Effect of Nucleos(t)ide Analogues Withdrawal on Survival Outcomes in Patients With Hepatitis B Virus-Related Acute-on-Chronic Liver Failure

Abstract

Nucleos(t)ide analogues (NA) withdrawal is an important cause of hepatitis B virus (HBV) infection relapse or flare, potentially triggering HBV-related acute-on-chronic liver failure (HBV-ACLF). Although both NA withdrawal and spontaneous severe acute exacerbation (SAE) of chronic hepatitis B are recognised HBV-ACLF triggers, comparative evidence regarding their distinct clinical trajectories remains absent. This multicenter retrospective cohort study sought to determine whether NA withdrawal independently predicts adverse outcomes in HBV-related ACLF compared to SAE-induced cases.