Clinical and Molecular Hepatology

"Heung Up Kim"

Case Reports

Viral hepatitis

Regression of esophageal varices and splenomegaly in two patients with hepatitis-C-related liver cirrhosis after interferon and ribavirin combination therapy: Soon Jae Lee, Yoo-Kyung Cho, Soo-Young Na, Eun Kwang Choi, Sun Jin Boo, Seung Uk Jeong, Hyung Joo Song, Heung Up Kim, Bong Soo Kim, Byung-Cheol Song; Clin Mol Hepatol 2016;22(3):390-395.
Published online August 30, 2016; DOI: https://doi.org/10.3350/cmh.2015.0050

Abstract
PDF

Some recent studies have found regression of liver cirrhosis after antiviral therapy in patients with hepatitis C virus (HCV)-related liver cirrhosis, but there have been no reports of complete regression of esophageal varices after interferon/ peg-interferon and ribavirin combination therapy. We describe two cases of complete regression of esophageal varices and splenomegaly after interferon-alpha and ribavirin combination therapy in patients with HCV-related liver cirrhosis. Esophageal varices and splenomegaly regressed after 3 and 8 years of sustained virologic responses in cases 1 and 2, respectively. To our knowledge, this is the first study demonstrating that complications of liver cirrhosis, such as esophageal varices and splenomegaly, can regress after antiviral therapy in patients with HCV-related liver cirrhosis.

Citations

Citations to this article as recorded by

Direct-acting antiviral therapy reduces variceal rebleeding and improves liver function in hepatitis C virus-related cirrhosis: A multicenter retrospective cohort study
Raafat SA Abdel Hafez, Atteyat A Semeya, Rasha Elgamal, Amira AA Othman
World Journal of Hepatology.2025;[Epub] CrossRef
Long term changes in thrombocytopenia and leucopenia after HCV eradication with direct-acting antivirals
Kazuto Tajiri, Kazuhiko Okada, Hiroyuki Ito, Kengo Kawai, Yoshiro Kashii, Yoshiharu Tokimitsu, Nozomu Muraishi, Aiko Murayama, Yuka Hayashi, Masami Minemura, Terumi Takahara, Yukihiro Shimizu, Ichiro Yasuda
BMC Gastroenterology.2023;[Epub] CrossRef
Small Esophageal Varices in Patients with Cirrhosis—Should We Treat Them?
Thomas Reiberger, Theresa Bucsics, Rafael Paternostro, Nikolaus Pfisterer, Florian Riedl, Mattias Mandorfer
Current Hepatology Reports.2018; 17(4): 301. CrossRef

16,901 View
134 Download
2 Web of Science
Crossref

Viral hepatitis

Regression of esophageal varices during entecavir treatment in patients with hepatitis-B-virus-related liver cirrhosis: Hye Young Jwa, Yoo-Kyung Cho, Eun Kwang Choi, Heung Up Kim, Hyun Joo Song, Soo-Young Na, Sun-Jin Boo, Seung Uk Jeong, Bong Soo Kim, Byoung-Wook Lee, Byung-Cheol Song; Clin Mol Hepatol 2016;22(1):183-187.
Published online March 28, 2016; DOI: https://doi.org/10.3350/cmh.2016.22.1.183

Abstract
PDF

Recent studies suggest that liver cirrhosis is reversible after administering oral nucleos(t)ide analogue therapy to patients with hepatitis B virus (HBV) infection. However, few studies have addressed whether esophageal varices can regress after such therapy. We report a case of complete regression of esophageal varices during entecavir therapy in patients with HBV-related liver cirrhosis, suggesting that complications of liver cirrhosis such as esophageal varices can regress after the long-term suppression of HBV replication.

Citations

Citations to this article as recorded by

Pathophysiology and Management of Variceal Bleeding
Saleh A. Alqahtani, Sunguk Jang
Drugs.2021; 81(6): 647. CrossRef
Antiviral therapy reduces rebleeding rate in patients with hepatitis B-related cirrhosis with acute variceal bleeding after endotherapy
Lingling He, Xiaohui Ye, Jiali Ma, Ping Li, Yu Jiang, Julong Hu, Junru Yang, Yuling Zhou, Xiuxia Liang, Yijun Lin, Hongshan Wei
BMC Gastroenterology.2019;[Epub] CrossRef
The noninvasive diagnosis of esophageal varices and its application in clinical practice
Etienne Pateu, Frédéric Oberti, Paul Calès
Clinics and Research in Hepatology and Gastroenterology.2018; 42(1): 6. CrossRef
Small Esophageal Varices in Patients with Cirrhosis—Should We Treat Them?
Thomas Reiberger, Theresa Bucsics, Rafael Paternostro, Nikolaus Pfisterer, Florian Riedl, Mattias Mandorfer
Current Hepatology Reports.2018; 17(4): 301. CrossRef

