title: Advanced therapeutic strategies for HBV-related acute-on-chronic liver failure.
abstract: BACKGROUND
  Acute-on-chronic liver failure (ACLF) is increasingly recognized as a distinct clinical entity and is associated with a high short-term mortality. The most common cause of ACLF is chronic hepatitis B worldwide. Currently, there is no standardized approach for the management of ACLF and the efficacy and safety of therapeutic modalities are uncertain.
  
  
  METHODS
  PubMed and Web of Science were searched for English-language articles. The search criteria focused on clinical trials and observational studies on the treatment of patients with HBV-related ACLF.
  
  
  RESULTS
  Therapeutic approaches for ACLF in patients with chronic hepatitis B included nucleos(t)ide analogues, artificial liver support systems, immune regulatory therapy, stem cell therapy and liver transplantation. All of these therapeutic approaches have shown the potential to improve liver function and increase patients' survival rate, but most of the studies were not randomized or controlled.
  
  
  CONCLUSIONS
  Substantial challenges for the treatment of HBV-related ACLF remain and further basic research and randomized controlled clinical trials are needed.
authors.affiliation: Liver Diseases Center, Second Xiangya Hospital, Central South University, Changsha 410011, China. drchenjun@163.com.
authors.forename: Xin-Yu
authors.initials: XY
authors.lastname: Liu
authors.forename: Feng
authors.initials: F
authors.lastname: Peng
authors.forename: Ya-Jie
authors.initials: YJ
authors.lastname: Pan
authors.forename: Jun
authors.initials: J
authors.lastname: Chen
mesh_terms: D065290:Acute-On-Chronic Liver Failure / Q000175:diagnosis / Q000401:mortality / Q000628:therapy* / Q000821:virology; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D019694:Hepatitis B, Chronic / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D006801:Humans; D007167:Immunotherapy / Q000009:adverse effects / Q000379:methods*; D016031:Liver Transplantation / Q000009:adverse effects; D019164:Liver, Artificial / Q000009:adverse effects; D012307:Risk Factors; D033581:Stem Cell Transplantation / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents