Clinical and Molecular Hepatology

"Beom Kyung Kim"

Original Article

Risk stratification by noninvasive tests in patients with metabolic dysfunction-associated steatotic liver disease: Hye Won Lee, Jae Seung Lee, Mi Na Kim, Beom Kyung Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Seung Up Kim; Clin Mol Hepatol 2025;31(3):1018-1031.
Published online April 4, 2025; DOI: https://doi.org/10.3350/cmh.2024.1183

Background/Aims
Recently, the Korean Association for the Study of the Liver (KASL) introduced a noninvasive test-based approach that uses the fibrosis-4 (FIB-4) index followed by vibration-controlled transient elastography (VCTE) to identify high-risk patients with metabolic-associated steatotic liver disease (MASLD). In this study, the KASL two-step approach was validated by assessing the risk of liver-related event (LRE) development.
Methods
We retrospectively analyzed 8,131 patients with MASLD who underwent VCTE between 2012 and 2020. The index date was defined as the date of the VCTE measurement. Using the KASL two-step approach (FIB-4 index and subsequent VCTE), patients were stratified into four groups (low-, intermediate-low-, intermediate-high-, and high-risk groups). Outcomes, including LREs such as decompensation (DCC) or hepatocellular carcinoma (HCC) were evaluated.
Results
During the follow-up (median 46.6 months), 86 (1.1%) patients developed LREs (39 [0.5%] with DCC and 47 [0.6%] with HCC). The KASL two-step approach classified 67.6%, 17.7%, 5.7% and 9.0% of patients in the low-, intermediate-low-, intermediate-high-, and high-risk groups, respectively. The cumulative incidences of LREs increased proportionally according to risk stratification (0.07%, 0.10%, 0.29%, and 1.51% at 3 years and 0.35%, 0.26%, 1.94% and 5.46% at 5 years). The overall accuracy in predicting LREs ranged from 67.7–99.8%. The FIB-4 index and subsequent Agile3+, Agile 4, or FibroScan aspartate aminotransferase scores showed similar predictive abilities compared to the KASL approach.
Conclusions
The KASL two-step approach is an effective and practical method for risk stratification in patients with MASLD, optimizing patient care through early identification of high-risk individuals.

Citations

Citations to this article as recorded by

Correspondence to editorial on “Risk stratification by noninvasive tests in patients with metabolic dysfunction-associated steatotic liver disease”
Hye Won Lee, Seung Up Kim
Clinical and Molecular Hepatology.2026; 32(1): e87. CrossRef
Risk stratification of metabolic dysfunction-associated steatotic liver disease: The KASL pathway: Editorial on “Risk stratification by noninvasive tests in patients with metabolic dysfunction-associated steatotic liver disease”
May Xuan Goh, Xin En Goh, Jarell Jie-Rae Tan, Vincent L Chen, Yu Jun Wong
Clinical and Molecular Hepatology.2026; 32(1): 429. CrossRef
Validation of combo ichroma as a reliable concentration-based alternative for AST and ALT measurement in liver disease monitoring
Minsoo Kim, Su A Kim, Jeong Min Kim, Hee Young Kim, Ho Yeong Yoon, Sung Won Park, Daegyun Park, Ji Sook Han, Ki Tae Suk
Methods.2025; 243: 66. CrossRef

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Correspondence

Viral hepatitis

HCV self-testing: Bridging screening gaps and ensuring cost-effectiveness for both high-risk and universal populations: Correspondence to editorial on “Self-testing strategy to eliminate hepatitis C as per World Health Organization’s goal: Analysis of disease burden and cost-effectiveness”: Gyeongseon Shin, Beom Kyung Kim, SeungJin Bae, Hankil Lee, Sang Hoon Ahn; Clin Mol Hepatol 2025;31(2):e163-e165.
Published online November 29, 2024; DOI: https://doi.org/10.3350/cmh.2024.1057

5,539 View
42 Download

Original Article

Viral hepatitis

Self-testing strategy to eliminate hepatitis C as per World Health Organization’s goal: Analysis of disease burden and cost-effectiveness: Gyeongseon Shin, Beom Kyung Kim, SeungJin Bae, Hankil Lee, Sang Hoon Ahn; Clin Mol Hepatol 2025;31(1):166-178.
Published online October 4, 2024; DOI: https://doi.org/10.3350/cmh.2024.0484

Background/Aims
The World Health Organization (WHO) aims to eliminate hepatitis C virus (HCV) by 2030; therefore, widespread HCV screening is required. The WHO recommends HCV self-testing (HCVST) as a new approach. We aimed to evaluate disease burden reduction using the HCVST screening strategy and identify the most cost-effective approach.
Methods
We developed a dynamic open-cohort Markov model to assess the long-term effects and costeffectiveness of HCVST in the Republic of Korea from 2024 to 2030. Strategies for comparison included universal, birth cohort, high-risk group screening, and no screening, focusing on the following: (1) incremental costeffectiveness ratio (ICER) per disability-adjusted life-year (DALY) saved; (2) severe liver disease cases; and (3) liverrelated death reduction.
Results
Universal HCVST screening is the most effective strategy for achieving the WHO goal by 2030, substantially lowering the incidence of severe liver disease by 71% and preventing liver-related deaths by 69%, thereby averting 267,942 DALYs. Moreover, with an ICER of US$8,078 per DALY and high cost-effectiveness, the sensitivity results prove that cost-effectiveness is robust. Although high-risk group screening offers the lowest cost compared with other strategies, its effectiveness in preventing severe liver disease is minimal, falling short of the current WHO goal.
Conclusions
Our study confirms that universal HCVST screening is a cost-effective strategy aligned with the WHO goal to eliminate HCV by 2030. Despite its higher costs compared to risk-based screening, the disease burden can be significantly reduced by providing effective HCVST access to individuals who might otherwise not be tested.

Citations

Citations to this article as recorded by

HCV self-testing: Bridging screening gaps and ensuring cost-effectiveness for both high-risk and universal populations: Correspondence to editorial on “Self-testing strategy to eliminate hepatitis C as per World Health Organization’s goal: Analysis of dis
Gyeongseon Shin, Beom Kyung Kim, SeungJin Bae, Hankil Lee, Sang Hoon Ahn
Clinical and Molecular Hepatology.2025; 31(2): e163. CrossRef
Universal self-testing as a cost-effective weapon to eliminate hepatitis C virus in the Republic of Korea: Editorial on “Self-testing strategy to eliminate hepatitis C as per World Health Organization’s goal: Analysis of disease burden and cost-effectiven
Eun Sun Jang
Clinical and Molecular Hepatology.2025; 31(2): 596. CrossRef
Cost-effectiveness and return on investment of hepatitis C virus elimination in China: A modelling study
Meiyu Wu, Jing Ma, Xuehong Wang, Sini Li, Chongqing Tan, Ouyang Xie, Andong Li, Aaron G Lim, Xiaomin Wan
Clinical and Molecular Hepatology.2025; 31(2): 394. CrossRef
Future Perspectives of Liver Research in the Asia‐Pacific Region: Focus on Hepatitis B and C
Beom Kyung Kim
Journal of Gastroenterology and Hepatology.2025; 40(8): 1855. CrossRef
Bridging the Gap in Elimination of Hepatitis C Virus among People Who Use Drugs in South Korea
Beom Kyung Kim
Gut and Liver.2025; 19(5): 635. CrossRef
OraQuick hepatitis C virus self-test: A new frontier in hepatitis C screening
Muneeb Saifullah, Mavra Khan, Muhammad Ashhad Usman, Qasim Mehmood, Abbas M Mehdi
World Journal of Virology.2025;[Epub] CrossRef

