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Subacute hepatic failure; is it a distinct entity?

B N Tandon, Y K Joshi, L Krishnamurthy

    Journal of Clinical Gastroenterology
    |August 1, 1982
    PubMed
    Summary
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    Subacute hepatic failure, a severe liver condition, is a significant concern in India. This study highlights its characteristics, causes like Hepatitis B virus, and a high mortality rate, emphasizing the need for better understanding and management.

    Area of Science:

    • Hepatology
    • Virology
    • Gastroenterology

    Background:

    • Subacute hepatic failure (SHF) is a distinct clinical entity.
    • Its prevalence, clinical profile, and prognosis require further elucidation.
    • Differentiating SHF from acute liver failure (ALF) and chronic liver failure (CLF) is crucial.

    Purpose of the Study:

    • To determine the relative prevalence of SHF compared to ALF and CLF.
    • To characterize the clinical, biochemical, and morphological features of SHF.
    • To investigate the etiological role of Hepatitis B virus (HBV) and identify prognostic predictors.

    Main Methods:

    • Prospective study of 33 patients with SHF over 3 years.
    • Defined SHF by persistent jaundice (>8 weeks) and ascites in acute viral hepatitis presentations.

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  • Clinical assessment, liver function tests, and liver histology were performed.

    • Main Results:

    • SHF accounted for a notable proportion of liver failure cases in India.
    • Common features included jaundice, ascites, and edema; encephalopathy and bleeding were infrequent.
    • Submassive and bridging necrosis were characteristic histological findings.
    • Hepatitis B virus (HBV) was implicated in 42% of cases.
    • Mortality rate was high at 66%.

    Conclusions:

    • SHF is a highly fatal liver condition prevalent in India.
    • HBV is a significant etiological factor.
    • Early identification and understanding of prognostic factors are essential for managing this severe liver disease.