This protocol covers patients with liver cirrhosis who develop acute-on-chronic liver failure (ACLF) precipitated by hepatitis B virus (HBV) reactivation — a high-acuity complication of chronic HBV-related liver disease that demands immediate structured management.
ACLF arising from HBV reactivation superimposed on established cirrhosis is a distinct, time-sensitive presentation. Early recognition of this precipitant and prompt escalation of care are critical in guiding management decisions for this population.
Management of this presentation involves early referral for specialist transplant evaluation. The complete structured protocol — including the full criteria, sequence, and decision points — is available via the link below.
DOI: 10.1016/j.jhep.2018.03.024
Administration of nucleoside analogues (tenofovir, entecavir) should be instituted as early as possible in patients with ACLF due to HBV infection (I;1).
Early referral of patients with ACLF to liver transplant centres for immediate evaluation is recommended (II-3;1).
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