6,637 View
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4 Web of Science
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Special Issue

Liver fibrosis, cirrhosis, and portal hypertension

KASL clinical practice guidelines for noninvasive tests to assess liver fibrosis in chronic liver disease: Mi Na Kim, Ji Won Han, Jihyun An, Beom Kyung Kim, Young-Joo Jin, Seung-seob Kim, Minjong Lee, Han Ah Lee, Yuri Cho, Hee Yeon Kim, Yu Rim Shin, Jung Hwan Yu, Moon Young Kim, YoungRok Choi, Young Eun Chon, Eun Ju Cho, Eun Joo Lee, Sang Gyune Kim, Won Kim, Dae Won Jun, Seung Up Kim, on behalf of The Korean Association for the Study of the Liver (KASL); Clin Mol Hepatol 2024;30(Suppl):S5-S105.
Published online August 19, 2024; DOI: https://doi.org/10.3350/cmh.2024.0506

Citations

Citations to this article as recorded by

Correspondence to editorial 1 on “Baveno VI-SSM stratifies the risk of portal hypertension-related events in patients with HBV-related cirrhosis”
Haiyu Wang, Jinjun Chen
Clinical and Molecular Hepatology.2026; 32(1): e58. CrossRef
Refining portal hypertension assessment: The clinical significance of spleen stiffness measurement in the Baveno VII Era: Editorial on “Baveno VI-SSM stratifies the risk of portal hypertension-related events in patients with HBV-related cirrhosis”
Do Seon Song
Clinical and Molecular Hepatology.2026; 32(1): 400. CrossRef
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Clinical and Molecular Hepatology.2025; 31(Suppl): S1. CrossRef
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G. Craig Wood, Anthony Hoovler, Rakesh Luthra, Christopher D. Still, Hamzah Shariff, Matthew Still, Jonathan Hayes, Peter Benotti, Chioma Uzoigwe
Expert Review of Gastroenterology & Hepatology.2025; 19(4): 427. CrossRef
Age serves as the silent architect of FIB-4’s precision in unveiling advanced hepatic fibrosis in MASLD with T2DM: Correspondence to letter to the editor on “Diagnostic accuracy of the fibrosis-4 index for advanced liver fibrosis in nonalcoholic fatty liv
Ji Won Han, Dae Won Jun
Clinical and Molecular Hepatology.2025; 31(2): e152. CrossRef
The association between modified cardiometabolic index with non-alcoholic fatty liver disease and liver fibrosis: a cross-sectional study
Yanjun Guo, Wei Su, Lulong Tao, Guoxin Zhang, Kun Wang
BMC Gastroenterology.2025;[Epub] CrossRef
Future Perspectives of Liver Research in the Asia‐Pacific Region: Focus on Hepatitis B and C
Beom Kyung Kim
Journal of Gastroenterology and Hepatology.2025; 40(8): 1855. CrossRef
Novel Insights into Noninvasive Assessment of Liver Fibrosis in Chronic Hepatitis C Patients
Guanlan Liu, Li Liu, Xing Yang, Qihao Wang, Mingqin Qian
Journal of Clinical and Experimental Hepatology.2025; 15(6): 102610. CrossRef
A Case Report of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) with Improved Cardiometabolic Risk Factors Following Treatment with Saenggangunbi-tang
Eun Kyung Lee, Min Jeong Park, Youngchul Kim, Jang-Hoon Lee
The Journal of Internal Korean Medicine.2025; 46(2): 303. CrossRef
Risk stratification by noninvasive tests in patients with metabolic dysfunction-associated steatotic liver disease
Hye Won Lee, Jae Seung Lee, Mi Na Kim, Beom Kyung Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Seung Up Kim
Clinical and Molecular Hepatology.2025; 31(3): 1018. CrossRef
Performance of APRI and FIB-4 Scores Compared to FibroScan: A Cross-Sectional Study in a Black Sub-Saharan African Population
Jean-Bonny Nsumbu, Jean-Robert Makulo, Trésor Mutombo Tshiswaka, Christian Kisoka Lusunsi, Charles Nlombi Mbendi
Hepatic Medicine: Evidence and Research.2025; Volume 17: 27. CrossRef
Quantification of liver steatosis of metabolic dysfunction-associated steatotic liver disease based on body composition analysis
Toshikazu Kohira, Satoshi Oeda, Erina Eto, Yoshihito Kubotsu, Misa Norita, Kaori Inoue, Nagisa Hara, Shotaro Noge, Kenichi Tanaka, Shigenobu Yoshimura, Noriko Oza, Keizo Anzai, Yuichiro Eguchi, Cheng Han Ng, Daniel Q. Huang, Mark D. Muthiah, Atsushi Kawag
Scientific Reports.2025;[Epub] CrossRef
Longitudinal Effects of Glecaprevir/Pibrentasvir on Liver Function, Fibrosis, and Hepatocellular Carcinoma Risk in Chronic Hepatitis C: A Prospective Multicenter Cohort Study
Jung Hee Kim, Jae Hyun Yoon, Sung-Eun Kim, Ji-Won Park, Yewan Park, Gi-Ae Kim, Seong Kyun Na, Young-Sun Lee, Jeong Han Kim
Medicina.2025; 61(9): 1601. CrossRef
Comment on ‘Association Between Handgrip Strength and Cardiovascular Disease Risk in MASLD: A Prospective Study From UK Biobank’ by T. S. Lim et al.—Authors' Reply
Tae Seop Lim, Sujin Kwon, Sung A Bae, Hye Yeon Chon, Seol A. Jang, Ja Kyung Kim, Chul Sik Kim, Seok Won Park, Kyoung Min Kim
Journal of Cachexia, Sarcopenia and Muscle.2025;[Epub] CrossRef
Aspirin Use and Risk of HCC and Gastrointestinal Bleeding in Patients With HBV‐Related Cirrhosis: A Landmark Analysis
Mi Na Kim, Geun U. Park, Seng Chan You, Jae Seung Lee, Hye Won Lee, Beom Kyung Kim, Seung Up Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn
Journal of Gastroenterology and Hepatology.2025; 40(11): 2750. CrossRef
Prospects of late-stage development agents in the treatment of metabolic dysfunction-associated steatohepatitis
Brian Lee, Ussama Ghumman, Lisa D. Pedicone, Andres Gomez Aldana, Eric Lawitz
Clinical and Molecular Hepatology.2025; 31(4): 1167. CrossRef
Discovery of ultrasound-derived fat fraction as a non-invasive tool for MASLD diagnosis
Huiru Jin, Mengfan Jiao, Chengxiao Yu, Tingting Ren, Qingling Chen, Zixing Dai, Erfu Xie, Longfeng Jiang, Yuwen Li
European Journal of Medical Research.2025;[Epub] CrossRef
Mistakes in the utilization of vibration-controlled transient elastography in the evaluation of liver fibrosis: a narrative review
Madunil Anuk Niriella, Uditha Bandara Dassanayake, Charith Priyanga Madurapperuma, Indeewari Prathibha Wijesingha, Arjuna Priyadarshin De Silva, Hithnadura Janaka de Silva
Expert Review of Gastroenterology & Hepatology.2025; 19(12): 1299. CrossRef
Enhanced Prediction of Hepatitis B Virus-Related Hepatocellular Carcinoma Using Age-male-albumin-bilirubin-platelet (aMAP) and Liver Stiffness Assessed by Vibration-controlled Transient Elastography
Hye Yeon Chon, Hyung Joon Yim, Seok-Jae Heo, Su Jong Yu, Ja Kyung Kim, Sang Hoon Ahn, Grace Lai-Hung Wong, Jimmy Che-To Lai, Terry Cheuk-Fung Yip, Sang Gyune Kim, Yeon Seok Seo, Seung Up Kim
Clinical Gastroenterology and Hepatology.2025;[Epub] CrossRef
A Novel Deep Learning Framework for Liver Fibrosis Staging and Etiology Diagnosis Using Integrated Liver–Spleen Elastography
Kai Yang, Fei Chen, Aiping Tian, Long Deng, Xiaorong Mao
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Jung Hwan Yu
The Korean Journal of Medicine.2024; 99(5): 232. CrossRef
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Mi Na Kim
The Korean Journal of Gastroenterology.2024; 84(5): 201. CrossRef
Non-Invasive Test for Assessment of Liver Fibrosis in Chronic Hepatitis B
Ye Ji Jun, Minjong Lee, Ho Soo Chun, Tae Hun Kim
The Korean Journal of Gastroenterology.2024; 84(5): 206. CrossRef
Serological Markers to Assess Liver Fibrosis and Their Roles
Beom Kyung Kim
The Korean Journal of Gastroenterology.2024; 84(5): 195. CrossRef
Liver Fibrosis Assessment in Chronic Liver Diseases Using Elastography: A Comprehensive Review of Vibration-Controlled Transient Elastography and Shear Wave Elastography
Han Ah Lee
Clinical Ultrasound.2024; 9(2): 70. CrossRef

