Hepatitis Monthly最新文献

{"title":"A Survey of HBV Core/Pre-Core Mutations in Iraqi Patients with Chronic Hepatitis","authors":"Abdul Hussain Sahib Kadhim, Maryam Esghaei, Mohammad Hadi Karbalaie Niya, Hadi Sayah, Mohammad Hossein Razizadeh, Ali Gholami, Leila Mousavizadeh, Hossein Keyvani","doi":"10.5812/hepatmon-137139","DOIUrl":"https://doi.org/10.5812/hepatmon-137139","url":null,"abstract":"Objectives: The present study was conducted to assess the pattern of HBV Core/Pre-Core mutations and HBV genotype in Iraqi patients with chronic hepatitis B virus (HBV) infection. Methods: In the current cross-sectional study in an Iraqi province, we evaluated 134 patients diagnosed with HBV hepatitis. We used PCR and, subsequently, Sanger sequencing to assess HBV Core/Pre-Core mutations. Sanger sequencing reads were further used for phylogenetic analysis and multiple sequence alignment. A phylogenetic tree was generated according to the neighbor-joining method. Results: The current study revealed that 58 (45%) of the patients were male, and 72 (55%) of them were female. The mean age of the patients was 36 ± 12.7 years, and the mean duration of infection was 5.2 ± 4.8 years. The results revealed 21 nucleic acid alterations in the samples analyzed. The generated phylogenetic tree divided samples into two genotypes. Pre-core/Core mutations were significantly associated with the treatment received (P = 0.0.001) but not with laboratory parameters. Most samples were matched with the genotype D clade, while only four samples were positioned adjacent to the genotype E clade. Direct nucleic acid translation disclosed five nucleic acid variants (73T>G, 347T>G, 364A>G, 365T>C, and 366A>G) on the core protein. Conclusions: This study has detected 21 nucleotide variants and 5 amino acid alterations within the coding sequences of the C gene. This study revealed that genotype D represents the primary genotype for the identified viral infections. The current study highlights the importance of these mutations evaluation for future, more comprehensive studies.","PeriodicalId":12895,"journal":{"name":"Hepatitis Monthly","volume":"22 5","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135272223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Plasma Exchange and a Double-Plasma Molecular Absorption System for Treating Immune Checkpoint Inhibitor-Related Hepatitis","authors":"Ying Liu, Lihua Zheng, Wenxiong Xu, Qihuan Xu, Xinhua Li, Qu Lin, Lu Wang, Jing Lai","doi":"10.5812/hepatmon-137153","DOIUrl":"https://doi.org/10.5812/hepatmon-137153","url":null,"abstract":"Background: Immune checkpoint inhibitor (ICI)-related hepatitis has been increasing in the past decade. Objectives: This study aimed to investigate the effectiveness of plasma exchange (PE) and a double-plasma molecular absorption system (DPMAS) for ICI-related hepatitis. Methods: A retrospective analysis was conducted on patients with ICI-related hepatitis treated at the Third Affiliated Hospital of Sun Yat-Sen University (China). The collected data included biochemical indices, treatments, the use of an artificial liver support system (ALSS), and outcomes. Results: From June 2021 to January 2023, 16 patients were treated and included in the analysis. Eight patients in group A received general support. The other 8 patients in group B received general support, plus 3 rounds of ALSS every 2 - 4 days (4 patients were treated with PE and the others with DPMAS + PE). There was no significant difference in age and treatment days between the two groups. Before treatment, there was no significant difference in direct bilirubin (DBIL), glutamine transpeptidase (GGT), alkaline phosphatase (ALP), aspartate transaminase, alanine transaminase (ALT), procalcitonin, the international normalized ratio (INR), model for end-stage liver disease scores, albumin, globulin, and hemocyte count between groups A and B (in all cases, P > 0.05). However, the total bilirubin (TBIL) of group B was significantly higher than that of group A (P = 0.029). After treatment, TBIL and DBIL were significantly decreased in group B (both P < 0.05), and group B had a significantly lower GGT (P = 0.028) and higher INR (P = 0.004) than group A. The ALP level of group B was also lower, but the difference was not significant (P = 0.068). No allergic reaction or severe adverse effect was observed. Conclusions: Both PE and DPMAS + PE can effectively improve ICI-related hepatitis within the short term and are more effective for patients with hyperbilirubinemia. Liver function should be monitored continuously during treatment.","PeriodicalId":12895,"journal":{"name":"Hepatitis Monthly","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135168217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimization and Application of Quantitative In-House ELISA for Diagnosis of HBsAg and its Correlation with Commercial ELISA and Molecular Kits","authors":"Mohammad Ghorbani, Zahra Daryabour, Rahman Shokri, Vahid Kia, Zohreh Sharifi, Mahdi Paryan","doi":"10.5812/hepatmon-133150","DOIUrl":"https://doi.org/10.5812/hepatmon-133150","url":null,"abstract":"Background: Several studies have indicated the role of quantitative hepatitis B surface antigen (HBsAg) evaluation in managing and prognosis of hepatitis B virus (HBV) infection. Thus, quantitative evaluation of HBsAg using cost-effective assays can be an important approach to managing HBV patients. Objectives: This study aimed to set up and apply an in-house quantitative enzyme-linked immunosorbent assay (ELISA) to evaluate HBsAg in research and diagnosis. Methods: New Zealand white rabbits were immunized with HBsAg. Sera were collected 28 days after immunization, and polyclonal HBsAb (antibody to hepatitis B surface antigen) were purified and evaluated. Then, the in-house quantitative ELISA was optimized. Finally, the functional characteristics of the assay were evaluated using 200 plasma samples compared to commercial ELISA and quantitative TaqMan real-time PCR. Results: The assay has a limit of detection (LOD) of 0.5 ng/mL with a specificity and sensitivity of 94% and 97%, respectively. The assay's highest coefficient of variation (CV) values for intra- and inter-assays were 7.23% and 8.59%, respectively. The correlation of the developed assay with commercial ELISA was 0.987 (P-value = 0.024). The correlations of the developed assay and commercial ELISA with quantitative TaqMan real-time PCR were 0.739 and 0.658, respectively (P-value = 0.017). Conclusions: The developed assay has a suitable sensitivity and specificity. It is also reproducible and well-correlated with commercial assays. Most importantly, it is cost-effective and, thus, can be used for detecting and quantifying HBsAg in research and diagnosis.","PeriodicalId":12895,"journal":{"name":"Hepatitis Monthly","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136353093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resveratrol and Saroglitazar: A Promising Combination for Targeting TGF-β/Smad3 Signaling and Attenuating Inflammatory Response in Nonalcoholic Steatohepatitis in Rats","authors":"Mojtaba Rashidi, Reza Afarin, Maryam Kouchak, Benyamin Kabizadeh, Masoumeh Shamsi, Mahdi Hatami","doi":"10.5812/hepatmon-138237","DOIUrl":"https://doi.org/10.5812/hepatmon-138237","url":null,"abstract":"Background: This study aimed to investigate the combined effects of resveratrol (RES) and saroglitazar (SARO) on a high-fat diet (HFD)-induced non-alcoholic fatty liver disease (NAFLD) in a rat model. Methods: In this animal study, rats were treated with RES, SARO, or a combination of both. Male rats were fed with an HFD to induce nonalcoholic steatohepatitis (NASH) and then divided into 4 groups: RES treatment, SARO treatment, combined RES and SARO treatment, and no treatment. Various parameters were measured, including body and liver weight, liver enzymes, gene expression of inflammatory markers and reactive oxygen species (ROS), protein expression levels of transforming growth factor-beta (TGF-β) and p-Smad3, and liver histology. Results: The combination of RES and SARO significantly reduced blood and hepatic lipids, attenuated weight gain, and decreased inflammatory cytokine production in a NAFLD study. The combination diminished hepatic lipid accumulation, oxidative stress, and TGF-β1 expression, suggesting antifibrotic effects. Histological evaluations showed antisteatotic and antifibrotic outcomes of the combined treatment. Improved glycemic index, blood lipids, and reduced NASH indicators (i.e., aspartate aminotransferase [AST] and alanine aminotransferase [ALT]) were observed after 6 weeks. The treatment also decreased ROS and NOX family expression, lessening oxidative stress. The inhibition of the TGF-β-Smad3 pathway in HFD-induced rats resulted in reduced NASH (P < 0.05). Conclusions: The results indicated that the group receiving the combination of RES and SARO showed a more efficient reduction in fibrosis and steatosis in the NASH model induced by an HFD than the groups receiving RES or SARO alone.","PeriodicalId":12895,"journal":{"name":"Hepatitis Monthly","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46687411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of the Benefit of Surgical Treatment for Patients with Hepatocellular Carcinoma with Extrahepatic Metastases: A Nomogram for a Propensity Score Matching Study","authors":"B. Luo, Haichuan Long, Kecheng Zhang, Sikai Wu, Weiwei