Lower level of complement component C3 and C3a in the plasma means poor outcome in the patients with hepatitis B virus related acute-on-chronic liver failure

Abstract Background The purpose of this study was to investigate whether or not the complement system is activated systemically activated and to specify the clinical and prognostic implications of its components during hepatitis B virus related acute-on-chronic liver failure (HBV-ACLF).Methods Blood samples from twenty-seven patients diagnosed with HBV-ACLF, twenty-five patients diagnosed with chronic hepatitis B but without liver failure, and nine health volunteers were enrolled in this survey. Plasma complement components were measured with Enzyme-linked immunosorbent assay. Correlative analysis were assessed between the levels of complement components and the liver failure related index.Results The concentrations of C1q, C3, C3a, C4, C4a and sC5b-9 were significantly higher in the control group than those in the HBV-ACLF group (3.5, 2.4, 2.1, 1.4, 1.3 and 6.0 fold, respectively). However, there was no statistical significance of the differences in the plasma concentrations of mannose binding lectin and factor B between the HBV-ACLF and control groups. The levels of C3 and C3a were inversely correlated with MELDs (P < 0.05) or CLIF-C OFs (P < 0.05).Conclusions Our data demonstrated that the plasma levels of C3 and C3a might be potential novel biomarkers to predict the outcome of HBV-ACLF.