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"Seung Up Kim"

Original Article

Histological severity and hepatic outcomes in patients with MASLD and discrepant FIB-4 and liver stiffness measurement
Joseph Rabbat, Boyu Yang, Hye Won Lee, Huapeng Lin, Emmanuel Tsochatzis, Salvatore Petta, Elisabetta Bugianesi, Masato Yoneda, Ming-Hua Zheng, Hannes Hagström, Jérôme Boursier, José Luis Calleja, George Boon-Bee Goh, Wah-Kheong Chan, Rocio Gallego-Durán, Arun J. Sanyal, Victor de Lédinghen, Philip N Newsome, Jian-Gao Fan, Laurent Castéra, Michelle Lai, Céline Fournier-Poizat, Grace Lai-Hung Wong, Mirko Zoncape, Grazia Pennisi, Angelo Armandi, Atsushi Nakajima, Wen-Yue Liu, Ying Shang, Marc de Saint-Loup, Elba Llop, Kevin Kim Jun Teh, Carmen Lara-Romero, Amon Asgharpour, Sara Mahgoub, Mandy Sau-Wai Chan, Clemence M Canivet, Manuel Romero-Gomez, Vincent Wai-Sun Wong, Seung Up Kim, Terry Cheuk-Fung Yip
Received August 6, 2025  Accepted November 2, 2025  Published online November 11, 2025  
DOI: https://doi.org/10.3350/cmh.2025.0888    [Accepted]
Background/Aims
Current guidelines recommend a 2-step approach for identifying advanced fibrosis in metabolic dysfunction-associated steatotic liver disease (MASLD), using FIB-4 followed by liver stiffness measurement (LSM) via vibration-controlled transient elastography. However, some patients may exhibit discordant results. This study evaluates the histological severity and outcomes in patients with discordant FIB-4 and LSM results.
Methods
This secondary analysis of the VCTE-Prognosis study included 12,950 patients evaluated for MASLD at 16 tertiary centers, of whom 2,915 underwent liver biopsy. Patients were categorized into four groups based on established FIB-4 (1.3) and LSM (8 kPa) cutoffs.
Results
F3-F4 fibrosis was observed in 6.4%, 13.7%, 30.6%, and 62.4% in low-FIB-4-low-LSM (n=6,403), high-FIB-4-low-LSM (n=3,017), low-FIB-4-high-LSM (n=1,363), and high-FIB-4-high-LSM (n=2,167) groups, respectively. During a median follow-up of 47.4 months, 248 patients experienced hepatic decompensation, hepatocellular carcinoma, liver transplantation, or liver-related death. The incidence rates of liver-related events (LREs) were 0.67, 1.19, 2.58, and 21.30 per 1,000 person-years, respectively. Compared to low-FIB-4-low-LSM patients, those with low-FIB-4-high-LSM (adjusted subdistribution hazard ratio [aSHR] 4.2) and high-FIB-4-high-LSM (aSHR 21.3) had a significantly higher risk of LREs, while high-FIB-4-low-LSM patients did not. Similar findings were observed when hepatic decompensation and hepatocellular carcinoma were analyzed separately.
Conclusions
Approximately 30% of patients in tertiary centers exhibit discordant FIB-4 and LSM results, with LSM more likely reflecting true severity. While some patients with discordant results may have advanced fibrosis, the overall incidence of LREs remains low.
  • 749 View
  • 99 Download

Correspondences

Correspondence to letter to the editor on “Risk stratification by noninvasive tests in patients with metabolic dysfunction-associated steatotic liver disease”
Hye Won Lee, Seung Up Kim
Received June 17, 2025  Accepted June 20, 2025  Published online June 24, 2025  
DOI: https://doi.org/10.3350/cmh.2025.0644    [Accepted]
  • 2,567 View
  • 15 Download
Correspondence to editorial on “Risk stratification by noninvasive tests in patients with metabolic dysfunction-associated steatotic liver disease”
Hye Won Lee, Seung Up Kim
Received April 29, 2025  Accepted May 3, 2025  Published online May 8, 2025  
DOI: https://doi.org/10.3350/cmh.2025.0477    [Epub ahead of print]
  • 3,835 View
  • 7 Download

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  Crossref logo
  • 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
  • Correspondence to letter to the editor on “Risk Stratification of Metabolic Dysfunction-Associated Steatotic Liver Disease: The KASL Pathway
    Hye Won Lee, Seung Up Kim
    Clinical and Molecular Hepatology.2025;[Epub]     CrossRef
  • 9,947 View
  • 196 Download
  • 1 Web of Science
  • Crossref

