Creation and assessment of a new prognostic scoring system for HBV-associated acute-on-chronic liver failure
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By
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Qian Song
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Lin Lv
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Chuanfei Li
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Zhechuan Mei
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Shengtao Liao
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July 17, 2026
Clinical Scorecard: Creation and assessment of a new prognostic scoring system for HBV-associated acute-on-chronic liver failure
At a Glance
| Category | Detail |
|---|
| Condition | HBV-associated acute-on-chronic liver failure (ACLF) |
| Key Mechanisms | High short-term mortality rates due to multi-organ failure on the background of cirrhosis. |
| Target Population | Patients with HBV-ACLF, particularly in Asian countries. |
| Care Setting | Hospitalized patients in liver failure units. |
Key Highlights
- Development of AHF-MELD and AHN-MELD scores for predicting mortality.
- Scores demonstrated stronger predictive capacity than existing models.
- 28-day and 90-day mortality rates significantly lower in high-risk groups.
Guideline-Based Recommendations
Diagnosis
- Patients must meet COSSH-ACLF standards including jaundice and coagulopathy.
Management
- Standardized medical therapy and antiviral treatment for eligible patients.
Monitoring & Follow-up
- Follow-up until death or day 90 to assess survival outcomes.
Risks
- High short-term mortality rates (≥ 15% at 28 days) in HBV-ACLF patients.
Patient & Prescribing Data
1170 HBV-ACLF cases enrolled from a larger cohort of liver failure patients.
Nucleoside analogs or interferon for patients meeting criteria for antiviral therapy.
Clinical Best Practices
- Utilize AHF-MELD and AHN-MELD scores for risk stratification in HBV-ACLF.
- Implement early evaluation of prognosis to prevent adverse outcomes.
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