Abstract: Objective To investigate the effect of the interferon-λ3（IFN-λ3） and IL-28B polymorphisms in peripheral blood on the prognosis of hepatitis B acute (subacute)-on- chronic liver failure and try to establish an early, sensitive and specific prognosis model of hepatitis B acute (subacute)-on- chronic liver failure combined with other influencing factors. Method Retrospective cohort study of 97 patients diagnosed with chronic and subacute (subacute) liver failure and viral hepatitis B in Mengchao Hepatobiliary Hospital of Fujian Medical University from October 2019 to March 2020. All the enrolled patients were followed up for half a year, and the end point of follow-up was death. The level of IFN-λ3 and polymorphism of IL-28B rs12979860 were detected. Clinical indicators such as cholesterol, cholinesterase, albumin, total serum bilirubin (TBil), international normalized ratio (INR), plasma thromboplastin antecedent (PTA), and serum creatinine (cr) were collected at baseline treatment, and MELD values at baseline treatment were calculated. Univariate and multiple regression analyses were performed for the above indicators to establish a prognosis assessment model of hepatitis B acute (subacute)-on- chronic liver failure. Result After six months of follow-up, 15 cases died and 82 cases survived, with a mortality rate of 15.5%. Age, total bilirubin, direct bilirubin, indirect bilirubin, cholesterol, prothrombin time, PTA, INR, fibrinogen, IFN-λ3 level and MELD score were statistically different between the two groups (P<0.05). The above indexes were included in logistic regression analysis, and the model was established by stepwise regression method. The results showed that PTA and IFN-λ3 level were independent risk factors for survival. PTA and IFN-λ3 levels were lower in the death group than in the survival group. A new prognostic model equation was established: Y=0.144+0.054×age +0.005×TBil(µmol/L) -0.07×PTA(%) -0.002×IFN-λ3 (pg/ml). ROC curve comparison: The diagnostic value of the newly established model, MELD score, and IFN-λ3 were compared respectively. The results showed that the area under ROC curve of the new predictive model was larger than the MELD score and IFN-λ3 level. IL-28Brs12979860 polymorphism sequencing: Only one died patient was CT genotype, and the rest were CC genotype, so genotype frequency was not statistically different between the two groups. Conclusion The level of IFN-λ3 can be used as an indicator of prognosis in patients with hepatitis B acute (subacute)-on- chronic liver failure. The new model of IFN-λ3 combined with PTA, total bilirubin level and age can predict the prognosis of patients with liver failure better.

Key words: Interleukin-28B, Single nucleotide polymorphism, IFN-λ3, Liver failure