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Reply to Correspondence

Viral hepatitis

Reply to correspondence on “Hepatocellular carcinoma prediction model performance decreases with long-term antiviral therapy in chronic hepatitis B patients”: Beom Kyung Kim; Clin Mol Hepatol 2024;30(4):1044-1046.
Published online July 29, 2024; DOI: https://doi.org/10.3350/cmh.2024.0584

Citations

Citations to this article as recorded by

Prediction Model for Familial Aggregated HBV‐Associated Hepatocellular Carcinoma Based on Serum Biomarkers
Linmei Zhong, Guole Nie, Qiaoping Wu, Honglong Zhang, Haiping Wang, Jun Yan
Cancer Reports.2025;[Epub] CrossRef

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Editorial

Viral hepatitis

Decreasing performance of HCC prediction models during antiviral therapy for hepatitis B: what else to keep in mind: Editorial on “Hepatocellular carcinoma prediction model performance decreases with long-term antiviral therapy in chronic hepatitis B patients”: Beom Kyung Kim; Clin Mol Hepatol 2024;30(4):656-658.
Published online July 8, 2024; DOI: https://doi.org/10.3350/cmh.2024.0499

Citations

Citations to this article as recorded by

Prediction Model for Familial Aggregated HBV‐Associated Hepatocellular Carcinoma Based on Serum Biomarkers
Linmei Zhong, Guole Nie, Qiaoping Wu, Honglong Zhang, Haiping Wang, Jun Yan
Cancer Reports.2025;[Epub] CrossRef
Reply to correspondence on “Hepatocellular carcinoma prediction model performance decreases with long-term antiviral therapy in chronic hepatitis B patients”
Beom Kyung Kim
Clinical and Molecular Hepatology.2024; 30(4): 1044. CrossRef
Correspondence to editorial on “Hepatocellular carcinoma prediction model performance decreases with long-term antiviral therapy in chronic hepatitis B patients”
Xiaoqian Xu, Hong You, Jidong Jia, Yuanyuan Kong
Clinical and Molecular Hepatology.2024; 30(4): 994. CrossRef

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Original Articles

Steatotic liver disease

Global prevalence of metabolic dysfunction-associated fatty liver disease-related hepatocellular carcinoma: A systematic review and meta-analysis: Harry Crane, Guy D. Eslick, Cameron Gofton, Anjiya Shaikh, George Cholankeril, Mark Cheah, Jian-Hong Zhong, Gianluca Svegliati-Baroni, Alessandro Vitale, Beom Kyung Kim, Sang Hoon Ahn, Mi Na Kim, Simone I Strasser, Jacob George; Clin Mol Hepatol 2024;30(3):436-448.
Published online April 16, 2024; DOI: https://doi.org/10.3350/cmh.2024.0109

Background/Aims
The global proportion of hepatocellular carcinoma (HCC) attributable to metabolic dysfunction-associated fatty liver disease (MAFLD) is unclear. The MAFLD diagnostic criteria allows
objective
diagnosis in the presence of steatosis plus defined markers of metabolic dysfunction, irrespective of concurrent liver disease. We aimed to determine the total global prevalence of MAFLD in HCC cohorts (total-MAFLD), including the proportion with MAFLD as their sole liver disease (single-MAFLD), and the proportion of those with concurrent liver disease where MAFLD was a contributary factor (mixed-MAFLD).
Methods
This systematic review and meta-analysis included studies systematically ascertaining MAFLD in HCC cohorts, defined using international expert panel criteria including ethnicity-specific BMI cut-offs. A comparison of clinical and tumour characteristics was performed between single-MAFLD, mixed-MAFLD, and non-MAFLD HCC.
Results
22 studies (56,565 individuals with HCC) were included. Total and single-MAFLD HCC prevalence was 48.7% (95% confidence interval [CI] 34.5–63.0%) and 12.4% (95% CI 8.3–17.3%), respectively. In HCC due to chronic hepatitis B, C, and alcohol-related liver disease, mixed-MAFLD prevalence was 40.0% (95% CI 30.2–50.3%), 54.1% (95% CI 40.4–67.6%) and 64.3% (95% CI 52.7–75.0%), respectively. Mixed-MAFLD HCC had significantly higher likelihood of cirrhosis and lower likelihood of metastatic spread compared to single-MAFLD HCC, and a higher platelet count and lower likelihood of macrovascular invasion compared to non-MAFLD HCC.
Conclusions
MAFLD is common as a sole aetiology, but more so as a co-factor in mixed-aetiology HCC, supporting the use of positive diagnostic criteria.

