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Hepatol Res. 2016 Mar;46(5):369-71. doi: 10.1111/hepr.12626. Epub 2016 Jan 19.

Revised criteria for classification of the etiologies of acute liver failure and late-onset hepatic failure in Japan: A report by the Intractable Hepato-biliary Diseases Study Group of Japan in 2015.

Hepatology research : the official journal of the Japan Society of Hepatology

Satoshi Mochida, Nobuaki Nakayama, Akio Ido, Yasuhiro Takikawa, Osamu Yokosuka, Isao Sakaida, Hisataka Moriwaki, Takuya Genda, Hajime Takikawa

Affiliations

  1. Department of Gastroenterology and Hepatology, Saitama Medical University, Moroyama-Machi, Japan.
  2. Department of Digestive and Life-Style Related Disease, Health Research Course, Human and Environmental Sciences, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
  3. Department of Gastroenterology and Hepatology, School of Medicine, Iwate Medical University, Morioka, Japan.
  4. Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba, Japan.
  5. Department of Gastroenterology, Yamaguchi University Graduate School of Medicine, Ube, Japan.
  6. Department of Gastroenterology, Gifu University Graduate School of Medicine, Gifu, Japan.
  7. Department of Gastroenterology, Shizuoka Hospital, Juntendo University, Izunokuni, Japan.
  8. Department of Medicine, School of Medicine, Teikyo University, Tokyo, Japan.

PMID: 26615003 DOI: 10.1111/hepr.12626

Abstract

In 2011, the Intractable Liver Diseases Study Group of Japan, established novel diagnostic criteria for "acute liver failure ", and published the classification criteria for the etiologies of acute liver failure and late-onset hepatic failure (LOHF) in 2013. According to this classification, HBV carriers showing acute hepatitis exacerbation were divided into 3 subgroups; asymptomatic or inactive HBV carriers without drug exposure, asymptomatic or inactive HBV carriers developing HBV reactivation during and after immunosuppressive therapies and/or antineoplastic chemotherapies and those with previously resolved HBV infection showing iatrogenic HBV reactivation. In an annual nationwide survey in 2013, however, a patient with previously resolved HBV infection was enrolled, in whom LOHF developed as a result of HBV reactivation despite in the absence of immunosuppressive therapies and/or antineoplastic chemotherapies. Thus, the study group revised the classification criteria in 2015; HBV carriers developing acute hepatitis exacerbation were classified into asymptomatic or inactive HBV carriers and patients with previously resolved HBV infection, and both groups were further sub-classified into those receiving immunosuppressive therapies and/or antineoplastic chemotherapies and those without such drugs exposure.

© 2015 The Japan Society of Hepatology.

Keywords: acute liver failure; de novo hepatitis B; fulminant hepatitis; hepatitis B virus

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