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Invasive fungal infections secondary to acute-on-chronic liver failure: a retrospective study

Li Na Lin1, Yu Zhu, Fu Bin Che

  • 1Department of Dermatology, Changzheng Hospital, The Second Military Medical University, Shanghai, China.

Mycoses
|February 2, 2013
PubMed

Insights

Invasive fungal infections (IFIs) are common in acute-on-chronic liver failure (ACLF) patients with hepatitis B. High hepatitis B viral DNA levels significantly increase the risk of developing secondary IFIs in these vulnerable patients.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Invasive fungal infections (IFIs) pose serious risks to patients with chronic hepatitis B.
  • The incidence and risk factors for IFIs in acute-on-chronic liver failure (ACLF) patients are not well understood.

Purpose of the Study:

  • To determine the incidence of IFIs in ACLF patients with hepatitis B.
  • To identify the main pathogenic factors contributing to secondary IFIs in this population.

Main Methods:

  • Retrospective analysis of 1200 hepatitis B patients treated between January 2006 and January 2009.
  • Screening ACLF patients based on liver failure guidelines and comparing those with and without secondary IFI.

Main Results:

  • The incidence of IFIs in ACLF patients was 47.62%, with 60 patients affected (14 confirmed, 46 suspected).
  • Elevated hepatitis B viral (HBV) DNA levels ( > 3.16 × 10^3 copies/mL) were identified as a significant risk factor for secondary IFI.
  • Higher white blood cell counts demonstrated a protective effect against IFIs in ACLF patients.

Conclusions:

  • IFIs occur frequently in ACLF patients with hepatitis B.
  • High HBV DNA levels are a key independent risk factor for secondary IFIs in ACLF patients, highlighting the need for targeted monitoring and prevention strategies.

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