[The short-term efficacy of antiviral treatment in patients with acute-on-chronic hepatitis B liver failure].

OBJECTIVE To investigate the short-term efficacy of antiviral therapy in acute-on-chronic liver failure associated with hepatitis B. METHODS A total of 348 patients with acute-on-chronic liver failure associated with hepatitis B, of which 173 cases of low viral load (HBV DNA <105 copies/ml) and 175 cases of high viral load (HBV DNA > or =105 copies/ml), were divided into two groups. One was treated with antiviral therapy (LAM or ETV or Ltd) and routine supportive therapy, and the other received supportive therapy only. The clinical features, survival rate and the short-term efficacy of antiviral therapy were compared between the two. RESULTS It was indicated in Cox regression analysis of multiple factors that antiviral therapy is the favorable factor of affecting prognosis. The survival rate of the group receiving antiviral therapy was higer than that of the one in control group in a 24-week observation. In patients with 4 weeks treatment there were statistical significant differences (P < or = 0.05) in both the level of TBil in serum and the decreasing amplitude of HBV DNA between the two groups. Also after 24-week therapy the survival rates of the patients with both low and high viral load was higer in the group with antiviral therapy,and that made statistically significant (P < or = 0.05). CONCLUSION Antiviral therapy can improve the survival rate of the acute-on-chronic liver failure associated with hepatitis B. And it is also needed in patients with low viral load.