Outcomes of Glucocorticoid Treatment in HBVAssociated Acute-on-Chronic Liver Failure Patients: A Retrospective Observational Study

Background: Our study aimed to investigate the effects of glucocorticoid (GC) treatment on liver function, hospitalization length, and expenses, as well as 28-day mortality in patients suffered from hepatitis B virus (HBV)-associated acute-on-chronic liver failure (ACLF). Methods: This is a retrospective study of 349 patients who were hospitalized with HBV-associated ACLF. Biochemical assay results of alanine aminotransferase (ALT) level, aspartate aminotransferase (AST) level, total bilirubin (TBil) level, and creatinine (Cr) level both at admission and before discharge were recorded. GC and antivirus treatment condition, hospitalization length and expenses, as well as 28-day status were also recorded. Results: Among 349 patients with HBV-associated ACLF, GC treatment did not benefit in liver function outcomes, and even ended in higher ALT and TBil levels comparing to patients treated without GC. However, patients treated with GC might have lower 28-day mortality. Similar results were shown in patients with or without antivirus treatment. In addition, GC treatment could not shorten hospitalization length and could increase the expenses. Conclusion: Using GC in HBV-associated ACLF patients could not improve their liver function, but might reduce the risk of death, no matter the patient had had antivirus treatment or not. In addition, GC treatment could not shorten hospitalization length and could increase the expenses in HBV-associated ACLF patients.