Published online Aug 7, 2020. doi: 10.3748/wjg.v26.i29.4288
Peer-review started: April 11, 2020
First decision: May 21, 2020
Revised: July 4, 2020
Accepted: July 15, 2020
Article in press: July 15, 2020
Published online: August 7, 2020
Patients with hepatitis B virus-associated acute-on-chronic liver failure (HBV-ACLF) have inadequate nutrient intake and malnutrition at admission or diagnosis. However, the nutritional status of HBV-ACLF patients has been poorly studied.
We have found that HBV-ACLF patients had inadequate nutrient intake and malnutrition. Little is known about the impact of nutritional support on the outcome and function of the gastrointestinal barrier.
To investigate the nutritional risk and nutritional status of HBV-ACLF patients and evaluated the impact of nutritional support on the gastrointestinal barrier and 28-d mortality.
The nutritional risk screening assessment, baseline characteristics, and biomarkers of the gastrointestinal barrier of patients with HBV-ACLF (n = 234) and patients with compensatory cirrhosis (n = 234) were analyzed. The 28-d survival of the nutritional support group (n = 234) and non-nutritional support group (n = 207) was compared.
The nutritional risk of the HBV-ACLF patients was significantly higher than that of the control group. The coccus-bacillus ratio, secretory immunoglobulin A, and serum D-lactate were significantly increased in HBV-ACLF patients. Interleukin-10 may be a potential predictor of death in HBV-ACLF patients. The 28-d survival of the nutritional support group was better than that of the non-nutritional support group (P = 0.016).
This is the first study to investigate the nutritional risk and status of HBV-ACLF patients and evaluated the impact of nutritional support. We found that nutritional support initiated promptly for malnourished HBV-ACLF patients was associated with a better prognosis of 28-d mortality and improved the status of the gastrointestinal barrier.
More attention should be paid to nutritional risk screening and corresponding nutritional support for HBV-ACLF patients. Nutritional support initiated promptly for malnourished HBV-ACLF patients is associated with a better prognosis.