China.
authors.forename: Zenguang
authors.initials: Z
authors.lastname: Wu
authors.affiliation: Department of Infectious Disease, Tongji Hospital, Tongji Medical College, University of Science and Technology, No 1095, Jiefang Avenue, 430030, Wuhan, China.
authors.forename: Daofeng
authors.initials: D
authors.lastname: Yang
authors.affiliation: Department of Infectious Disease, Tongji Hospital, Tongji Medical College, University of Science and Technology, No 1095, Jiefang Avenue, 430030, Wuhan, China.
authors.forename: Jiaquan
authors.initials: J
authors.lastname: Huang
authors.affiliation: Department of Infectious Disease, Tongji Hospital, Tongji Medical College, University of Science and Technology, No 1095, Jiefang Avenue, 430030, Wuhan, China.
authors.forename: Yuancheng
authors.initials: Y
authors.lastname: Huang
authors.affiliation: Department of Infectious Disease, Tongji Hospital, Tongji Medical College, University of Science and Technology, No 1095, Jiefang Avenue, 430030, Wuhan, China.
authors.forename: Xiping
authors.initials: X
authors.lastname: Zhao
authors.affiliation: Department of Infectious Disease, Tongji Hospital, Tongji Medical College, University of Science and Technology, No 1095, Jiefang Avenue, 430030, Wuhan, China.
authors.forename: Deying
authors.initials: D
authors.lastname: Tian
authors.affiliation: Department of Infectious Disease, Tongji Hospital, Tongji Medical College, University of Science and Technology, No 1095, Jiefang Avenue, 430030, Wuhan, China.
authors.forename: Jianxin
authors.initials: J
authors.lastname: Song
authors.affiliation: Department of Infectious Disease, Tongji Hospital, Tongji Medical College, University of Science and Technology, No 1095, Jiefang Avenue, 430030, Wuhan, China.
authors.forename: Junying
authors.initials: J
authors.lastname: Qi
authors.affiliation: Department of Infectious Disease, Tongji Hospital, Tongji Medical College, University of Science and Technology, No 1095, Jiefang Avenue, 430030, Wuhan, China. qning@tjh.tjmu.edu.cn.
authors.forename: Qin
authors.initials: Q
authors.lastname: Ning
keywords: Acute-on-chronic liver failure; Entecavir; Hepatitis B virus; Scoring model