Citations

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Hepatic neoplasm

Sorafenib vs. Lenvatinib in advanced hepatocellular carcinoma after atezolizumab/bevacizumab failure: A real-world study: Young Eun Chon, Dong Yun Kim, Mi Na Kim, Beom Kyung Kim, Seung Up Kim, Jun Yong Park, Sang Hoon Ahn, Yeonjung Ha, Joo Ho Lee, Kwan Sik Lee, Beodeul Kang, Jung Sun Kim, Hong Jae Chon, Do Young Kim; Clin Mol Hepatol 2024;30(3):345-359.
Published online March 12, 2024; DOI: https://doi.org/10.3350/cmh.2023.0553

Background/Aims
Atezolizumab plus bevacizumab (ATE+BEV) therapy has become the recommended first-line therapy for patients with unresectable hepatocellular carcinoma (HCC) because of favorable treatment responses. However, there is a lack of data on sequential regimens after ATE+BEV treatment failure. We aimed to investigate the clinical outcomes of patients with advanced HCC who received subsequent systemic therapy for disease progression after ATE+BEV.
Methods
This multicenter, retrospective study included patients who started second-line systemic treatment with sorafenib or lenvatinib after HCC progressed on ATE+BEV between August 2019 and December 2022. Treatment response was assessed using the Response Evaluation Criteria in Solid Tumors (version 1.1.). Clinical features of the two groups were balanced through propensity score (PS) matching.
Results
This study enrolled 126 patients, 40 (31.7%) in the lenvatinib group, and 86 (68.3%) in the sorafenib group. The median age was 63 years, and males were predominant (88.1%). In PS-matched cohorts (36 patients in each group), the
objective
response rate was similar between the lenvatinib- and sorafenib-treated groups (5.6% vs. 8.3%; P=0.643), but the disease control rate was superior in the lenvatinib group (66.7% vs. 22.2%; P<0.001). Despite the superior progression- free survival (PFS) in the lenvatinib group (3.5 vs. 1.8 months, P=0.001), the overall survival (OS, 10.3 vs. 7.5 months, P=0.353) did not differ between the two PS-matched treatment groups.
Conclusions
In second-line therapy for unresectable HCC after ATE+BEV failure, lenvatinib showed better PFS and comparable OS to sorafenib in a real-world setting. Future studies with larger sample sizes and longer follow-ups are needed to optimize second-line treatment.

Citations

Citations to this article as recorded by

Comparative analysis of lenvatinib use after atezolizumab plus bevacizumab versus lenvatinib as first-line therapy in unresectable hepatocellular carcinoma
Kazuki Maesaka, Hayato Hikita, Yuki Tahata, Chinatsu Nishioka, Machiko Kai, Kumiko Shirai, Kazuhiro Murai, Yuki Makino, Yoshinobu Saito, Takahiro Kodama, Kazuyoshi Ohkawa, Masanori Miyazaki, Yasutoshi Nozaki, Takayuki Yakushijin, Ryotaro Sakamori, Nobuyuk
Journal of Gastroenterology.2026; 61(1): 68. CrossRef
EASL Clinical Practice Guidelines on the management of hepatocellular carcinoma
Bruno Sangro, Josepmaria Argemi, Maxime Ronot, Valerie Paradis, Tim Meyer, Vincenzo Mazzaferro, Peter Jepsen, Rita Golfieri, Peter Galle, Laura Dawson, Maria Reig
Journal of Hepatology.2025; 82(2): 315. CrossRef
Lenvatinib versus sorafenib as second-line therapy following progression on atezolizumab–bevacizumab in patients with unresectable hepatocellular carcinoma: a multicenter retrospective study from Korea and Japan
Jaekyung Cheon, Shigeo Shimose, Hyung-Don Kim, Takashi Niizeki, Min-Hee Ryu, Tomotake Shirono, Baek-Yeol Ryoo, Hideki Iwamoto, Changhoon Yoo
Journal of Cancer Research and Clinical Oncology.2025;[Epub] CrossRef
Treatment for hepatocellular carcinoma after immunotherapy
Landon L. Chan, Tsz Tung Kwong, Johnny C.W. Yau, Stephen L. Chan
Annals of Hepatology.2025; 30(2): 101781. CrossRef
Evaluating Sorafenib (SORA-2) as Second-Line Treatment for Unresectable Hepatocellular Carcinoma: A European Retrospective Multicenter Study
Christian Möhring, Moritz Berger, Farsaneh Sadeghlar, Xin Zhou, Taotao Zhou, Malte Benedikt Monin, Kateryna Shmanko, Sabrina Welland, Friedrich Sinner, Birgit Schwacha-Eipper, Ulrike Bauer, Christoph Roderburg, Angelo Pirozzi, Najib Ben Khaled, Peter Schr
Cancers.2025; 17(6): 972. CrossRef
Therapeutic Sequences of Systemic Therapy After Atezolizumab Plus Bevacizumab for Hepatocellular Carcinoma: Real‐World Analysis of the IMMUreal Cohort
Najib Ben Khaled, Valentina Zarka, Bernard Hobeika, Julia Schneider, Monika Rau, Alexander Weich, Hans Benno Leicht, Liangtao Ye, Ignazio Piseddu, Michael T. Dill, Arne Kandulski, Matthias Pinter, Ursula Ehmer, Peter Schirmacher, Jens U. Marquardt, Julia
Alimentary Pharmacology & Therapeutics.2025; 61(11): 1755. CrossRef
Application of the associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) technique in conversion therapy for hepatocellular carcinoma
Jingyun Ning, Cao Dai, Qin Liu, Haoming Lin, Rui Zhang
British Journal of Surgery.2025;[Epub] CrossRef
Recent advances in polydopamine-coated metal–organic frameworks for cancer therapy
Jingchao He, Guangtian Wang, Yongfang Zhou, Bin Li, Pan Shang
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Targeting STAT3 by erianin to overcome sorafenib resistance in hepatocellular carcinoma: Integrated network pharmacology with molecular docking, dynamics simulations, and in vitro validation
Zixian Liu, Ruoning Qian, Yuanchao Feng, Ruogu Qi, Zhengguang Zhang, Fuqiong Zhou
Biochemical and Biophysical Research Communications.2025; 778: 152348. CrossRef
PEGylated liposomal metformin overcomes pharmacokinetic barriers to trigger potent mitochondrial disruption and cell cycle arrest in hepatocellular carcinoma
Zeinab A. Elzanaty, Medhat W. Shafaa, Seifeldin Elabed, Mohamed M. Omran
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Multicenter Phase 2 Trial of Second-Line Regorafenib in Patients with Unresectable Hepatocellular Carcinoma after Progression on Atezolizumab plus Bevacizumab
Jaekyung Cheon, Baek-Yeol Ryoo, Hong Jae Chon, Hyung-Don Kim, Min-Hee Ryu, Kyu-Pyo Kim, Beodeul Kang, Richard S. Finn, Stephen Lam Chan, Changhoon Yoo
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Hepatology.2025;[Epub] CrossRef
Multicenter single-arm phase II trial of lenvatinib in patients with advanced hepatocellular carcinoma after progression on first-line atezolizumab plus bevacizumab
Hyung-Don Kim, Sun Jin Sym, Hong Jae Chon, Moonho Kim, Jung Hun Kang, Baek-Yeol Ryoo, Choong-kun Lee, Joohyun Hong, Hyewon Ryu, Woo Kyun Bae, Hyeyeong Kim, Hyunho Kim, Jin Won Kim, Tae-Yong Kim, Changhoon Yoo
Journal of Hepatology.2025;[Epub] CrossRef
Lenvatinib vs. sorafenib as second-line treatment post atezolizumab plus bevacizumab for hepatocellular carcinoma: The LEVIATHAN study
Pasquale Lombardi, Jung Sun Kim, Giulia F. Manfredi, Ciro Celsa, Claudia A.M. Fulgenzi, Antonio D’Alessio, Bernardo Stefanini, Niraj C. Doshi, Emily Warmington, Thomas U. Marron, Matthias Pinter, Bernhard Scheiner, Beodeul Kang, Ho Yeong Lim, Wei-Fan Hsu,
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Yuefeng Shang, Tong Liu, Wenjing Wang
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Xiaoyi Zhang, Yachuan Tao, Zhongli Xu, Biao Jiang, Xiaobao Yang, Taomin Huang, Wenfu Tan
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Edoardo G. Giannini
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Correspondence to editorial on “Sorafenib vs. Lenvatinib in advanced hepatocellular carcinoma after atezolizumab/bevacizumab failure: A real-world study”
Young Eun Chon, Dong Yun Kim, Hong Jae Chon, Do Young Kim
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Frontiers in Oncology.2024;[Epub] CrossRef

