{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T05:59:59Z","timestamp":1768543199237,"version":"3.49.0"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,9,26]],"date-time":"2023-09-26T00:00:00Z","timestamp":1695686400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Spontaneous bacterial peritonitis (SBP) is common in patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF). The prognostic value of interleukin-related serum markers for patients with ACLF is coming to the fore. However, there is an unmet need to predict the survival of such patients. We aimed to analyze the independent predictors of 28- and 90-day mortality in HBV-ACLF patients with SBP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective study that included 368 patients with HBV-ACLF. In the SBP group, logistic regression analysis was used to understand the independent predictors of mortality at 28-day and 90-day. The accuracy of prediction was analyzed using the area under the receiver operating characteristic curve (AUROC). Finally, decision curve analysis (DCA) was used to determine the clinical utility value.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Interleukin 10 (IL-10) levels were statistically significantly different between the HBV-ACLF group with SBP and without. Aspartate aminotransferase (AST), serum sodium, IL-10 and vasoactive drug treatment were independent risk factors for 28-day mortality. International normalized ratio (INR), AST and IL-10 were independent risk factors for 90-day mortality. IL-10 combined with the Chinese Severe Hepatitis B Study Group-ACLF II score (COSH-ACLF IIs) had excellent performance in predicting 28- and 90-day mortality (AUCs: 0.848 and 0.823, respectively). DCA analysis suggests promising clinical utility.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>IL-10 is an independent predictor of mortality at 28- and 90-day in HBV-ACLF patients with SBP and predictive performance is improved when combined with COSH-ACLF IIs.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2023.1188300","type":"journal-article","created":{"date-parts":[[2023,9,27]],"date-time":"2023-09-27T09:16:49Z","timestamp":1695806209000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["IL-10 predicts the prognosis of patients with hepatitis B virus-related acute-on-chronic liver failure combined with spontaneous bacterial peritonitis"],"prefix":"10.3389","volume":"10","author":[{"given":"Linxiang","family":"Liu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nanxi","family":"Xiao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peng","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xuan","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,9,26]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1561","DOI":"10.1136\/gut.2009.189639","article-title":"Early features of acute-on-chronic alcoholic liver failure: a prospective cohort study","volume":"59","author":"Katoonizadeh","year":"2010","journal-title":"Gut"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"2053","DOI":"10.1016\/S0140-6736(14)60220-8","article-title":"Hepatitis B virus infection","volume":"384","author":"Tr\u00e9po","year":"2014","journal-title":"Lancet"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1007\/s12072-019-09946-3","article-title":"Acute-on-chronic liver failure: consensus recommendations of the Asian Pacific association for the study of the liver (Apasl): an update","volume":"13","author":"Sarin","year":"2019","journal-title":"Hepatol Int"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1576","DOI":"10.1016\/S0140-6736(15)00309-8","article-title":"Acute-on-chronic liver failure","volume":"386","author":"Bernal","year":"2015","journal-title":"Lancet"},{"key":"ref5","first-page":"7794890","article-title":"Serum interleukins as potential prognostic biomarkers in Hbv-related acute-on-chronic liver failure","author":"Zhang","year":"2022","journal-title":"Mediat Inflamm"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1035699","DOI":"10.3389\/fmed.2022.1035699","article-title":"A practical nomogram based on serum interleukin-6 for the prognosis of liver failure","volume":"9","author":"Xiao","year":"2022","journal-title":"Front Med (Lausanne)"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1219","DOI":"10.1136\/gutjnl-2012-302339","article-title":"Bacterial infections in end-stage liver disease: current challenges and future directions","volume":"61","author":"Bajaj","year":"2012","journal-title":"Gut"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1225","DOI":"10.1016\/j.dld.2018.05.013","article-title":"Prevalence, predictors and impact of bacterial infection in acute on chronic liver failure patients","volume":"50","author":"Shalimar","year":"2018","journal-title":"Dig Liver Dis"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1870","DOI":"10.1136\/gutjnl-2017-314240","article-title":"Bacterial and fungal infections in acute-on-chronic liver failure: prevalence, characteristics and impact on prognosis","volume":"67","author":"Fern\u00e1ndez","year":"2018","journal-title":"Gut"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1104","DOI":"10.1016\/j.jhep.2021.05.026","article-title":"Development and validation of a new prognostic score for hepatitis B virus-related acute-on-chronic liver failure","volume":"75","author":"Li","year":"2021","journal-title":"J Hepatol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1839","DOI":"10.1007\/s40121-022-00695-9","article-title":"Bacterial