Expert consensus on the diagnosis and treatment of end-stage liver disease complicated by infections

Chen T 1 , Chen G 1 , Wang G 2 , Treeprasertsuk S 3 , Lesmana CRA 4 , Lin HC 5 Show all authors , Al-Mahtab M 6 , Chawla YK 7 , Tan SS 8 , Kao JH 9 , Yuen MF 10 , Lee GH 11 , Alcantara-Payawal D 12 , Nakayama N 13 , Abbas Z 14 , Jafri W 15 , Kim DJ 16 , Choudhury A 17 , Mahiwall R 17 , Hou J 18 , Hamid S 15 , Jia J 19 , Bajaj JS 20 , Wang F 21 , Sarin SK 17 , Ning Q 22

Affiliations 

  • 1 State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095, Jiefang Avenue, Wuhan, 430030, P.R. China
  • 2 Department of Infectious Disease, Center for Liver Disease, Peking University First Hospital, Beijing, China
  • 3 Department of Medicine, Division of Gastroenterology, Faculty of Medicine, Chulalongkorn University, and Thai Red Cross, Bangkok, Thailand
  • 4 Internal Medicine, Hepatobiliary Division, Dr. Captor Mangunkusumo National General Hospital, Universitas Indonesia, Jakarta, DKI, Indonesia
  • 5 Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
  • 6 Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
  • 7 Department of Gastroenterology and Hepatology, Kalinga Institute of Medical Sciences, Bhubaneswar, India
  • 8 Department of Hepatology, Hospital Selayang, Selangor Darul Ehsan, Malaysia
  • 9 Graduate Institute of Clinical Medicine and Hepatitis Research Center, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan
  • 10 Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Pokfulam, Hong Kong
  • 11 Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore, Singapore
  • 12 Fatima University Medical Center Manila, Manila, Philippines
  • 13 Department of Gastroenterology & Hepatology, Saitama Medical University, Saitama, Japan
  • 14 Department of Medicine, Ziauddin University Hospital, Karachi, Pakistan
  • 15 Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
  • 16 Department of Internal Medicine, Chuncheon Sacred Heart Hospital of Hallym University Medical Center, Chuncheon, Korea
  • 17 Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
  • 18 Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Guangdong Provincial Clinical Research Center for Viral Hepatitis, Key Laboratory of Infectious Diseases Research in South China, Ministry of Education, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
  • 19 Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China
  • 20 Department of Medicine, Virginia Commonwealth University and Central Virginia Veterans Healthcare System, Richmond, VA, USA
  • 21 Senior Department of Infectious Diseases, The Fifth Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing, China
  • 22 State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095, Jiefang Avenue, Wuhan, 430030, P.R. China. qning@vip.sina.com
Hepatol Int, 2024 Jun;18(3):817-832.
PMID: 38460060 DOI: 10.1007/s12072-023-10637-3

Abstract

End-stage liver disease (ESLD) is a life-threatening clinical syndrome and when complicated with infection the mortality is markedly increased. In patients with ESLD, bacterial or fungal infection can induce or aggravate the occurrence or progression of liver decompensation. Consequently, infections are among the most common complications of disease deterioration. There is an overwhelming need for standardized protocols for early diagnosis and appropriate management for patients with ESLD complicated by infections. Asia Pacific region has the largest number of ESLD patients, due to hepatitis B and the growing population of alcohol and NAFLD. Concomitant infections not only add to organ failure and high mortality but also to financial and healthcare burdens. This consensus document assembled up-to-date knowledge and experience from colleagues across the Asia-Pacific region, providing data on the principles as well as evidence-based current working protocols and practices for the diagnosis and treatment of patients with ESLD complicated by infections.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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