{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T15:27:53Z","timestamp":1773242873716,"version":"3.50.1"},"reference-count":28,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T00:00:00Z","timestamp":1752537600000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Rapid prognostic assessment of patients with hepatitis B virus\u2010related acute\u2010on\u2010chronic liver failure (HBV\u2010ACLF) is crucial for optimizing clinical interventions. This study aimed to explore the clinical value of combining Hepatitis B Virus (HBV) pregenomic RNA (pgRNA) with the Model for End\u2010stage Liver Disease (MELD) score predicting the short\u2010term outcomes in HBV\u2010ACLF patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study enrolled 220 HBV\u2010ACLF patients from Fuqing Hospital in Fujian Province between July 2016 and July 2024. Clinical data collected within 24 h of diagnosis included HBV pgRNA levels, complete blood counts, C\u2010reactive protein, biochemical profiles, coagulation parameters, and MELD scores. Patients were stratified into survival and non\u2010survival groups based on 90\u2010day outcomes. Independent risk factors for mortality were identified through binary logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      During the 90\u2010day follow\u2010up after hospitalization and discharge, 90 patients died, and 130 survived. Nonsurvivors exhibited significantly higher HBV pgRNA levels (6.07 (5.62\u20136.71) log10pgRNA [IU\/mL] vs. 4.12 [3.81\u20135.06] log10pgRNA [IU\/mL],\n                      <jats:italic>Z<\/jats:italic>\n                      \u2009=\u2009\u2212\u200910.14,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and MELD scores (31.88 [27.82\u201334.66] vs. 21.27 [18.50\u201323.14],\n                      <jats:italic>Z<\/jats:italic>\n                      \u2009=\u2009\u2212\u200912.03,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) compared to survivors. Multivariate analysis identified both HBV pgRNA (OR\u2009=\u200912.38, 95% CI\u2009=\u20092.68\u201357.25) and MELD score (OR\u2009=\u20093.20, 95% CI\u2009=\u20091.33\u20137.70) as independent predictors of 90\u2010day mortality (both\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). The combined model demonstrated superior discriminative ability, with an area under the ROC curve (AUC) of 0.988 (95% CI\u2009=\u20090.978\u20130.998), significantly outperforming HBV pgRNA alone (AUC\u2009=\u20090.902, Z\u2009=\u20094.487,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and MELD score alone (AUC\u2009=\u20090.977, Z\u2009=\u20092.012,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.044). The optimal cutoff for the pgRNA\u2010MELD score (\u221242.253\u2009+\u20092.516\u2009\u00d7\u2009log10pgRNA [IU\/mL]\u2009+\u20091.165\u2009\u00d7\u2009MELD) was 0.302 (Youden index\u2009=\u20090.967). Patients with pgRNA\u2010MELD scores \u2265\u20090.302 had markedly reduced survival rates (\n                      <jats:italic>\u03c7<\/jats:italic>\n                      \u00b2\u2009=\u2009253.09,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The novel pgRNA\u2010MELD score effectively predicts short\u2010term prognosis in HBV\u2010ACLF patients, offering enhanced clinical utility compared to individual models and guiding timely therapeutic decisions in clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.71069","type":"journal-article","created":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T09:38:29Z","timestamp":1752572309000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Prognostic Value of Combined HBV pgRNA and MELD Score for Mortality in HBV\u2010Related Acute\u2010on\u2010Chronic Liver Failure: A Single\u2010Center Retrospective Study"],"prefix":"10.1002","volume":"8","author":[{"given":"Fenlan","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases Fuqing City Hospital Affiliated to Fujian Medical University Fuzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiongle","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Fuqing City Hospital Affiliated to Fujian Medical University Fuzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chaohui","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Fuqing City Hospital Affiliated to Fujian Medical University Fuzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wen","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Fuqing City Hospital Affiliated to Fujian Medical University Fuzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shizhong","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Fuqing City Hospital Affiliated to Fujian Medical University Fuzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qinqi","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Fuqing City Hospital Affiliated to Fujian Medical University Fuzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4140-8956","authenticated-orcid":false,"given":"Jun","family":"Huang","sequence":"additional","affiliation":[{"name":"School of Life Sciences Zhengzhou University Zhengzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1960-5435","authenticated-orcid":false,"given":"Liping","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Shanghai Geriatric Medical Center Shanghai China"},{"name":"Department of Gastroenterology and Hepatology, Zhongshan Hospital Fudan University Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,7,15]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"crossref","unstructured":"S.Piano N.Mahmud P.Caraceni M.Tonon andR. 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