17,234 View
155 Download
4 Web of Science
Crossref

Original Article

Viral hepatitis

Is it necessary to delay antiviral therapy for 3-6 months to anticipate HBeAg seroconversion in patients with HBeAg-positive chronic hepatitis B in endemic areas of HBV genotype C?: Byung-Cheol Song, Yoo-Kyung Cho, Hyeyoung Jwa, Eun Kwang Choi, Heung Up Kim, Hyun Joo Song, Soo-Young Na, Sun-Jin Boo, Seung Uk Jeong; Clin Mol Hepatol 2014;20(4):355-360.
Published online December 24, 2014; DOI: https://doi.org/10.3350/cmh.2014.20.4.355

Abstract
PDF

Background/Aims

Spontaneous HBeAg seroconversion occurs frequently in the immune reactive phase in HBeAg-positive chronic hepatitis B (CHB). Therefore, observation for 3-6 months before commencing antiviral therapy is recommended in patients with alanine aminotransferase (ALT) levels that exceed twice the upper limit of normal (ULN). However, HBeAg seroconversion occurs infrequently in patients infected with hepatitis B virus (HBV) genotype C. The aim of the present study was to determine whether the waiting policy is necessary in endemic areas of HBV genotype C infection.

Methods

Ninety patients with HBeAg-positive CHB were followed prospectively without administering antiviral therapy for 6 months. Antiviral therapy was initiated promptly at any time if there was any evidence of biochemical (i.e., acute exacerbation of HBV infection or aggravation of jaundice) or symptomatic deterioration. After 6 months of observation, antiviral therapy was initiated according to the patient's ALT and HBV DNA levels.

Results

Only one patient (1.1%) achieved spontaneous HBeAg seroconversion. Biochemical and symptomatic deterioration occurred before 6 months in 17 patients (18.9%) and 5 patients, respectively. High ALT and HBV DNA levels were both independent risk factors for biochemical deterioration. Of 15 patients with HBV DNA ≥5.1×10⁷ IU/mL and ALT ≥5×ULN, biochemical deterioration occurred in 7 (46.7%), including 1 patient receiving liver transplantation due to liver failure.

Conclusions

Spontaneous HBeAg seroconversion in patients with HBeAg-positive CHB is rare within 6 months. Biochemical deterioration was common and may lead to liver failure. Immediate antiviral therapy should be considered, especially in patients with high ALT and HBV DNA levels in endemic areas of genotype C infection.

Citations

Citations to this article as recorded by

Replication and Expression of the Consensus Genome of Hepatitis B Virus Genotype C from the Chinese Population
Fenfang Liao, Junmou Xie, Rongsong Du, Wenbo Gao, Lanyin Lan, Min Wang, Xia Rong, Yongshui Fu, Hao Wang
Viruses.2023; 15(12): 2302. CrossRef
KASL clinical practice guidelines for management of chronic hepatitis B

Clinical and Molecular Hepatology.2022; 28(2): 276. CrossRef
Comparison of clinical practice guidelines for the management of chronic hepatitis B: When to start, when to change, and when to stop
Hyung Joon Yim, Ji Hoon Kim, Jun Yong Park, Eileen L. Yoon, Hana Park, Jung Hyun Kwon, Dong Hyun Sinn, Sae Hwan Lee, Jeong-Hoon Lee, Hyun Woong Lee
Clinical and Molecular Hepatology.2020; 26(4): 411. CrossRef
2018 Korean Association for the Study of the Liver (KASL) Clinical Practice Guidelines of Chronic Hepatitis B: What's Different?
Ji Hoon Kim
The Korean Journal of Gastroenterology.2019; 73(3): 132. CrossRef
KASL clinical practice guidelines for management of chronic hepatitis B

Clinical and Molecular Hepatology.2019; 25(2): 93. CrossRef
Natural History and Treatment Indications of Chronic Hepatitis B
Dong Hyun Sinn
The Korean Journal of Gastroenterology.2019; 74(5): 245. CrossRef
Management of chronic hepatitis B patients in immunetolerant phase: what latest guidelines recommend
Grace Lai-Hung Wong
Clinical and Molecular Hepatology.2018; 24(2): 108. CrossRef