infections confer a risk of progression to acute-on-chronic liver failure in patients with Hbv-related compensated cirrhosis during severe hepatitis flares","volume":"11","author":"Chu","year":"2022","journal-title":"Infect Dis Ther"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"619039","DOI":"10.3389\/fimmu.2020.619039","article-title":"Characterization of blood immune cells in patients with decompensated cirrhosis including Aclf","volume":"11","author":"Weiss","year":"2020","journal-title":"Front Immunol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1136\/gutjnl-2020-323395","article-title":"Pbmc transcriptomics identifies immune-metabolism disorder during the development of Hbv-Aclf","volume":"71","author":"Li","year":"2022","journal-title":"Gut"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1116","DOI":"10.1111\/apt.13172","article-title":"Review article: spontaneous bacterial peritonitis - bacteriology, diagnosis, treatment, risk factors and prevention","volume":"41","author":"Dever","year":"2015","journal-title":"Aliment Pharmacol Ther"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"646","DOI":"10.1002\/bjs.1800600817","article-title":"Transection of the oesophagus for bleeding oesophageal varices","volume":"60","author":"Pugh","year":"1973","journal-title":"Br J Surg"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"464","DOI":"10.1053\/jhep.2001.22172","article-title":"A model to predict survival in patients with end-stage liver disease","volume":"33","author":"Kamath","year":"2001","journal-title":"Hepatology"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"1018","DOI":"10.1056\/NEJMoa0801209","article-title":"Hyponatremia and mortality among patients on the liver-transplant waiting list","volume":"359","author":"Kim","year":"2008","journal-title":"N Engl J Med"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"565","DOI":"10.1177\/0272989X06295361","article-title":"Decision curve analysis: a novel method for evaluating prediction models","volume":"26","author":"Vickers","year":"2006","journal-title":"Med Decis Mak"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"1426","DOI":"10.1053\/j.gastro.2013.02.042","article-title":"Acute-on-chronic liver failure is a distinct syndrome that develops in patients with acute decompensation of cirrhosis","volume":"144","author":"Moreau","year":"2013","journal-title":"Gastroenterology"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"871","DOI":"10.1016\/j.immuni.2019.03.020","article-title":"Il-10 family cytokines Il-10 and Il-22: from basic science to clinical translation","volume":"50","author":"Ouyang","year":"2019","journal-title":"Immunity"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"1906","DOI":"10.3892\/etm.2017.5629","article-title":"Effects of Il-10 on Ox62, Mhc-ii and Cd86 in bone marrow Dcs in rats with organophosphate poisoning","volume":"15","author":"Wang","year":"2018","journal-title":"Exp Ther Med"},{"key":"ref22","first-page":"5545181","article-title":"Plasma Interleukin-6 level: A potential prognostic Indicator of emergent Hbv-associated Aclf","volume":"11","author":"Wu","year":"2021","journal-title":"Can J Gastroenterol Hepatol"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"481","DOI":"10.1007\/s10096-006-0168-1","article-title":"Evaluation of serum C-reactive protein, procalcitonin, tumor necrosis factor alpha, and interleukin-10 levels as diagnostic and prognostic parameters in patients with community-acquired sepsis, severe sepsis, and septic shock","volume":"25","author":"Heper","year":"2006","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"1967","DOI":"10.4049\/jimmunol.177.3.1967","article-title":"Circulating cytokine\/inhibitor profiles reshape the understanding of the sirs\/cars continuum in sepsis and predict mortality","volume":"177","author":"Osuchowski","year":"2006","journal-title":"J Immunol"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"733","DOI":"10.1111\/j.1478-3231.2010.02219.x","article-title":"Admission levels and early changes in serum interleukin-10 are predictive of poor outcome in acute liver failure and decompensated cirrhosis","volume":"30","author":"Berry","year":"2010","journal-title":"Liver Int"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1016\/j.imlet.2004.07.009","article-title":"The anti-inflammatory response dominates after septic shock: association of low monocyte Hla-Dr expression and high interleukin-10 concentration","volume":"95","author":"Monneret","year":"2004","journal-title":"Immunol Lett"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"1013439","DOI":"10.3389\/fmicb.2022.1013439","article-title":"Prognosis prediction performs better in patients with non-cirrhosis hepatitis B virus-related acute-on-chronic liver failure than those with cirrhosis","volume":"13","author":"Yu","year":"2022","journal-title":"Front Microbiol"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2023.1188300\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,27]],"date-time":"2023-09-27T09:16:54Z","timestamp":1695806214000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2023.1188300\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,26]]},"references-count":27,"alternative-id":["10.3389\/fmed.2023.1188300"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2023.1188300","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,26]]},"article-number":"1188300"}}