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516 Download
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Hepatic neoplasm

Global burden of primary liver cancer and its association with underlying aetiologies, sociodemographic status, and sex differences from 1990–2019: A DALY-based analysis of the Global Burden of Disease 2019 study: Sungchul Choi, Beom Kyung Kim, Dong Keon Yon, Seung Won Lee, Han Gyeol Lee, Ho Hyeok Chang, Seoyeon Park, Ai Koyanagi, Louis Jacob, Elena Dragioti, Joaquim Radua, Jae Il Shin, Seung Up Kim, Lee Smith; Clin Mol Hepatol 2023;29(2):433-452.
Published online January 4, 2023; DOI: https://doi.org/10.3350/cmh.2022.0316

Background/Aims
Global distribution of dominant liver cancer aetiologies has significantly changed over the past decades. This study analyzed the updated temporal trends of liver cancer aetiologies and sociodemographic status in 204 countries and territories from 1990 to 2019.
Methods
The Global Burden of Disease 2019 report was used for statistical analysis. In addition, we performed stratification analysis to five quintiles using sociodemographic index and 21 geographic regions.
Results
The crude numbers of liver cancer disease-adjusted life years (DALYs) and deaths significantly increased during the study period (DALYs; 11,278,630 in 1990 and 12,528,422 in 2019, deaths; 365,215 in 1990 and 484,577 in 2019). However, the Age-standardized DALY and mortality rates decreased. Hepatitis B virus (HBV) remains the leading cause of liver cancer DALYs and mortality, followed by hepatitis C virus (HCV), alcohol consumption, and non-alcoholic steatohepatitis/non-alcoholic fatty liver disease (NASH/NAFLD). Although Age-standardized DALY and mortality rates of liver cancer due to HBV and HCV have decreased, the rates due to alcohol consumption and NASH/NAFLD have increased. In 2019, the population of the East Asia region had the highest Age-standardized DALY and mortality rates, followed by high-income Asia-Pacific and Central Asia populations. Although East Asia and high-income Asia-Pacific regions showed a decrease during the study period, Age-standardized DALY rates increased in Central Asia. High-income North American and Australasian populations also showed a significant increase in Age-standardized DALY.
Conclusions
Liver cancer remains an ongoing global threat. The burden of liver cancer associated with alcohol consumption and NASH/NAFLD is markedly increasing and projected to continuously increase.

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Global prevalence of depression and anxiety in patients with hepatocellular carcinoma: Systematic review and meta-analysis: Darren Jun Hao Tan, Sabrina Xin Zi Quek, Jie Ning Yong, Adithya Suresh, Kaiser Xuan Ming Koh, Wen Hui Lim, Jingxuan Quek, Ansel Tang, Caitlyn Tan, Benjamin Nah, Eunice Tan, Taisei Keitoku, Mark D. Muthiah, Nicholas Syn, Cheng Han Ng, Beom Kyung Kim, Nobuharu Tamaki, Cyrus Su Hui Ho, Rohit Loomba, Daniel Q. Huang; Clin Mol Hepatol 2022;28(4):864-875.
Published online July 25, 2022; DOI: https://doi.org/10.3350/cmh.2022.0136

Background/Aims
Depression and anxiety are associated with poorer outcomes in patients with hepatocellular carcinoma (HCC). However, the prevalence of depression and anxiety in HCC are unclear. We aimed to establish the prevalence of depression and anxiety in patients with HCC.
Methods
MEDLINE and Embase were searched and original articles reporting prevalence of anxiety or depression in patients with HCC were included. A generalized linear mixed model with Clopper-Pearson intervals was used to obtain the pooled prevalence of depression and anxiety in patients with HCC. Risk factors were analyzed via a fractional-logistic regression model.
Results
Seventeen articles involving 64,247 patients with HCC were included. The pooled prevalence of depression and anxiety in patients with HCC was 24.04% (95% confidence interval [CI], 13.99–38.11%) and 22.20% (95% CI, 10.07–42.09%) respectively. Subgroup analysis determined that the prevalence of depression was lowest in studies where depression was diagnosed via clinician-administered scales (16.07%;95% CI, 4.42–44.20%) and highest in self-reported scales (30.03%; 95% CI, 17.19–47.01%). Depression in patients with HCC was lowest in the Americas (16.44%; 95% CI, 6.37–36.27%) and highest in South-East Asia (66.67%; 95% CI, 56.68–75.35%). Alcohol consumption, cirrhosis, and college education significantly increased risk of depression in patients with HCC.
Conclusions
One in four patients with HCC have depression, while one in five have anxiety. Further studies are required to validate these findings, as seen from the wide CIs in certain subgroup analyses. Screening strategies for depression and anxiety should also be developed for patients with HCC.

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Review

Viral hepatitis

Cost-effectiveness of chronic hepatitis C screening and treatment: Hye Won Lee, Hankil Lee, Beom Kyung Kim, Young Chang, Jae Young Jang, Do Young Kim; Clin Mol Hepatol 2022;28(2):164-173.
Published online December 27, 2021; DOI: https://doi.org/10.3350/cmh.2021.0193

Hepatitis C virus (HCV) infection is the second most common cause of chronic liver disease in South Korea, with a prevalence ranging from 0.6% to 0.8%, and HCV infection incidence increases with age. The anti-HCV antibody test, which is cheaper than the HCV RNA assay, is widely used to screen for HCV infections; however, the underdiagnosis of HCV is a major barrier to the elimination of HCV infections. Although several risk factors have been associated with HCV infections, including intravenous drug use, blood transfusions, and hemodialysis, most patients with HCV infections present with no identifiable risk factors. Universal screening for HCV in adults has been suggested to improve the detection of HCV infections. We reviewed the cost-effectiveness of HCV screening and the methodologies used to perform screening. Recent studies have suggested that universal HCV screening and treatment using direct-acting antivirals represent cost-effective approaches to the prevention and treatment of HCV infection. However, the optimal timing and frequency of HCV screening remain unclear, and further studies are necessary to determine the best approaches for the elimination of HCV infections.

