AUTHOR=Garg Pallavi , Madan Kaushal 

TITLE=Acute-on-chronic liver failure due to hepatitis B

JOURNAL=Frontiers in Gastroenterology

VOLUME=Volume 2 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/gastroenterology/articles/10.3389/fgstr.2023.1016915

DOI=10.3389/fgstr.2023.1016915

ISSN=2813-1169

ABSTRACT=ACLF is a complex health problem  with a high short term mortality rate. It is the end stage liver disease characterised by acute hepatic insult on the background of an underlying chronic liver disease along with other organ failures. Due to its rapid onset and progression  it is a challenge for Hepatologists and Intensivists. Geographical variations exist regarding its definition leading to various clinical phenotypes. The occurrence of acute on chronic liver failure is not uncommon in patients with chronic hepatitis B or HBV related cirrhosis. Different severity criteria and prognostic scores have been proposed and validated. The management is mainly centered on support of various organ failures while anti virals take effect. Liver transplant still remains to be the definitive treatment for HBV- ACLF. Medical therapies, such as nucleoside analogue and artificial liver support may improve survival in a specific subset of patients. This review updates the understanding  about HBV-ACLF from epidemiological studies and clinical studies and provide new insights into the definition, diagnostic criteria, epidemiology, pathogenesis, treatment and prognostication of HBV-ACLF.