Analysis of the occurrence, clinical characteristics and regression of invasive fungal infections in patients with HBV-ACLF after treatment with an artificial liver support system

Abstract

Abstract: Objective To analyze the incidence, clinical characteristics and prognosis of invasive fungal infection in patients with HBV-ACLF after artificial liver support system treatment. Methods Fifty patients with HBV-ACLF treated with artificial liver support system admitted to our hospital between October 2018 and January 2024 were divided into occurrence group (n=25) and non-occurrence group (n=25) according to whether fungal infection occurred or not. The two groups were compared in terms of clinical characteristics, glucocorticoid treatment regression analysis, and multi-factor logistic regression was used to analyze independent risk factors for invasive fungal infections in patients with HBV-ACLF after treatment with artificial liver support system. Results The mean number of hospital days and duration of treatment was (68.0±4.7) d in the occurrence group, respectively, which was higher than in the non-occurrence group [(34.6±6.8) d, P<0.05], The number of people with a history of cirrhosis and diabetes was 32.0% and 44.0%, respectively, which were higher than those in the no-incidence group (8.0% and 16.0%, respectively, P<0.05). The albumin, total bilirubin, white blood cell count and model score of end-stage liver disease in the occurrence group were (31.2±4.5) g/L, (314.2±101.3) μmol/L, (12.7±1.8) ×10⁹/L, and (26.1±2.6), respectively, which were significantly different from the non-occurrence group [(34.8±4.9) g/L, (212.5±101.6) μmol/L, (10.6±0.2) × 10⁹/L, and (22.9±1.8) points], P<0.05. The number of hospital days, albumin, total bilirubin level, and white blood cell count in the death group were (94.6±5.8) d, (29.1±4.0) g/L, (412.5±121.6) μmol/L and (13.6±2.2) × 10⁹/L, which were different from the survival group [(60.3±4.2) d, (33.2±4.3) g/L, (118.2±2.3) μmol/L, and (5.6±2.5) × 10⁹/L, respectively, P<0.05]. Multifactorial logistic regression analysis showed that days of hospitalization, albumin, total bilirubin level and white blood cell count were independent risk factors for invasive fungal infections in patients with HBV-ACLF after treatment with an artificial liver support system (OR=5.217, 4.928, 5.063, 4.923, P<0.05). Conclusion The prognosis of invasive fungal infection in HBV-ACLF patients is related to the number of days in hospital, albumin, total bilirubin level, and white blood cell count after treatment with artificial liver support system.

Key words: Artificial liver, Hepatitis B virus, Acute-on-chronic liver failure, Invasive fungal infection, Clinical features, Regression

ZHU Xiao-hong, WANG Juan, HUANG Zuo-yu. Analysis of the occurrence, clinical characteristics and regression of invasive fungal infections in patients with HBV-ACLF after treatment with an artificial liver support system[J]. Chinese Hepatolgy, 2025, 30(11): 1525-1528.

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