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Editorial

Liver fibrosis, cirrhosis, and portal hypertension

The cutoff of transient elastography for the evaluation of portal hypertension should be different according to the etiology?: Beom Kyung Kim; Clin Mol Hepatol 2021;27(1):91-93.
Published online December 3, 2020; DOI: https://doi.org/10.3350/cmh.2020.0311

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Original Article

Negligible risks of hepatocellular carcinoma during biomarker-defined immune-tolerant phase for patients with chronic hepatitis B: Mi Young Jeon, Beom Kyung Kim, Jae Seung Lee, Hye Won Lee, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Kwang-Hyub Han, Seung Up Kim; Clin Mol Hepatol 2021;27(2):295-304.
Published online December 3, 2020; DOI: https://doi.org/10.3350/cmh.2020.0216

Background/Aims
The immune-tolerant (IT) phase of chronic hepatitis B (CHB) patients is not generally indicative of antiviral therapy (AVT). We assessed and compared the risk of hepatocellular carcinoma (HCC) during the IT-phase stringently defined by a low fibrosis-4 (FIB-4) index, compared to that in patients undergoing AVT.
Methods
Among 125 untreated patients that were hepatitis B e-antigen positive, hepatitis B virus-DNA >20,000 IU/mL, with normal alanine aminotransferase level from 2012 to 2018, those with a FIB-4 index of <1.45 were classified into the IT-group. The cumulative probability of HCC was estimated using Kaplan-Meier analysis. All patients were assessed until HCC development (intention-to-treat [ITT] analysis), whereas those suspected of experiencing CHB phase switch were assessed using the per-protocol (PP) and censored at the time of phase switch.
Results
The cumulative probability of HCC at 1-, 3-, and 5-years among the IT-group was zero, compared to AVT-treated patients with FIB-4 indices <1.45 during the same period: 0.2%, 0.6%, and 1.4%, respectively (P=0.264 for ITT and P=0.533 for PP). Among the initially screened 125 untreated patients, those with a FIB-4 index of ≥1.45 had a higher risk of HCC compared to the IT-group (P=0.005). Furthermore, among AVT-treated patients, those with a FIB-4 index of ≥1.45 had a higher risk of HCC compared to their counterpart (P<0.001).
Conclusions
The risk of HCC was negligible in the IT-group stringently defined by a low FIB-4 index. However, given that a higher HCC risk exists among untreated patients with higher FIB-4, appropriate criteria for AVT should be established.

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Letter to the Editor

Viral hepatitis

How does low-level viremia affect the prognosis of patients with chronic hepatitis B?: Hye Won Lee, Beom Kyung Kim; Clin Mol Hepatol 2020;26(3):376-377.
Published online June 11, 2020; DOI: https://doi.org/10.3350/cmh.2020.0121

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Original Articles

Hepatic neoplasm

Serum Wisteria floribunda agglutinin-positive human Mac-2 binding protein level predicts recurrence of hepatitis B virus-related hepatocellular carcinoma after curative resection: Hye Soo Kim, Seung Up Kim, Beom Kyung Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Kwang-Hyub Han, Young Nyun Park, Dai Hoon Han, Kyung Sik Kim, Jin Sub Choi, Gi Hong Choi, Hyon-Suk Kim; Clin Mol Hepatol 2020;26(1):33-44.
Published online June 27, 2019; DOI: https://doi.org/10.3350/cmh.2018.0073

Background/Aims
To investigate whether serum Wisteria floribunda agglutinin-positive human Mac-2-binding protein (WFA⁺-M2BP) can predict the recurrence of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) after curative resection.
Methods
Patients with chronic hepatitis B (CHB) who underwent curative resection for HCC between 2004 and 2015 were eligible for the study. Recurrence was sub-classified as early (<2 years) or late (≥2 years).
Results
A total of 170 patients with CHB were selected. During the follow-up period (median, 22.6 months), 64 (37.6%) patients developed recurrence. In multivariate analyses, WFA⁺-M2BP level was an independent predictor of overall (hazard ratio [HR]=1.490), early (HR=1.667), and late recurrence (HR=1.416), together with male sex, des-gamma carboxyprothrombin level, maximal tumor size, portal vein invasion, and satellite nodules (all P<0.05). However, WFA⁺- M2BP level was not predictive of grade B-C posthepatectomy liver failure. The cutoff value that maximized the sum of sensitivity (30.2%) and specificity (90.6%) was 2.14 (area under receiver operating characteristic curve=0.632, P=0.010). Patients with a WFA⁺-M2BP level >2.14 experienced recurrence more frequently than those with a WFA⁺-M2BP level ≤2.14 (P=0.011 by log-rank test), and had poorer postoperative outcomes than those with a WFA⁺-M2BP level ≤2.14 in terms of overall recurrence (56.0 vs. 34.5%, P=0.047) and early recurrence (52.0 vs. 20.7%, P=0.001).
Conclusions
WFA⁺-M2BP level is an independent predictive factor of HBV-related HCC recurrence after curative resection. Further studies should investigate incorporation of WFA⁺-M2BP level into tailored postoperative surveillance strategies for patients with CHB.

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Hepatic neoplasm

Risk assessment of hepatocellular carcinoma development for indeterminate hepatic nodules in patients with chronic hepatitis B: Haneulsaem Shin, Yeon Woo Jung, Beom Kyung Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Kwang-Hyub Han, Yeun-Yoon Kim, Jin-Young Choi, Seung Up Kim; Clin Mol Hepatol 2019;25(4):390-399.
Published online May 31, 2019; DOI: https://doi.org/10.3350/cmh.2018.0103

Background/Aims
A risk prediction model for the development of hepatocellular carcinoma (HCC) from indeterminate nodules detected on computed tomography (CT) (RadCT score) in patients with chronic hepatitis B (CHB)-related cirrhosis was proposed. We validated this model for indeterminate nodules on magnetic resonance imaging (MRI).
Methods
Between 2013 and 2016, Liver Imaging Reporting and Data System (LI-RADS) 2/3 nodules on MRI were detected in 99 patients with CHB. The RadCT score was calculated.
Results
The median age of the 72 male and 27 female subjects was 58 years. HCC history and liver cirrhosis were found in 47 (47.5%) and 44 (44.4%) patients, respectively. The median RadCT score was 112. The patients with HCC (n=41, 41.4%) showed significantly higher RadCT scores than those without (median, 119 vs. 107; P=0.013); the Chinese university-HCC and risk estimation for HCC in CHB (REACH-B) scores were similar (both P>0.05). Arterial enhancement, T2 hyperintensity, and diffusion restriction on MRI were not significantly different in the univariate analysis (all P>0.05); only the RadCT score significantly predicted HCC (hazard ratio [HR]=1.018; P=0.007). Multivariate analysis showed HCC history was the only independent HCC predictor (HR=2.374; P=0.012). When the subjects were stratified into three risk groups based on the RadCT score (<60, 60–105, and >105), the cumulative HCC incidence was not significantly different among them (all P>0.05, log-rank test).
Conclusions
HCC history, but not RadCT score, predicted CHB-related HCC development from LI-RADS 2/3 nodules. New risk models optimized for MRI-defined indeterminate nodules are required.

