Abstract
Hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) is a life-threatening condition, and the lipid metabolism disorder is common in the development of this disease. This prospective observational study aimed to define the characteristics of plasma apolipoprotein A-V (apoA-V) in long-term outcome prediction of HBV-ACLF, and a total of 330 HBV-ACLF patients were included and followed for more than 12 months. In this cohort, the 4-week, 12-week, 24-week and 48-week cumulative mortality of HBV-ACLF was 18.2%(60/330), 50.9%(168/330), 59.7%(197/330) and 63.3%(209/330), respectively. As compared to survivors, the non-survivors had significantly lower concentrations of plasma apoA-V on admission. Plasma apoA-V concentrations were positively correlated with prothrombin time activity (PTA), and negatively correlated with interleukin-10, tumor necrosis factor-α, and iMELD scores. Though plasma apoA-V, PTA, total bilirubin(TBil) and blood urea nitrogen(BUN) were all independent factors to predict one-year outcomes of HBV-ACLF, plasma apoA-V had the highest prediction accuracy. And its optimal cutoff value for one-year survival prediction was 480.00 ng/mL, which had a positive predictive value of 84.68% and a negative predictive value of 92.23%. In summary, plasma apoA-V decreases significantly in non-survivors of HBV-ACLF, and it may be regarded as a new predictive marker for the prognosis of patients with HBV-ACLF.
Highlights
ApoA-V is an apolipoprotein that was independently discovered by Pennacchio et al and van der Vliet et al as a result of their investigations on new open-reading frames on chromosome 11q23 in the ApoA-I/ApoC-III/ ApoA-IV gene cluster[17,18]
In this prospective observational study, we aimed to define the characteristics of plasma apolipoprotein A-V (apoA-V) in HBV-ACLF and investigate whether the concentration of apoA-V was associated with prognosis of patients
The lipid metabolism disorder is common in the development of HBV-ACLF, and our previous animal study showed that the changes of the plasma concentrations of apoA-V were more significantly than that of other apoproteins
Summary
ApoA-V is an apolipoprotein that was independently discovered by Pennacchio et al and van der Vliet et al as a result of their investigations on new open-reading frames on chromosome 11q23 in the ApoA-I/ApoC-III/ ApoA-IV gene cluster[17,18]. As the newest member of the Apo A class of proteins, apoA-V is expressed in liver and secreted into plasma. In our previous animal studies with fulminant hepatic failure, the changes of the plasma concentrations and mRNA expression of apoA-V were more significantly than that of other apoproteins[9]. We hypothesize that low levels of apoA-V are associated with a more pronounced lipid metabolism disorder and liver damage in patients with HBV-ALCF. In this prospective observational study, we aimed to define the characteristics of plasma apoA-V in HBV-ACLF and investigate whether the concentration of apoA-V was associated with prognosis of patients
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