title: Correlation between high mobility group box-1 protein and chronic hepatitis B infection with severe hepatitis B and acute-on-chronic liver failure: a meta-analysis.
abstract: BACKGROUND
  The aim of this study was to evaluate the correlation of High-mobility group box 1 (HMGB1) expression in the serum with chronic hepatitis B (CHB) related liver fibrosis, severe hepatitis B and acute-on-chronic liver failure (ACLF).
  
  
  METHODS
  We made a literature search in PubMed, Embase, Web of Science, Medline, Google Scholar, China National Knowledge Infrastructure, WanFang with no language restriction. Pooled data were analyzed and mean difference with corresponding 95% confidence intervals were calculated.
  
  
  RESULTS
  A total of 16 relevant studies were identified. HMGB1 serum levels were higher in severe hepatitis B or ACLF patients than those in CHB patients. Pooled mean differences of HMGB1 in severe hepatitis B and ACLF patients compared with CHB patients were 4.32 (95% CI: 0.34-8.29, Z=2.13, I2=59%, P=0.03) and 15.96 (95% CI: -0.37-32.28, Z=1.92, P=0.06). Four studies showed there was a different HMGB1 expression in mild, moderate and severe CHB patients (P values were <0.05, <0.05, <0.05 and <0.01, respectively). Pooled mean difference of HMGB1 in low liver fibrosis patients compared with high liver fibrosis was -125.38 (95% CI: -539.44-288.68, Z=0.59, I2=98%, P=0.55).
  
  
  CONCLUSIONS
  The results suggested that HMGB1 levels in the serum were statistically higher in severe hepatitis B and ACLF patients. Therefore, HMGB1 may be a useful therapeutic target for severe hepatitis B and ACLF diagnosis.
authors.affiliation: Department of Infectious Diseases, the Third Affiliated Hospital of Wenzhou Medical University, Rui'an, China.
authors.forename: Yi-Bing
authors.initials: YB
authors.lastname: Hu
authors.affiliation: Department of Infectious Diseases, the Third Affiliated Hospital of Wenzhou Medical University, Rui'an, China.
authors.forename: Dan-Ping
authors.initials: DP
authors.lastname: Hu
authors.affiliation: Department of Infectious Diseases, the Third Affiliated Hospital of Wenzhou Medical University, Rui'an, China - yibing_hu90@163.com.
authors.forename: Rong-Quan
authors.initials: RQ
authors.lastname: Fu
mesh_terms: D065290:Acute-On-Chronic Liver Failure / Q000097:blood*; D024243:HMGB1 Protein / Q000097:blood*; D019694:Hepatitis B, Chronic / Q000097:blood* / Q000150:complications; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood* / Q000209:etiology; D012720:Severity of Illness Index
chemical_list: D024243:HMGB1 Protein