N-acetylcysteine treatment in viral-induced acute liver failure

ABSTRACT

Background:Acute liver failure (ALF) is characterized by acute derangement of liver function and carries high mortality. Viral hepatitis is still one of the main causes of ALF in the India as well in world. A prospective case control study was carried with the aim to determine the effect of N-acetylcysteine (NAC) on survival ofviral-ALFpatients.Methods:37 patients with a diagnosis of viral-ALFwere included in the study. 18 patients received NAC infusion for 72hrs whereas 19 patients in control group received placebo. The variables evaluated were demographic, biochemical, outcome and length of hospital stay.Results:Out of 37viral-ALFpatients, acute HEV-induced ALF (48.6%) was most common followed by HBV (24.3%) and HAV (21.6%). The two groups were comparable for the various baseline characteristics (age, INR, bilirubin,ALT, creatinine, albumin, grade of encephalopathy,mean grade of comaetc.). Use of NAC was associated with a shorter length of hospital stay of survived patients (p=0.024). A total of 20 of 37 (54.1%) patients died with ALF complications; 7 (38.9%) patients belonged to NACgroup and 13 (68.4%) patients to control group (p=0.079).HEV induced ALFshowed significant improved in survival than Non HEV inducedALF with NAC administration (p=0.022). Conclusions: HEV was the most frequently cause ofviral-ALF. Overall survival was not improved by NAC. HEV induced ALFshowed significant improved in survival than Non HEV inducedALF with NAC administration.NAC reduced duration of hospital stay