Chen, Ning Fu, Zhiming Yang, Jingcheng Hao","doi":"10.5812/hepatmon-136351","DOIUrl":"https://doi.org/10.5812/hepatmon-136351","url":null,"abstract":"Background: Most patients with extrahepatic metastases (EHM) from hepatocellular carcinoma (HCC) die from developing the primary tumor within the liver, not from EHM. Although surgery for primary tumors is not recommended in guidelines, some studies suggest that surgical treatment might prolong patient survival. Objectives: This study aimed to develop and validate an easy-to-use nomogram for preoperative assessment by physicians of patients with advanced extrahepatic metastatic hepatocellular carcinoma (HCC-EHM), factors associated with surgical treatment, and probability of benefit. Methods: By searching the SEER database of HCC patients with EHM by propensity score matching (PSM), 912 patients were finally included in the study. The patients in the surgery group were randomly assigned to the training and validation groups (7:3), and a nomogram was constructed to predict whether patients in the surgery group could benefit from receiving surgical treatment at the primary site and to validate the accuracy of the model and the overall survival of the surgery patients at 1, 3, and 5 years. Results: Several factors related to the grade, T staging, NM staging, tumor size, primary site surgery, alpha-fetoprotein (AFP), chemotherapy, and fibrosis score were finally included (P < 0.05). The area under the receiver operating characteristic curve (AUROC/area under the curve (AUC)) was 0.738 and 0.769 for the training and validation groups, respectively. The 1-, 3-, and 5-year survival rates were 0.725, 0.720, and 0.716, respectively. Conclusions: Based on the results, a nomogram can individually predict patients suitable for surgery and provide a reference for clinical decision-making.","PeriodicalId":12895,"journal":{"name":"Hepatitis Monthly","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47040515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of the Effects of the WeChat Health Management Platform on the Self-Care Ability and Quality of Life of Patients with Liver Cancer Undergoing Interventional Therapy","authors":"Jing Li, Youyuan Yuan, Jiaqi Chen, Xueqi Wang","doi":"10.5812/hepatmon-137227","DOIUrl":"https://doi.org/10.5812/hepatmon-137227","url":null,"abstract":"Background: With the popularity of WeChat, Internet-based nursing approaches are gradually being applied to disease care, as they can better meet nursing requirements. Objectives: To explore the impact of the WeChat health management platform on the self-care ability and quality of life of patients with liver cancer undergoing interventional therapy Methods: A total of 82 patients with liver cancer who underwent interventional therapy were selected from January 2020 to January 2021 and randomly divided into the observation (n = 41) and control (n = 41) groups. The control group received routine nursing measures, while the observation group received the new nursing mode based on the WeChat health management platform. The WeChat health management platform can help patients develop health education plans, remind them of follow-up appointments, promote knowledge about nursing measures for liver cancer interventional therapies, provide feedback on medication use to doctors, and strengthen doctor–patient communication. The self-care ability and quality of life of the two groups of patients were compared before and after the intervention. Results: After the intervention, the Hamilton Anxiety Scale (HAMA) and Hamilton Rating Scale for Depression (HAMD) scores were lower in the patients of the observation group than those in the control group, indicating an improvement in the adverse moods and quality of life of patients in the observation group. Also, the psychological, physical, and social functions and overall health scores of patients in the observation group were higher than those in the control group (all P-values < 0.05). Conclusions: The WeChat health management platform could improve the self-care ability of liver cancer patients undergoing interventional therapy and their mood and quality of life, which is worthy of clinical reference.","PeriodicalId":12895,"journal":{"name":"Hepatitis Monthly","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46944485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors for Liver Cirrhosis in Patients with Hepatitis C Virus: A Cross-Sectional Study","authors":"Abolfazl Namazi, A. Sarveazad, Mohsen Khaleghian, Mansour Bahardoost, M. Mokhtare, S. Agah","doi":"10.5812/hepatmon-136164","DOIUrl":"https://doi.org/10.5812/hepatmon-136164","url":null,"abstract":"Background: Cirrhosis is one of