Abstract: Objective MELD score, MELD-Na score, CLIF-C OF score, and CLIF-C ACLF score were used to predict the short-term mortality risk in patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) complicated with invasive pulmonary aspergillosis（IPA）, to explore and compare the predictive value of various scoring systems for the short-term fatality rate in patients with HBV-ACLF incorporates the IPA. Method Collect the clinical data of HBV-ACLF patients who admitted to the Infection Department of the First Affiliated Hospital of Nanchang University from January 2019 to December 2021. The MELD score, MELD-Na score, CLIF-C OF score and CLIF-C ACLF score were calculated respectively, and the receiver operating characteristic curve (ROC curve) was applied to compare the diagnostic value of the above scoring system. Comparisons between two groups meeting the normal distribution were performed by the t-test, Comparisons between two groups who did not fit the normal distribution were performed using the Mann-Whitney U test. Result Among the 110 patients, 36 patients (32.7%) died after 28 days of treatment.The area under the ROC curve (AUC) of the MELD score, MELD-Na score, CLIF-C OF score and CLIF-C ACLF score was 0.77,0.74,0.93 and 0.89, respectively. The AUC of CLIF-C OF score was the largest, and there was no significant difference with CLIF-C ACLF score (P>0.05).There were significant differences in AUC between CLIF-C OF score, CLIF-C ACLF score, MELD score and MELD-Na score (P<0.05). Conclusion The CLIF-C OF score and CLIF-C ACLF score can effectively predict the 28-day risk of death in patients with ACLF incorporates the IPA.

Key words: Acute-on-chronic liver failure, Hepatitis B virus, Aspergillus, Prognosis