Mahtab Mamun-Al, Rahman Salimur, Khan Mobin, Karim Md Fazal
Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
Hepatobiliary Pancreat Dis Int. 2009 Feb;8(1):50-2.
Acute-on-chronic liver failure (ACLF) is common in Bangladesh. Acute viral E hepatitis is sporadically encountered in this country each year, with a rising incidence in the rainy season. This study aimed to identify the etiology of ACLF in Bangladesh.
In this retrospective study, 69 ACLF patients were included. They presented to our department at the Bangabandhu Sheikh Mujib Medical University in Dhaka. History of diseases was recorded and appropriate investigations were conducted in all patients.
Acute hepatitis E virus (HEV) infection was positive in 21.7% (15/69) of the patients, while 14.5% (10/69) had septicemia. Upper gastrointestinal tract hemorrhage was seen in 4.3% of the patients (3/69), while another 4.3% (3/69) had a positive history for alcohol or drugs. None of the patients tested positive for hepatitis A virus infection and no evidence of hepatitis B virus flare was found in any patient. No specific cause for ACLF could be identified.
Acute HEV infection is a leading cause of ACLF in Bangladesh. Many patients were thought to have decompensation of cirrhosis, but subsequently were recognized as having ACLF by a retrospective review according to the definition of the Asian Pacific Association for the Study of the Liver Working Party Meeting on ACLF in New Delhi in early 2008.
急性-on-慢性肝衰竭（ACLF）在孟加拉国很常见。急性戊型病毒性肝炎在该国每年偶有发生，在雨季发病率呈上升趋势。本研究旨在确定孟加拉国ACLF的病因。
在这项回顾性研究中，纳入了69例ACLF患者。他们在达卡的班加班杜·谢赫·穆吉布医科大学我们科室就诊。记录了所有患者的疾病史并进行了适当的检查。
21.7%（15/69）的患者急性戊型肝炎病毒（HEV）感染呈阳性，而14.5%（10/69）的患者患有败血症。4.3%（3/69）的患者出现上消化道出血，另有4.3%（3/69）的患者有酒精或药物使用史阳性。没有患者甲型肝炎病毒感染检测呈阳性，也没有患者发现乙型肝炎病毒复发的证据。无法确定ACLF的具体病因。
急性HEV感染是孟加拉国ACLF的主要病因。许多患者最初被认为是肝硬化失代偿，但随后根据2008年初在新德里举行的亚太肝脏研究协会ACLF工作组会议的定义进行回顾性审查后被认定为患有ACLF。
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