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ORIGINAL RESEARCH article

Front. Cell. Infect. Microbiol.
Sec. Virus and Host
Volume 14 - 2024 | doi: 10.3389/fcimb.2024.1458818
This article is part of the Research Topic Frontiers in Chronic Hepatitis B Clinical Cure View all 4 articles

High-Density Lipoprotein Cholesterol as a Prognostic Marker for 90-Day Transplant-Free Mortality in Hepatitis B Virus-Related Acute-on-Chronic Liver Failure

Provisionally accepted
Ke Shi Ke Shi Yi Zhang Yi Zhang Yanqiu Li Yanqiu Li Xiaojing Wang Xiaojing Wang Ying Feng Ying Feng *Xianbo Wang Xianbo Wang *
  • Beijing Ditan Hospital, Capital Medical University, Beijing, Beijing Municipality, China

The final, formatted version of the article will be published soon.

    Background: Hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) is linked to dyslipidemia and inflammatory responses. This study aimed to investigate the correlation between high-density lipoprotein cholesterol (HDL-C) levels and 90-day transplant-free (TF) mortality in patients with HBV-ACLF.A prospective cohort of 287 patients with HBV-ACLF from Beijing Ditan Hospital was enrolled between January 2016 and December 2019. The prognostic accuracy of lipid profile parameters was evaluated by the area under the receiver operating characteristic curve (AUC), and HDL-C and mortality in HBV-ACLF 2 the association between HDL-C levels and mortality was assessed using a restricted cubic spline analysis. Correlations between lipid profile parameters and inflammatory factors were analyzed.Kaplan-Meier curves were used to assess 90-day TF mortality, and log-rank tests were used for comparison analysis. These results were internally validated between January 2020 and December 2023 (n=125).Results: Patients with lower HDL-C levels exhibited higher mortality rates (adjusted hazard ratio for HDL-C < 0.13 mmol/L: 4.04, 95% confidence interval: 1.35-11.85) compared with those in the reference group (with HDL-C levels above 0.36 mmol/L). An "L-shaped" association was observed between HDL-C levels and TF mortality. The prognostic value of HDL-C (AUC at day 90: 0.732) was comparable to the model for end-stage liver disease score of 0.729. Additionally, HDL-C levels were inversely correlated with interleukin (IL)-4, IL-6, and tumor necrosis factor-α (all P<0.05). In the training cohort, the 90-day TF mortality rates were 8.3%, 15.2%, 24.0%, and 43.2% for the extremely low, low, medium, and high-risk subgroups, respectively, while in the validation cohort, they were 4.5%, 18.5%, 31.2%, and 44.7%, respectively.Conclusions: HDL-C levels < 0.13 mmol/L were associated with increased 90-day transplant-free mortality in patients with HBV-ACLF. An inverse correlation was found between HDL-C levels and inflammatory markers.

    Keywords: hepatitis B vir us, high-density lipopr otein cholester ol, acute-on-chr onic liver failur e, inflammator y factor, mor tality, pr ognosis

    Received: 03 Jul 2024; Accepted: 30 Dec 2024.

    Copyright: © 2024 Shi, Zhang, Li, Wang, Feng and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Ying Feng, Beijing Ditan Hospital, Capital Medical University, Beijing, Beijing Municipality, China
    Xianbo Wang, Beijing Ditan Hospital, Capital Medical University, Beijing, Beijing Municipality, China

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