the most critical health problems with a great economic burden on the health system. Objectives: This study evaluated cirrhosis predictors in patients with hepatitis C virus (HCV). Methods: A total of 608 patients with HCV were included in the present study within 2011 and 2017 and divided into two groups based on the presence and absence of cirrhosis. Demographic and laboratory data (e.g., blood group, aspartate transaminase (AST), alanine transaminase (ALT), prothrombin time (PT), platelet count, anti-HCV antibodies, and virus level count) were collected by referring to patients’ files and compared between the two groups. Predictive factors were determined using the regression model. Results: In this study, 85 patients (13.9%) had liver cirrhosis. Univariate analysis showed that hepatic enzymes AST, ALT, platelet count, PT, partial thromboplastin time, international normalized ratio, and HCV ribonucleic acid levels in cirrhosis patients were significantly higher than in non-cirrhosis patients (P < 0.05). Adjusted logistic regression analysis showed age < 45 years (adjusted odds ratio (ORAdj): 1.11, P = 0.028), male gender (ORAdj: 2.08, P = 0.023), co-infection with hepatitis B virus (HBV) infection (ORAdj: 2.58, P = 0.001), and alcohol consumption (ORAdj: 1.87, P = 0.001) were predictive factors for cirrhosis in patients with HCV Conclusions: This study showed that in patients with hepatitis C, age > 45 years, male gender, alcohol consumption, and co-infection with HBV significantly increased the risk of liver cirrhosis.","PeriodicalId":12895,"journal":{"name":"Hepatitis Monthly","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44971531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vitamin D Improves the Lipotoxicity of Liver Cells by Adjusting Epigenetic Characteristics of Genes","authors":"Suxia Hu, Reyimu Abdusemer","doi":"10.5812/hepatmon-133758","DOIUrl":"https://doi.org/10.5812/hepatmon-133758","url":null,"abstract":"Background: With the improvement in living standards and the change in eating habits, the prevalence of nonalcoholic fatty liver disease (NAFLD) has gradually increased, and it has become one of the most common chronic liver diseases worldwide. Objectives: In this study, we used vitamin D3 to interfere with the hyperlipidemia-induced NAFLD cell model to explore the mechanism of vitamin D in improving the lipotoxicity of liver cells by regulating the epigenetic characteristics of genes and to provide new clues for the treatment of late-stage NAFLD. Methods: GSE200765, a data chip for vitamin D3 intervention in liver cell lipotoxicity, was screened from the GEO database. They were divided into the control group (untreated), model group (oleic OA/PA), and vitamin D3 intervention group (OA/PA+SV-VD3 group). Differential expression genes between the control group and model group, model group, and vitamin D3 intervention group were screened by the GEO2R tool. Differentially expressed genes construct a target PPI network map through the STRING database and analyze the KEGG pathway of differentially expressed genes in the DAVID database. The t-test or Unpaired t-test with Welch's correction was used to analyze the expression trend of pathway genes. Results: Compared with the control group, 218 genes were up-regulated, and 255 genes were down-regulated in the model group, of which 26 genes were enriched in the complex and coagulation cascades and cell cycle pathways. After oleic OA/PA was added to HepaRG cells, the complex and coordination cascades pathway was relatively weak, and the cell cycle pathway was relatively strong. Compared with the model group, 554 genes were up-regulated, and 704 genes were down-regulated in the vitamin D3 intervention group, of which 23 genes were enriched in the apoptosis pathway. The apoptosis pathway was relatively weakened after vitamin D3 intervened in oleic OA/PA-treated HepaRG cells. The trend analysis of gene expression in the pathway showed that gene expression disorder in the complex and coagulation cascades, cell cycle, and apoptosis pathways were reversed after vitamin D3 intervention. Conclusions: Through bioinformatics, key pathway genes of vitamin D intervention on hepatocyte lipotoxicity were discovered, which were related to the complex and coordination cascades, cell cycles, and apoptosis pathways. The inhibition of vitamin D on lipotoxicity of human hepatocytes and the possible reversal mechanism was found, which provided ideas for the later treatment of NAFLD and hepatocyte damage.","PeriodicalId":12895,"journal":{"name":"Hepatitis Monthly","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44557101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is There any Need for