{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T01:35:13Z","timestamp":1787621713217,"version":"build-2736575974"},"reference-count":27,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T00:00:00Z","timestamp":1750377600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T00:00:00Z","timestamp":1750377600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2025,7]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background & Aims<\/jats:title>\n Only 25% of hepatitis B\u2010related acute liver failure (HBV\u2010ALF) patients survive without liver transplantation (transplant\u2010free survival, TFS). There is limited study of immunological and virological profiles in these patients. We analysed the association between hepatitis B viremia and cytokine patterns on TFS of HBV\u2010ALF patients.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We identified 48 acute and 20 history of HBV infection ALF patients from the US ALF Study Group registry (>\u20093400 patients). The inclusion criteria were age\u2009>\u200918\u2009years, diagnosis of HBV\u2010ALF with hepatic encephalopathy and INR \u2265\u20091.5. Data were collected from ICU admission through day 21. Serum collected at admission and at days 3\u20135 were used for cytokine quantification by Luminex and novel HBV biomarkers, genotypes and variants.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n In 48 acute (50% F, median age 40\u2009years) and 20 history\/reactivation (40% F, median age 53\u2009years) HBV\u2010ALF patients, there were 26 (54%) and 5 (25%) TFS, respectively. Detectable HBV DNA by clinical PCR assay (median 3.39 log\n 10<\/jats:sub>\n IU\/mL, aOR 5.308; 95% CI: 1.217\u201323.155,\n p<\/jats:italic>\n \u2009=\u20090.026) and qAHBc levels (median 4.5 log\n 10<\/jats:sub>\n IU\/mL, aOR 4.466, 95% CI: 0.968\u201320.608,\n p<\/jats:italic>\n \u2009=\u20090.050) were associated with TFS in acute HBV\u2010ALF patients. HBV variants associated with anti\u2010viral immune escape were more frequently detected in acute HBV\u2010ALF TFS patients compared to non\u2010TFS (\n p<\/jats:italic>\n \u2009<\u20090.05). TFS with acute HBV\u2010ALF had higher angiogenic factors (PDGF\u2010AA,\n p<\/jats:italic>\n \u2009=\u20090.008; PDGF\u2010BB,\n p<\/jats:italic>\n \u2009=\u20090.0006; VEGF\u2010A,\n p<\/jats:italic>\n \u2009=\u20090.014) and lower pro\u2010inflammatory cytokine levels (IL\u20101\u03b1,\n p<\/jats:italic>\n \u2009=\u20090.031; IL\u20102,\n p<\/jats:italic>\n \u2009=\u20090.014; IL\u20106,\n p<\/jats:italic>\n \u2009=\u20090.039). Significant differences in HBV viremia were not observed in history\/reactivation of HBV\u2010ALF patients.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Acute HBV\u2010ALF patients with TFS were often viremic with immune escape variants, increased angiogenic factors and decreased pro\u2010inflammatory cytokines.<\/jats:p>\n \n Trial Registration:<\/jats:bold>\n ClinicalTrials.gov<\/jats:ext-link>\n identifier: NCT00518440\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/liv.70175","type":"journal-article","created":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T12:39:20Z","timestamp":1750423160000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Hepatitis B Virus Variants and Cytokine Patterns in Acute Liver Failure and Transplant\u2010Free Survival"],"prefix":"10.1111","volume":"45","author":[{"given":"Nishi H.","family":"Patel","sequence":"first","affiliation":[{"name":"Department of Medicine, Cross\u2010Appointment to Microbiology and Infectious Diseases Snyder Institute, Cumming School of Medicine, University of Calgary Calgary Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annie Y.","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Medicine, Cross\u2010Appointment to Microbiology and Infectious Diseases Snyder Institute, Cumming School of Medicine, University of Calgary Calgary Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla","family":"Osiowy","sequence":"additional","affiliation":[{"name":"National Microbiology Laboratory Public Health Agency of Canada Winnipeg Manitoba Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerie","family":"Durkalski Mauldin","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences Medical University of South Carolina Charleston USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2783-5441","authenticated-orcid":false,"given":"William M.","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Digestive and Liver Diseases University of Texas Southwestern Medical Center Dallas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1472-0901","authenticated-orcid":false,"given":"Carla S.","family":"Coffin","sequence":"additional","affiliation":[{"name":"Department of Medicine, Cross\u2010Appointment to Microbiology and Infectious Diseases Snyder Institute, Cumming School of Medicine, University of Calgary Calgary Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1555-1089","authenticated-orcid":false,"given":"Constantine J.","family":"Karvellas","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine and Division of Gastroenterology (Liver Unit), School of Health Sciences University of Alberta Edmonton Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the US Acute Liver Failure Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,20]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11894-008-0023-x"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ncp.10459"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/HEP.0000000000000458"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1208937"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2016.06.008"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1133656"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v28.i4.479"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.24732"},{"issue":"48","key":"e_1_2_13_10_1","first-page":"E11369","article-title":"Role of Humoral Immunity Against Hepatitis B Virus Core Antigen 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