biostudies-literatureWang LNatural Science Foundation of Chinathe National major science and technology project for the prevention and treatment of AIDS and viral hepatitisSun Yat-Sen University Clinical Research 5010 ProgramGuangzhou Municipal Science and Technology ProjectResearch project on degree and postgraduate education reform in Guangdong provinceYoung teacher training program of Sun Yat-Sen universitythe Five-Year Plan of Third Affiliated Hospital of Sun Yat-Sen University162https://www.ebi.ac.uk/biostudies/studies/S-EPMC8976971biostudies-literatureUnknown22(1)<h4>Background</h4>The long-term prognosis of patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) is not well characterised. We assessed long-term outcomes and the associated risk factors of HBV-ACLF patients in southern China.<h4>Methods</h4>We retrospectively analysed clinical data, adverse events, and clinical endpoint events of HBV-ACLF patients treated at our department between January 2014 and December 2018.<h4>Results</h4>A total of 616 (52.3%) patients with cirrhosis and 561 (47.7%) patients without cirrhosis were included. In 973 (83%) patients, the disease was associated only with HBV, while 204 (17%) patients had two or more aetiological factors. The proportion of patients receiving antiviral treatment for HBV was low (20.3%). Further analyses indicated that patients without cirrhosis had a significantly lower 90-day liver transplantation-free mortality and higher 5-year survival rate than those with cirrhosis (59.5% vs. 27.6%; 62% vs. 36%; P < 0.05). Remarkably, self-withdrawal of nucleos(t)ide analog (NA) was an independent risk factor for short-term prognosis. Age, cirrhosis at admission, and platelet level were closely related to long-term prognosis of HBV-ACLF patients.<h4>Conclusion</h4>The proportion of HBV-ACLF patients receiving antiviral treatment is very low in south China. Cirrhosis at admission has a significant effect on both short-term and long-term prognosis. No significant improvement in the short-term prognosis of HBV-ACLF patients was observed compared with previous studies. More comprehensive access to antiviral treatment and long-term surveillance of HBV patients are key imperatives to reduce the incidence of HBV-ACLF and improve the prognosis. Trial Registration The trial was registered at ClinicalTrials.gov (CT.gov identifier: NCT04231565) on May 13, 2020: https://register.<h4>Clinicaltrials</h4>gov/prs/app/action/SelectProtocol?sid=S0009OZY&selectaction=Edit&uid=U00036P1&ts=2&cx=27seqt.BMC gastroenterologyLong-term prognosis of patients with hepatitis B virus-related acute-on-chronic liver failure: a retrospective study.PMC89769712018009 to CX, 2020007 to LP16ykpy40 to CX2018JGXM04 to CXK00006 to LPNo. 81873572 to LP , 82070611 to LP201904010442 to CX, 202102010204 to LP2018ZX10302204-002 to LP, 2018ZX10302205-002 to CXLi XLuo QZhang YChen YPeng LXu WWang JXie CWang LChen DfalseLong-term prognosis of patients with hepatitis B virus-related acute-on-chronic liver failure: a retrospective study.<h4>Background</h4>The long-term prognosis of patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) is not well characterised. We assessed long-term outcomes and the associated risk factors of HBV-ACLF patients in southern China.<h4>Methods</h4>We retrospectively analysed clinical data, adverse events, and clinical endpoint events of HBV-ACLF patients treated at our department between January 2014 and December 2018.<h4>Results</h4>A total of 616 (52.3%) patients with cirrhosis and 561 (47.7%) patients without cirrhosis were included. In 973 (83%) patients, the disease was associated only with HBV, while 204 (17%) patients had two or more aetiological factors. The proportion of patients receiving antiviral treatment for HBV was low (20.3%). Further analyses indicated that patients without cirrhosis had a significantly lower 90-day liver transplantation-free mortality and higher 5-year survival rate than those with cirrhosis (59.5% vs. 27.6%; 62% vs. 36%; P < 0.05). Remarkably, self-withdrawal of nucleos(t)ide analog (NA) was an independent risk factor for short-term prognosis. Age, cirrhosis at admission, and platelet level were closely related to long-term prognosis of HBV-ACLF patients.<h4>Conclusion</h4>The proportion of HBV-ACLF patients receiving antiviral treatment is very low in south China. Cirrhosis at admission has a significant effect on both short-term and long-term prognosis. No significant improvement in the short-term prognosis of HBV-ACLF patients was observed compared with previous studies. More comprehensive access to antiviral treatment and long-term surveillance of HBV patients are key imperatives to reduce the incidence of HBV-ACLF and improve the prognosis. Trial Registration The trial was registered at ClinicalTrials.gov (CT.gov identifier: NCT04231565) on May 13, 2020: https://register.<h4>Clinicaltrials</h4>gov/prs/app/action/SelectProtocol?sid=S0009OZY&selectaction=Edit&uid=U00036P1&ts=2&cx=27seqt.2022-01-01T00:00:00Z2022 Apr2025-05-29T19:47:18.462Z2025-05-29T19:47:18.462ZS-EPMC89769713536680510.1186/s12876-022-02239-4