{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T16:03:29Z","timestamp":1785168209301,"version":"3.55.0"},"reference-count":22,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,1,16]],"date-time":"2019-01-16T00:00:00Z","timestamp":1547596800000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81602409"],"award-info":[{"award-number":["81602409"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81770565"],"award-info":[{"award-number":["81770565"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Digest Diseases"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate retrospectively the efficacy of steroids in patients with acute\u2010on\u2010chronic liver failure (ACLF) precipitated by hepatitis B.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with ACLF precipitated by hepatitis B were included and categorized according to treatment modalities (steroid <jats:italic>vs<\/jats:italic>. control). Survival and clinical characteristics, including patients\u2019 age, baseline ACLF grade, the model for end\u2010stage liver disease (MELD) score, and occurrence of infection were compared between the two groups. Survival analyses of subgroups classified by their age, ACLF grade and MELD score were performed. Cox regression analyses were conducted to identify factors associated with 60\u2010day cumulative and transplant\u2010free mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From 2007 to 2016, 293 patients with hepatitis B\u2010precipitated ACLF were recruited, among whom 162 received at least five consecutive doses of corticosteroids. By day 60 transplant\u2010free survival was 62.6% in the control group compared with 53.7% in the steroid group (<jats:italic>P<\/jats:italic> = 0.126). Steroid treatment failed to show a survival benefit in the survival analysis among the subgroup. Within 60 days, pulmonary and overall infections occurred with higher frequency in the steroid\u2010treated group than in the controls (<jats:italic>P<\/jats:italic> = 0.003 and &lt; 0.001, respectively). In the univariate analysis, age, baseline MELD score &gt;20, CLIF consortium (CLIF\u2010C) ACLF grade 2\u20103, pulmonary infection and overall infection were associated with 60\u2010day mortality. In the multivariate analysis, older age, baseline MELD score &gt;20 and CLIF\u2010C ACLF grade 2\u20103 were independent risk factors of 60\u2010day mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Steroid treatment did not improve transplant\u2010free survival in patients with ACLF precipitated by hepatitis B.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1751-2980.12691","type":"journal-article","created":{"date-parts":[[2018,12,5]],"date-time":"2018-12-05T07:54:18Z","timestamp":1543996458000},"page":"38-44","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Steroid treatment in patients with acute\u2010on\u2010chronic liver failure precipitated by hepatitis B: A 10\u2010year cohort study in a university hospital in East China"],"prefix":"10.1111","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6538-2607","authenticated-orcid":false,"given":"Chong","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases Huashan Hospital, Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kang Kang","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Huashan Hospital, Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian Ming","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Huashan Hospital, Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ning","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Huashan Hospital, Fudan University  Shanghai 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