Hepatology International

, Volume 7, Issue 2, pp 714–720 | Cite as

Changing etiology of liver failure in 3,916 patients from northern China: a 10-year survey

  • Shaoli You
  • Yihui Rong
  • Bing Zhu
  • Aimin Zhang
  • Hong Zang
  • Hongling Liu
  • Dongze Li
  • Zhihong WanEmail author
  • Shaojie XinEmail author
Original Article



To investigate the etiological characteristics of patients with liver failure in the past 10 years.


Clinical and investigational data in hospitalized patients with liver failure admitted from 2002 to 2011 were retrospectively analyzed. Standard definitions and criteria were used to assess disease etiology.


Of these 3,916 patients, 3,429 (87.6 %) had acute-on-chronic liver failure (ACLF), 114 (2.9 %) acute liver failure (ALF), and 373 (9.5 %) subacute liver failure. Viral infection was the most common cause of liver failure in the 3,295 patients (84.1 %). Hepatitis of unknown etiology was deemed responsible for 371 cases of liver failure (9.5 %). Drug-induced liver injury, alcoholic hepatitis, and autoimmune hepatitis led to 120 cases (3.1 %), 109 cases (2.8 %), and 19 cases (0.5 %), respectively. The most common cause of ACLF was HBV infection (87.3 %), while the main causes of acute and subacute liver failure were hepatitis of unknown etiology (39.4 %), viral infection (36.6 %), and drug-induced liver injury (19.3 %). Our data showed that the incidence of liver failure caused by HBV gradually decreased from 86.5 % in 2002 to 69.2 % in 2011. However, the incidence of hepatitis of unknown etiology, drug-induced liver injury, and alcoholic hepatitis was increased.


HBV infection is the main cause of liver failure in China. However, the incidence of HBV-related liver failure has gradually decreased in the past 10 years. Hepatitis of unknown etiology has replaced HBV infection as the most common apparent cause of acute liver failure.


Liver injury Liver failure Etiology Prognosis 


Conflict of interest

None to declare.

Financial support

This research was supported by grants from the 12th Five-Year National Science and Technology Major Project for Infectious Diseases (No. 2012ZX10002004-005) and 12th Five-Year Grand Project of PLA (No. BWS11J075).


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Copyright information

© Asian Pacific Association for the Study of the Liver 2013

Authors and Affiliations

  • Shaoli You
    • 1
  • Yihui Rong
    • 1
  • Bing Zhu
    • 1
  • Aimin Zhang
    • 1
  • Hong Zang
    • 1
  • Hongling Liu
    • 1
  • Dongze Li
    • 1
  • Zhihong Wan
    • 1
    Email author
  • Shaojie Xin
    • 1
    Email author
  1. 1.Liver Failure Treatment and Research Center, Beijing 302 HospitalBeijingChina

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