{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T08:48:25Z","timestamp":1777452505965,"version":"3.51.4"},"reference-count":34,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2013,2,1]],"date-time":"2013-02-01T00:00:00Z","timestamp":1359676800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Antiviral Therapy"],"published-print":{"date-parts":[[2013,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Prognostic factors have not been elucidated for severe acute exacerbation of chronic hepatitis B treated with antiviral therapy. This study aimed to explore the role of baseline viral load in predicting mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study screened consecutive chronic hepatitis B patients ( n=84) receiving antiviral therapy for severe acute exacerbation, defined as abrupt elevation of serum alanine aminotransferase &gt;10x the upper limit of normal along with hyperbilirubinaemia. Survival pattern was evaluated by the Kaplan\u2013Meier method and predictors for mortality determined by the Cox regression analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 66 patients were eligible and followed-up for a median of 23 months (range 0.1\u201375.0). Overall, 20 (30.3%) patients died during the study period, with the vast majority ( n=17) succumbing rapidly within 3 months of severe acute exacerbation. The multivariate Cox model revealed that mortality was associated with baseline viral DNA level (HR 1.49 per log copies\/ml, 95% CI 1.13, 1.96), international normalized ratio for prothrombin time (HR 2.68 per unit, 95% CI 1.81, 3.98), platelet count (HR 0.87 per 10\n                      <jats:sup>4<\/jats:sup>\n                      cells\/ml, 95% CI 0.78, 0.98) and age (HR 1.10 per year, 95% CI 1.05, 1.15). A significant interaction existed between viral DNA and prolonged prothrombin time ( P=0.005). Stratified analyses further demonstrated that pronounced coagulopathy heralded death irrespective of viral load, whereas serum level of viral DNA stratified mortality risk among those without marked coagulopathy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Pretreatment viral DNA level stratifies risk of death in patients with severe acute exacerbation of chronic hepatitis B before the manifestation of overt liver failure.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3851\/imp2435","type":"journal-article","created":{"date-parts":[[2012,11,6]],"date-time":"2012-11-06T06:11:44Z","timestamp":1352182304000},"page":"221-228","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["Pretreatment Viral Dna Stratifies Mortality Risk in Patients Receiving Antiviral Therapy for Severe Acute Exacerbation of Chronic Hepatitis B"],"prefix":"10.1177","volume":"18","author":[{"given":"Yao-Chun","family":"Hsu","sequence":"first","affiliation":[{"name":"Graduate Institute of Clinical Medicine, China Medical University, Taichung, Taiwan"},{"name":"Department of Medicine, E-Da Hospital\/I-Shou University, Kaohsiung, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chun-Ying","family":"Wu","sequence":"additional","affiliation":[{"name":"Graduate Institute of Clinical Medicine, China Medical University, Taichung, Taiwan"},{"name":"School of Medicine, National Yang-Ming University, Taipei, Taiwan"},{"name":"Division of Gastroenterology, Taichung Veterans General Hospital, Taichung, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chi-Yang","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Medicine, E-Da Hospital\/I-Shou University, Kaohsiung, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chih-Min","family":"Tai","sequence":"additional","affiliation":[{"name":"Department of Medicine, E-Da Hospital\/I-Shou University, Kaohsiung, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cheng-Hao","family":"Tseng","sequence":"additional","affiliation":[{"name":"Department of Medicine, E-Da Hospital\/I-Shou University, Kaohsiung, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daw-Shyong","family":"Perng","sequence":"additional","affiliation":[{"name":"Department of Medicine, E-Da Hospital\/I-Shou University, Kaohsiung, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lein-Ray","family":"Mo","sequence":"additional","affiliation":[{"name":"Department of Medicine, E-Da Hospital\/I-Shou University, Kaohsiung, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaw-Town","family":"Lin","sequence":"additional","affiliation":[{"name":"School of Medicine, Fu Jen Catholic University, New Taipei, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2013,2,1]]},"reference":[{"key":"bibr1-IMP2435","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199712113372406"},{"key":"bibr2-IMP2435","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840070106"},{"key":"bibr3-IMP2435","doi-asserted-by":"publisher","DOI":"10.1016\/0168-8278(90)90069-4"},{"key":"bibr4-IMP2435","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0676.1990.tb00455.x"},{"key":"bibr5-IMP2435","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(85)90566-9"},{"key":"bibr6-IMP2435","doi-asserted-by":"publisher","DOI":"10.1086\/374226"},{"key":"bibr7-IMP2435","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(02)00419-1"},{"key":"bibr8-IMP2435","doi-asserted-by":"publisher","DOI":"10.1002\/hep.24109"},{"key":"bibr9-IMP2435","doi-asserted-by":"publisher","DOI":"10.1007\/s12072-008-9106-x"},{"key":"bibr10-IMP2435","doi-asserted-by":"publisher","DOI":"10.1007\/s12072-009-9148-8"},{"key":"bibr11-IMP2435","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2893.2002.00385.x"},{"key":"bibr12-IMP2435","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1746.2004.03534.x"},{"key":"bibr13-IMP2435","doi-asserted-by":"publisher","DOI":"10.1111\/j.1478-3231.2007.01565.x"},{"key":"bibr14-IMP2435","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2010.02.023"},{"key":"bibr15-IMP2435","doi-asserted-by":"publisher","DOI":"10.1002\/hep.23190"},{"key":"bibr16-IMP2435","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1746.2009.05924.x"},{"key":"bibr17-IMP2435","doi-asserted-by":"publisher","DOI":"10.1007\/s005350300025"},{"key":"bibr18-IMP2435","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0258(19960229)15:4<361::AID-SIM168>3.0.CO;2-4"},{"key":"bibr19-IMP2435","doi-asserted-by":"publisher","DOI":"10.1001\/jama.295.1.65"},{"key":"bibr20-IMP2435","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2005.11.016"},{"key":"bibr21-IMP2435","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jir687"},{"key":"bibr22-IMP2435","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2010.06.043"},{"key":"bibr23-IMP2435","doi-asserted-by":"publisher","DOI":"10.1002\/hep.20703"},{"key":"bibr24-IMP2435","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2004.00775.x"},{"key":"bibr25-IMP2435","doi-asserted-by":"publisher","DOI":"10.1053\/he.2000.5852"},{"key":"bibr26-IMP2435","doi-asserted-by":"publisher","DOI":"10.1159\/000080877"},{"key":"bibr27-IMP2435","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2141.2001.02824.x"},{"key":"bibr28-IMP2435","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2005.41289.x"},{"key":"bibr29-IMP2435","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2006.00788.x"},{"key":"bibr30-IMP2435","doi-asserted-by":"publisher","DOI":"10.1002\/hep.23346"},{"key":"bibr31-IMP2435","doi-asserted-by":"publisher","DOI":"10.1002\/hep.23952"},{"key":"bibr32-IMP2435","doi-asserted-by":"publisher","DOI":"10.1002\/hep.24361"},{"key":"bibr33-IMP2435","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2011.04.046"},{"key":"bibr34-IMP2435","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2012.02.007"}],"container-title":["Antiviral 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