Indian Journal of Gastroenterology

, Volume 38, Issue 2, pp 143–149 | Cite as

Antithrombin as a marker of severe acute hepatitis B

  • Simona ArientováEmail author
  • O. Beran
  • P. Chalupa
  • M. Kořínková
  • M. Holub
Original Article



Acute hepatitis B (AHB) can run a severe course, which sometimes leads to a fulminant disease with acute liver failure (ALF). Pro-coagulation factors are well-established markers of AHB severity, but less is known about the levels of anti-coagulation parameters in AHB.


In this study, we demonstrate that antithrombin (AT) plasma levels were associated with AHB severity in 161 patients.


Nine (6%) patients had severe AHB (i.e. international normalized ratio [INR] ≥ 1.6 and total bilirubin ≥ 10 mg/dL). Coagulopathy (i.e. INR > 1.2 and/or AT < 80%) was observed in 65 (40%) AHB patients on admission. Low initial plasma AT levels (i.e. < 80%) were observed in 56 (35%) patients. In all, plasma AT levels decreased in 91 (57%) patients during their hospital stay. Both baseline and nadir AT levels were significantly lower in severe than in mild and moderate AHB. Moreover, the concentration of AT negatively correlated with INR, aspartate aminotransferase, and total and conjugated bilirubin levels. Interestingly, nadir AT levels positively correlated with the duration of hospitalization.


These results indicate that plasma AT levels can be used as an additional marker of AHB severity.


Acute hepatitis B Antithrombin Coagulopathy Severity 


Funding information

The study was supported by a project PROGRESS Q26-7 and UNCE 204022.

Compliance with ethical standards

Conflict of interest

SA, OB, PC, MK, and MH declare that they have no conflict of interest.

Ethics statement

The authors declare that the study was performed in a manner conforming to the Helsinki declaration of 1975, as revised in 2000 and 2008 concerning human and animal rights, and the authors followed the policy concerning informed consent as shown on


The authors are solely responsible for the data and the content of the paper. In no way, the Honorary Editor-in-Chief, Editorial Board Members, or the printer/publishers are responsible for the results/findings and content of this article.


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Copyright information

© Indian Society of Gastroenterology 2019

Authors and Affiliations

  1. 1.Department of Infectious Diseases, First Faculty of MedicineCharles University and Military University HospitalPragueCzech Republic
  2. 2.Department of Infectious and Tropical Diseases, First Faculty of MedicineCharles University and Na Bulovce HospitalPragueCzech Republic

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