the Early Detection of Non-alcoholic Fatty Liver Disease in Children with Type 1 Diabetes Mellitus?","authors":"Soudeh Salehi, Sanaz Mehrpour, Shahin Koohmanaee, Shohreh Maleknejad, Mohammad Ali Esfandiari, S. Maroufizadeh, Setila Dalili, A. Hassanzadeh Rad","doi":"10.5812/hepatmon-135941","DOIUrl":"https://doi.org/10.5812/hepatmon-135941","url":null,"abstract":"Background: Non-alcoholic fatty liver disease (NAFLD) is the most common cause of liver disorders worldwide. Regarding the shortage of evidence on NAFLD in type 1 diabetes mellitus (T1DM) and the importance of a thorough assessment of complications due to childhood diseases, this study aimed to assess the need for the early detection of NAFLD in children with T1DM. Methods: This cross-sectional study was conducted on 234 children with T1DM referred to 17 Shahrivar Hospital, Rasht, Iran. This study also assessed demographic characteristics, medical history, physical examination, laboratory tests, and hepatic ultrasound. The Mann-Whitney U and chi-square tests were used to compare the children with and without NAFLD. Additionally, univariate and multivariate logistic regressions were used to determine the predictors of NAFLD. Results: This study was conducted on 235 children with T1DM with a median age of 11.0 years (interquartile range (IQR): 8.0 - 14.0) and diabetes duration of 2.0 years (IQR: 1.0 - 4.0). The prevalence of NAFLD was estimated to be 10.2%. The children with NAFLD were significantly older (P = 0.016) and had a larger waist circumference (WC) z-score (P = 0.008) than those without NAFLD. Multiple logistic regression analyses showed that the odds of NAFLD increased with rising age (odds ratio (OR) = 1.29, 95% confidence interval (CI): 1.09 - 1.52) and WC z-score (OR = 2.39, 95% CI: 1.49 - 3.84). The cut-off point for the WC z-score was -0.025 (sensitivity = 58.3%, specificity = 72.0%). Conclusions: The NAFLD frequency in T1DM is relatively low (10.2%) and mainly consists of grade I fatty liver. The NAFLD screening should be further noticed in T1DM children with increasing age and WC as the predictors of NAFLD.","PeriodicalId":12895,"journal":{"name":"Hepatitis Monthly","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43336166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Validation of a Prognostic Nomogram Based on Fibrosis-4 Index to Predict 3-Month Mortality in Patients with Hepatic Encephalopathy","authors":"Yunxuan Guan, Kai Liu, Xiujun Zhang, Caoyan Qi, Xiaolu Chen, Wenhui Zhang, Yan Chen, Yu Ma, Lina Pu, Jiahong Yuan, Niansen Lu, Chaochao Zhang, Yuan Xue","doi":"10.5812/hepatmon-134771","DOIUrl":"https://doi.org/10.5812/hepatmon-134771","url":null,"abstract":"Background: Hepatic encephalopathy is a severe neuropsychiatric complication of decompensated cirrhosis associated with high short-term mortality. Objectives: This study aimed to evaluate the predictive value of non-invasive scoring systems and develop a prognostic nomogram to identify the risk of 3-month mortality in patients with hepatic encephalopathy. Methods: Retrospective data from 251 patients with decompensated cirrhosis and hepatic encephalopathy were collected. Clinical data and non-invasive scoring systems were compared between survivors and non-survivors using univariate and multivariate logistic regression analyses. A prognostic model was developed and validated using bootstrap resampling procedures. Results: Among the 251 patients, 40 (15.9%) died within three months. The non-survivor group had a higher incidence of complications and higher non-invasive scores (all P < 0.01). Multivariate analysis revealed that hepatorenal syndrome, spontaneous bacterial peritonitis, upper gastrointestinal bleeding, and Fibrosis-4 index were independent risk factors. A new model incorporating the Fibrosis-4 index and complications was developed, and discrimination was assessed using a bootstrap-corrected C statistic of 0.831. The area under the receiver operating characteristic curve of the new model (0.840, 95% confidence interval: 0.789 - 0.883) was significantly higher than that of the non-invasive scoring systems (all P < 0.05). The calibration plot and Hosmer-Lemeshow test (P = 0.771) showed good calibration accuracy. Kaplan-Meier survival analysis showed that the cumulative survival rate in the high-risk group was significantly lower (P < 0.01). Conclusions: The prognostic nomogram consisting of the Fibrosis-4 index and complications can effectively predict the risk of 3-month mortality in patients with hepatic encephalopathy.","PeriodicalId":12895,"journal":{"name":"Hepatitis Monthly","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48594484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}