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Hepatic neoplasm

A survey on transarterial chemoembolization refractoriness and a real-world treatment pattern for hepatocellular carcinoma in Korea: Jae Seung Lee, Beom Kyung Kim, Seung Up Kim, Jun Yong Park, Sang Hoon Ahn, Jin Sil Seong, Kwang-Hyub Han, Do Young Kim; Clin Mol Hepatol 2020;26(1):24-32.
Published online May 20, 2019; DOI: https://doi.org/10.3350/cmh.2018.0065

Background/Aims
Transarterial chemoembolization (TACE) is a standard treatment for intermediate-stage hepatocellular carcinoma (HCC), but there is much controversy about TACE refractoriness. The aim of this study was to identify trends in the actual clinical application of TACE and recognition of TACE refractoriness by Korean experts.
Methods
In total, 17 questionnaires on TACE refractoriness were administered to 161 clinicians via an online survey. Multiple answers were allowed for some questions.
Results
Most clinicians agreed that there is a need for standardization of TACE application through specific scoring systems (n=124, 77.0%). TACE refractoriness was predominantly expected by participants when recurrences were detected within 1 month (n=70, 43.5%), there were 4 to 6 tumors (n=77, 47.8%), the maximal tumor size was 3–5 cm (n=49, 30.4%), and when there was insufficient tumor necrosis despite TACE being repeated more than three times (n=78, 48.4%). Overall, sorafenib therapy (n=137) and radiotherapy (n=114) were preferred when repeated TACE was considered ineffective.
Conclusions
Treatment of HCC is often based on the clinical judgment of clinicians because of the heterogeneity among individuals. Experts need to continue discussions on the standardization and sub-classification of HCC treatment guidelines in Korea.

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Viral hepatitis

Influence of hepatic steatosis on the outcomes of patients with chronic hepatitis B treated with entecavir and tenofovir: David Sooik Kim, Mi Young Jeon, Hye Won Lee, Beom Kyung Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Kwang-Hyub Han, Seung Up Kim; Clin Mol Hepatol 2019;25(3):283-293.
Published online November 13, 2018; DOI: https://doi.org/10.3350/cmh.2018.0054

Background/Aims
The influence of hepatic steatosis (HS) on chronic hepatitis B (CHB) is unclear. We evaluated the influence of the degree of HS, assessed using the controlled attenuation parameter (CAP) of transient elastography (TE), on treatment outcomes in CHB patients initiated on antiviral therapy.
Methods
A total of 334 patients who were initiated on entecavir or tenofovir between 2007 and 2016 with available TE results were recruited.
Results
Of the total study population, 146 (43.7%) patients had HS (CAP > 238 dB/m). Three-hundred-three patients (90.7%) achieved complete virological response (CVR) (hepatitis B virus DNA<12 IU/L), and 25 patients (7.5%) developed hepatocellular carcinoma (HCC). Among hepatitis B e antigen (HBeAg)-positive patients (n=172, 51.5%), 37 (21.5%) experienced HBeAg loss. On univariate analysis, CAP value was not associated with the probability of HCC development (P=0.380). However, lower CAP value was independently associated with higher probability of HBeAg loss among HBeAg-positive patients (hazard ratio [HR]=0.991, P=0.026) and with CVR achievement in the entire study population (HR=0.996, P=0.004). The cumulative incidence of HBeAg loss among HBeAg-positive patients was significantly higher in patients without HS than in those with HS (log-rank, P=0.022).
Conclusions
CAP values were not correlated with HCC development in patients initiated on entecavir and tenofovir. However, CAP values were negatively correlated with the probability of HBeAg loss among HBeAg-positive patients and with CVR achievement.

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Editorial

Viral hepatitis

Assessment of fibrotic burden among chronic hepatitis B virus-infected patients with normal transaminase level: Mi Young Jeon, Beom Kyung Kim, Seung Up Kim; Clin Mol Hepatol 2018;24(4):367-369.
Published online September 19, 2018; DOI: https://doi.org/10.3350/cmh.2018.1008

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Addition of liver stiffness enhances the predictive accuracy of the PAGE‐B model for hepatitis B‐related hepatocellular carcinoma
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Negligible risks of hepatocellular carcinoma during biomarker-defined immune-tolerant phase for patients with chronic hepatitis B
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Review

Viral hepatitis

Current status of and strategies for hepatitis C control in South Korea: Beom Kyung Kim, Eun Sun Jang, Jeong Han Kim, Soo Young Park, Song Vogue Ahn, Hyung Joon Kim, Do Young Kim; Clin Mol Hepatol 2017;23(3):212-218.
Published online September 19, 2017; DOI: https://doi.org/10.3350/cmh.2017.0105

Abstract
PDF

Chronic hepatitis C (CHC) is caused by hepatitis C virus (HCV) infection. HCV infection causes acute hepatitis, and the majority of those infected progress to chronic hepatitis, and some of them develop cirrhosis and hepatocellular carcinoma. Transmission of HCV is parenteral, and the major transmission routes include drug abuse, insecure injections or medical procedures, contaminated syringes or needles, sexual contact with an HCV-infected person, vertical infection of newborns by infected mothers, the transfusion of blood or blood products contaminated with viruses, and organ transplants. As no vaccine against HCV is available, HCV management involves blocking routes of transmission transmission, screening for HCV infection, and protecting liver disease progression by treatment. Highly potent oral direct antiviral agents are now available. Therefore, early detection through nation-wide screening program and appropriate treatment should be implemented to improve the quality of life of patients with HCV. Furthermore, for the effective HCV control in South Korea, The organization of an ‘integrated national viral hepatitis control system’ is desirable.

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Editorial

Liver fibrosis, cirrhosis, and portal hypertension

Transient elastography can be integrated into routine clinical practice for the evaluation of portal hypertension?: Beom Kyung Kim; Clin Mol Hepatol 2017;23(1):27-30.
Published online March 24, 2017; DOI: https://doi.org/10.3350/cmh.2017.0101

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Original Articles

Viral hepatitis

Efficacy of switching from adefovir to tenofovir in chronic hepatitis B patients who exhibit suboptimal responses to adefovir-based combination rescue therapy due to resistance to nucleoside analogues (SATIS study): Hye Won Lee, Jun Yong Park, Beom Kyung Kim, Moon Young Kim, Jung Il Lee, Young Suk Kim, Ki Tae Yoon, Kwang-Hyub Han, Sang Hoon Ahn; Clin Mol Hepatol 2016;22(4):443-449.
Published online November 25, 2016; DOI: https://doi.org/10.3350/cmh.2016.0037

Abstract
PDF

Background/Aims
It remains to be determined whether switching from adefovir (ADV) to tenofovir (TDF) provides better virological outcomes in patients exhibiting suboptimal responses to ADV plus nucleoside analogue (ADV+NA) therapy for NA-resistant chronic hepatitis B (CHB).
Methods
In this prospective trial, patients who showed partial responses (defined as serum hepatitis B virus [HBV] DNA >60 IU/mL) to ADV+NA therapy for NA resistance were randomly allocated to receive TDF plus NA (TDF+NA group, n=16) or to continue their current therapy (ADV+NA group, n=16). The primary end point was the proportion of patients with complete virological response (CVR, defined as serum HBV DNA <60 IU/mL) at 48 weeks.
Results
The median age was 52 years (16 men), and 28 were positive for hepatitis B e antigen (HBeAg). The baseline characteristics did not differ significantly between the two groups. The proportion with CVR was significantly higher in the TDF+NA group than in the ADV+NA group at 24 weeks (81.3% vs. 25.0%, P=0.001) and 48 weeks (87.5% vs. 37.5%, P=0.002). Furthermore, a decrease in the serum HBV DNA level of >2log10 IU/mL was more likely in the TDF+NA group at both 24 and 48 weeks (68.8% vs. 56.3%, P=0.014 vs. 81.3% vs. 56.3%, P=0.001, respectively). During the follow-up, the rate of HBeAg seroconversion was higher in the TDF+NA group than the ADV+NA group (12.5% vs. 6.25%, P=0.640), as was that for the hepatitis B surface antigen (6.25% vs. 0%, P=0.080). No serious adverse events due to antiviral agents occurred.
Conclusions
In patients exhibiting suboptimal responses to ADV+NA therapy for NA-resistant CHB, switching from ADV to TDF might provide better virological outcomes.

