Abstract: Objective The aim of this study was to evaluate the efficacy of tenofovir disoproxil fumarate (TDF) and double plasma molecular absorb system (DPMAS) plus plasma exchange (PE) in treatment of patients with HBV-induced acute-on-chronic liver failure (HBV-ACLF). Methods 50 patients with HBV-ACLF HBV-ACLF were enrolled in this study and were divided into observation (n=25) and control group (n=25), receiving TDF, DPMAS and PE combination or TDF and DPMAS treatment. Serum interleukin-6 level was assayed by ELISA. Results At the end of 12 week treatment, serum bilirubin level in the observation group was (24.0 μmol/L, INR was(1.1±0.3), both significantly lower than 【(31.6±15.9)μmol/L and (1.3±0.4), respectively, P＜0.05】, while serum albumin level was (34.8±6.1)g/L, significantly higher than 【(30.9±5.2)g/L, P＜0.05】 in the control; serum IL-6 level was (52.7±25.2)ng/L, procalcitonin level was (0.4±0.1)ng/L, platelet-to-lymphocyte ratio was (120.6±24.4), and neutrophil-to-lymphocyte ratio was (1.9±0.5), all significantly lower than 【(67.2±30.8)ng/L, (0.5±0.2)ng/L, (139.3±26.7) and (2.4±0.6), respectively, P＜0.05】 in the control; the survival rate was significantly higher than that in the control group (72.0% vs. 48.0%,P＜0.05). Conclusion TDF combined with DPMAS and PE in treatment of patients with HBV-ACLF is efficacious, which might be related to the reduction of blood endotoxin and improve liver function recovery.

Key words: Acute-on-chronic liver failure, Hepatitis B, Tenofovir disoproxil fumarate, Plasma exchange, Double plasma molecular absorb system, Efficacy