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Published on: November 27, 2019
Clinical Profile and Prognostic Predictors in Hepatitis A Virus-Induced Acute Liver Failure
Karan Kumar1, Harshil Shaileshbhai Shah2, Naimish N Mehta3
1Department of Hepatology, Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan, India.
Journal of Clinical and Experimental Hepatology
|March 4, 2026
Summary
The Model for End-Stage Liver Disease (MELD) score is a reliable predictor of mortality in Hepatitis A Virus-induced Acute Liver Failure (HAV-ALF) patients in India. Elevated MELD, prolonged hospitalization, and high lactate levels independently predict poor outcomes in HAV-ALF.
Area of Science:
- Hepatology
- Infectious Diseases
- Public Health
Background:
- Rising incidence of Hepatitis A Virus (HAV)-induced Acute Liver Failure (ALF) in India.
- Scarcity of validated prognostic markers specifically for HAV-ALF.
- Limitations of existing prognostic models (MELD, ALFSGI, KCC, ALFA, ALFED) in Indian HAV-ALF cohorts.
Purpose of the Study:
- To evaluate the utility of existing prognostic scores in predicting outcomes for HAV-ALF in India.
- To identify independent predictors of mortality in HAV-ALF patients.
- To assess the prognostic accuracy of various scoring systems in this specific patient population.
Main Methods:
- Retrospective observational study of 79 patients with serologically confirmed HAV-ALF (age ≥14 years).
- Analysis of clinical and laboratory parameters, including MELD, ALFSGI, ALFA, KCC, and ALFED scores.
- Multivariate logistic regression and ROC curve analysis to identify predictors and evaluate prognostic accuracy.
Main Results:
- MELD score ≥32, prior hospitalization >3 days, and serum lactate ≥7.1 were independent predictors of mortality.
- The MELD score demonstrated the highest predictive accuracy (AUC = 0.768).
- King's College Criteria (KCC) showed limited sensitivity and poor standalone predictive value.
Conclusions:
- The MELD score is a reliable prognostic tool for HAV-ALF in the Indian context.
- Conventional criteria like KCC have limited utility in HAV-ALF.
- Combined ALFA and ALFSGI scores offer modest improvement but require further validation.
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