초록
Acute liver failure (ALF) is sometimes termed fulminant hepatic failure, and this is characterized by rapid deterioration of the liver function, which results in altered mentation and coagulopathy in previously normal individuals. Hepatitis B virus (HBV) infection is the most frequent cause of ALF worldwide. It has been reported that fulminant hepatitis B occurs in approximately 1% of the patients with acute HBV infection and it carries a mortality rate of up to 80% if the patient can not undergo liver transplantation (LT). Since Korea is an HBV-endemic area and most infections occur in infancy or early childhood, chronic HBV infection occupies a large portion of LT. Although ALF due to acute HBV infection is rare in Korea, there is no data on the national incidence of HBV-associated ALF. A single-center report shows that the incidence of HBV-related ALF is decreasing; 71.4% in the 1980s, 30% in the 1990s and 15.8% in 20002. A relevant issue is whether a patient with HBV-associated liver failure and with no prior history of liver disease can enter KONOS status 1 registration. Another issue is how to discern ALF due to acute HBV infection from acute-or-chronic liver failure in hepatitis B patient. A national survey is required to reveal the incidence of HBV-associated ALF.