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Journal of Medical Virology.2018; 90(3): 497. CrossRef
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Viral hepatitis

Tenofovir disoproxil fumarate monotherapy for nucleos(t)ide-naïve chronic hepatitis B patients in Korea: data from the clinical practice setting in a single-center cohort: Sung Soo Ahn, Young Eun Chon, Beom Kyung Kim, Seung Up Kim, Do Young Kim, Sang Hoon Ahn, Kwang-Hyub Han, Jun Yong Park; Clin Mol Hepatol 2014;20(3):261-266.
Published online September 25, 2014; DOI: https://doi.org/10.3350/cmh.2014.20.3.261

Abstract
PDF

Background/Aims

This study assessed the antiviral efficacy and safety of tenofovir disoproxil fumarate (TDF) for up to 12 months in Korean treatment-naïve chronic hepatitis B (CHB) patients.

Methods

A total of 411 treatment-naïve CHB patients who had been treated with TDF for at least 3 months (median 5.6) were consecutively enrolled. Clinical, biochemical, virological parameters and treatment adherence were routinely assessed every 3 months.

Results

The median age was 51.3 years, 63.0% of the patients were male, 49.6% were HBeAg (+), and 210 patients had liver cirrhosis. The median baseline HBV DNA was 5.98 (SD 1.68) log₁₀ IU/mL. Among the patients completing week 48, 83.3% had a complete virologic response (CVR, <12 IU/mL by HBV PCR assay), and 88.2% had normalized levels of alanine aminotransferase (ALT). The cumulative probabilities of CVR at 3, 6, 9 and 12 months were 22.8%, 53.1%, 69.3% and 85.0%. During the follow-up period, 9.8% patients achieved HBeAg loss and 7.8% patients achieved HBeAg seroconversion. There was no virological breakthrough after initiating TDF. The most common TDF-related adverse event was gastrointestinal upset, and three patients discontinued TDF therapy. However, no serious life-threatening side effect was noted.

Conclusions

In a clinical practice setting, TDF was safe and highly effective when administered for 12 months to Korean treatment-naïve CHB patients.

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Jae Young Choe, Jae Sung Ko, Byung-Ho Choe, Jung Eun Kim, Ben Kang, Kyung Jae Lee, Hye Ran Yang
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Effects of Entecavir and Tenofovir on Renal Function in Patients with Hepatitis B Virus-Related Compensated and Decompensated Cirrhosis
Jihye Park, Kyu Sik Jung, Hye Won Lee, Beom Kyung Kim, Seung Up Kim, Do Young Kim, Sang Hoon Ahn, Kwang-Hyub Han, Jun Yong Park
Gut and Liver.2017; 11(6): 828. CrossRef
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Viral hepatitis

Antiviral efficacies of currently available rescue therapies for multidrug-resistant chronic hepatitis B: Mi Sung Park, Beom Kyung Kim, Kyung Sik Kim, Ja Kyung Kim, Seung Up Kim, Jun Yong Park, Do Young Kim, Oidov Baartarkhuu, Kwang Hyub Han, Chae Yoon Chon, Sang Hoon Ahn; Korean J Hepatol 2013;19(1):29-35.
Published online March 25, 2013; DOI: https://doi.org/10.3350/cmh.2013.19.1.29

Abstract
PDF

Background/Aims

The incidence of multidrug-resistant (MDR) chronic hepatitis B (CHB) during sequential lamivudine (LAM) and adefovir dipivoxil (ADV) treatment is increasing. We investigated the antiviral efficacies of various rescue regimens in patients who failed sequential LAM-ADV treatment.

Methods

Forty-eight patients (83.3% of whom were HBeAg-positive) who failed sequential LAM-ADV treatment were treated with one of the following regimens: entecavir (ETV) (1 mg) monotherapy (n=16), LAM+ADV combination therapy (n=20), or ETV (1 mg)+ADV combination therapy (n=12). All patients had confirmed genotypic resistance to both LAM and ADV and were evaluated every 12 weeks.

Results

The baseline characteristics and treatment duration did not differ significantly among the study groups. During the treatment period (median duration: 100 weeks), the decline of serum HBV DNA from baseline tended to be greatest in the ETV+ADV group at all-time points (week 48: -2.55 log₁₀ IU/mL, week 96: -4.27 log₁₀ IU/mL), but the difference was not statistically significant. The ETV+ADV group also tended to have higher virologic response rates at 96 weeks compared to the ETV monotherapy or LAM+ADV groups (40.0% vs. 20.0% or 20.0%, P=0.656), and less virologic breakthrough was observed compared to the ETV monotherapy or LAM+ADV groups (8.3% vs. 37.5% or 30.0%; P=0.219), but again, the differences were not statistically significant. HBeAg loss occurred in one patient in the ETV+ADV group, in two in the ETV monotherapy group, and in none of the LAM+ADV group. The safety profiles were similar in each arm.

Conclusions

There was a nonsignificant tendency toward better antiviral efficacy with ETV+ADV combination therapy compared to LAM+ADV combination therapy and ETV monotherapy for MDR CHB in Korea, where tenofovir is not yet available.

Citations

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Mi Na Kim, Jae Seung Lee, Hye Won Lee, Beom Kyung Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Se Young Jang, Won Young Tak, Young-Oh Kweon, Soo Young Park, Seung Up Kim
Clinical Gastroenterology and Hepatology.2023; 21(9): 2278. CrossRef
Revised Korean Antiviral Guideline Reduces the Hepatitis B-related Hepatocellular Carcinoma Risk in Cirrhotic Patients
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Journal of Korean Medical Science.2021;[Epub] CrossRef
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Clinical Drug Investigation.2017; 37(3): 233. CrossRef
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Song Yang, Huichun Xing, Qi Wang, Xiaomei Wang, Shunai Liu, Jun Cheng
Annals of Clinical Microbiology and Antimicrobials.2016;[Epub] CrossRef
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Jeong Han Kim, Sung Hyun Ahn, Soon Young Ko, Won Hyeok Choe, Kyun-Hwan Kim, So Young Kwon
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YANG WANG, SHUANG LIU, YU CHEN, SUJUN ZHENG, LI ZHOU, FENGMIN LU, ZHONGPING DUAN
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Tenofovir disoproxil fumarate monotherapy for nucleos(t)ide-naïve chronic hepatitis B patients in Korea: data from the clinical practice setting in a single-center cohort
Sung Soo Ahn, Young Eun Chon, Beom Kyung Kim, Seung Up Kim, Do Young Kim, Sang Hoon Ahn, Kwang-Hyub Han, Jun Yong Park
Clinical and Molecular Hepatology.2014; 20(3): 261. CrossRef
Oral antiviral agents for treatment of chronic hepatitis B
Soon Young Ko, Won Hyeok Choe
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