Abstract: Objective To identify the association between IL-6 and liver impairment, and the impact of IL-6 on the prognosis of patients with hepatitis B virus related acute on-chronic liver failure (HBV -ACLF).Methods A total of 754 HBV - ACLF patients was included and analyzed the association between IL-6 level and indexes for liver impairment, and the impact of IL-6 on prognosis.Results IL-6 level was positively correlated with the international standardized ratio, total bilirubin, and MELD scores, and the correlation coefficients were 0.108, 0.143, and 0.173 (P<0.001), respectively. It was negatively correlated with platelet count, alanine aminotransferase, aspartate aminotransferase, and albumin, and the correlation coefficients were -0.160, -0.151, -0.129 (P<0.001). The patients at the early stage had lower IL-6 level than those at the mediate or late stages (P<0.001). The patients with 2 organ failures at least had higher level of IL-6 than those with no more than 1 organ failure (P=0.014). The 4-week and 48-week mortality rates in patients with high level of IL-6 (> 9.78 pg/ml) were significantly higher than those in patients with low level of IL-6 (≤9.78 pg/mL) (4 weeks: 17.2% vs 8.2%, P=0.002; 48 weeks: 33.7% vs 22.0%, P<0.001); after adjusting for age and MELD score, The HR were 1.93 (P=0.003), 1.47 (P=0.008), respectively.Conclusion IL-6 level is a promising candidate marker to reflect the severity of liver injury and to predict mortality in patients with HBV-ACLF.

Key words: Hepatitis B virus, Acute on-chronic liver failure, IL-6