Abstract:

Acute-on-chronic liver failure （ACLF） is generally accepted as a clinical syndrome characterized by an acute hepatic insult and rapid deterioration of liver function in patients with pre-existing chronic liver disease in combination with multi-organ failure with high short-term mortality. Because of the differences in etiology and inducement， there are different definitions and diagnostic criteria of ACLF in the East and West. Attempting to cover all ACLF diagnosed， WGO defined ACLF into three categories in 2014： patients with CLD but no cirrhosis （type A）， compensated cirrhosis （type B）， and decompensated cirrhosis （type C）. However， different types of ACLF have different pathophysiology， which leads to obvious differences in predisposition， injury， response， organ failure and mortality among different types of ACLF. The concept of PIRO， which is similar to that used in determining outcomes of sepsis， is contribute to comprehensively understand different types of HBV-ACLF， improve management. Therefore， it is of great significance to improve the survival rate of ACLF.

Key words: acute-on-chronic liver failure, hepatitis B, PIRO concept, clinical characteristics