Pattern of Acute on Chronic Liver Failure in Patient With HCV Related Chronic Liver Disease

Study Overview
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Brief Summary
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The concept of acute-on-chronic liver failure (ACLF) was introduced by Jalan and Williams in 2002 to describe the acute deterioration in liver function over 2 to 4 weeks in a patient with well-compensated cirrhosis associated with a precipitating event (hepatotoxic: superimposed hepatitis viral infection, drug-induced liver injury, hepatotoxins, or excessive alcohol consumption; extra hepatic: variceal bleeding or sepsis), leading to severe deterioration in clinical status with jaundice and hepatic encephalopathy and/or HRS. Following this concept, several proposals for the diagnostic criteria of ACLF have been suggested.

Detailed Description
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There may be regional differences in etiology, pathogenesis, and natural course of ACLF, which may in turn influence the overall outcome of this syndrome. So, proper diagnosis of ACLF and its precipitating factors in our locality enable us for proper management of these cases and dealing with these precipitating factors to be avoided later on in patients with liver cirrhosis Aim of the work: To identify the pattern of acute on chronic liver cell failure (ACLF) within 28 days including prevalence, percipitating factors, and outcome. Patients and methods Type of the study: Prospective hospital based study Site of the study: Tropical Medicine and Gastroenterology Department, Al-Rajhi University Hospital, Assiut University Hospitals, Assiut, Egypt. Written consent will be obtained from all the participants or their relatives before enrollment.

Official Title
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Pattern of Acute on Chronic Liver Failure in Patient With HCV Related Chronic Liver Disease

Conditions
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Acute-On-Chronic Liver Failure

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adult Patients with HCV related CLD based on clinical, biochemical and imaging evidence., with or without prior decompensation. Patients diagnosed to have ACLIF at any grade (1-3) Exclusion Criteria: Acute liver failure without evidence of chronic liver disease. Other etiology of chronic liver disease Patients diagnosed with no ACLIF No ACLF This category includes patients who either: Do not have any organ failure Have a single organ failure that does not involve the kidney with a serum creatinine level of <1.5 mg per dl and no hepatic encephalopathy Have a single brain failure with a serum creatinine level of <1.5 mg per dl Patients refuse to participate.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| pattern of acute on chronic liver cell failure | evaluation of cases with acute on chronic liver cell failure as number of cases diagnosed with ACLF in this period , the precipitating factor of the condition , the fate of the patient (improving or deterioration or death ) in the 28 days following diagnosis . | march 2018 to march 2019 |