Abstract: ObjectiveTo investigate the efficacy of entecavir in treatment of patients with HBV-associated acute-on-chronic liver failure（HBV-ACLF）. Methods 74 patients with HBV-ACLF were enrolled in Third People’s Hospital,Nantong,from 2003 to 2012. Among them,37 patients were given entecavir while receiving liver-protecting treatment,and the other 37 cases were given only basic protecting treatment without any antiviral medication as control group. The clinical characteristic at administration,the results of liver function such as alanine transaminase （ALT）,aspartate transaminase（AST）,albumin （ALB）,creatine（Cr）,prothrombin time （PT） , the score of model for end-stage liver disease （MELD）,cumulative survival rates and recurrence rates within 24 months were compared between the two groups by means of t-test and Chi-Square test. ResultsThe serum levels of ALT,AST,ALB,Cr,plasma prothrombin activity（PTA） and MELD scores between the two groups had no statistical differences after 4-week,8-week and 12 week treatment;The morbidity of ascites,gastrointestinal bleeding,encephalopathy,and hepatorenal syndrome between the two groups had no statistical differences except the morbidity of ascites in the survivors of the entecavir group was 41.4%,lowwer than 66.7%（P<0.05） in the control group at the end of the fourth week;The survival rates in 37 patients receiving antiviral therapy at 8w,12w and 24w,were 75.7%,75.7% and 70.3%,much higher than 67.6%,56.8% and 54.1%（P<0.05）in the control;At the end of 2-year observation, there was no recurrence in 26 survivals with entecavir treatment, while the recurrence rate was 65.0%（P<0.001） in 20 patients without antiviral therapy in the control. ConclusionEnticavir treatment may improve the survival of patients with HBV-ACLF with less disease recurrence.

Key words: Hepatitis B, Acute-on-chronic liver failure, Entecavir, Therapy, Survival rate