Correspondence

Viral hepatitis

Correspondence to editorial on “Adverse impact of metabolic dysfunction on fibrosis regression following direct-acting antiviral therapy: A multicenter study for chronic hepatitis C”
Tom Ryu, Young Chang, Seung Up Kim, Jae Young Jang
Clin Mol Hepatol 2025;31(2):e203-e205.
Published online February 24, 2025
DOI: https://doi.org/10.3350/cmh.2025.0179

Citations

Citations to this article as recorded by  Crossref logo
  • Reply to correspondence on “Adverse impact of metabolic dysfunction on fibrosis regression following direct-acting antiviral therapy: A multicenter study for chronic hepatitis C”
    Chen-Hua Liu, Yu-Ping Chang
    Clinical and Molecular Hepatology.2025; 31(2): e232.     CrossRef
  • 3,617 View
  • 25 Download
  • 1 Web of Science
  • Crossref

Original Article

Viral hepatitis

Adverse impact of metabolic dysfunction on fibrosis regression following direct-acting antiviral therapy: A multicenter study for chronic hepatitis C
Tom Ryu, Young Chang, Soung Won Jeong, Jeong-Ju Yoo, Sae Hwan Lee, Sang Gyune Kim, Young Seok Kim, Hong Soo Kim, Seung Up Kim, Jae Young Jang
Clin Mol Hepatol 2025;31(2):548-562.
Published online January 9, 2025
DOI: https://doi.org/10.3350/cmh.2024.0904
Background/Aims
Direct-acting antivirals (DAAs) effectively eradicate hepatitis C virus. This study investigated whether metabolic dysfunction influences the likelihood of fibrosis regression after DAA treatment in patients with chronic hepatitis C (CHC).
Methods
This multicenter, retrospective study included 8,819 patients diagnosed with CHC who were treated with DAAs and achieved a sustained virological response (SVR) between January 2014 and December 2022. Fibrosis regression was defined as a 20% reduction in noninvasive surrogates for liver fibrosis, such as liver stiffness (LS) measured by vibration-controlled transient elastography (VCTE) and the fibrosis-4 (FIB-4) score. Hypercholesterolemia (h-TC) was defined as >200 mg/dL.
Results
The median age of the study population was 59.6 years, with a predominance of male patients (n=4,713, 57.3%). Genotypes 1, 2, and others were confirmed in 3,872 (46.2%), 3,487 (41.6%), and 1,024 (12.2%) patients, respectively. Diabetes mellitus (DM) was present in 1,442 (17.2%) patients and the median LS was 7.50 kPa (interquartile range, 5.30–12.50). Multivariate analysis revealed that the presence of DM and pre-DAA h-TC were independently associated with a decreased probability of fibrosis regression by VCTE. Additionally, pre-DAA h-TC was independently associated with a decreased probability of fibrosis regression by the FIB-4.
Conclusions
Metabolic dysfunction has an unfavorable influence on fibrosis regression in patients with CHC who achieve SVR after DAA treatment.

Citations

Citations to this article as recorded by  Crossref logo
  • Editorial: Risk of Incident Type 2 Diabetes and Prediabetes in Patients With Direct Acting Antiviral‐Induced Cure of Hepatitis C Virus Infection—Authors' Reply
    Yu‐Ping Chang, Jia‐Horng Kao, Chen‐Hua Liu
    Alimentary Pharmacology & Therapeutics.2025; 61(9): 1553.     CrossRef
  • Epidemiologic Characteristics of Chronic Hepatitis B and Coinfections with Hepatitis C Virus or Human Immunodeficiency Virus in South Korea: A Nationwide Claims-Based Study Using the Korean Health Insurance Review and Assessment Service Database
    Hyunwoo Oh, Won Sohn, Na Ryung Choi, Hyo Young Lee, Yeonjae Kim, Seung Woo Nam, Jae Yoon Jeong
    Pathogens.2025; 14(7): 715.     CrossRef
  • 6,972 View
  • 143 Download
  • 5 Web of Science
  • Crossref

Correspondences

Liver fibrosis, cirrhosis, and portal hypertension

Correspondence to editorial on “Optimal cut-offs of vibration-controlled transient elastography and magnetic resonance elastography in diagnosing advanced liver fibrosis in patients with nonalcoholic fatty liver disease: a systematic review and meta-analysis”
Young Eun Chon, Jung Hwan Yu, Seung Up Kim
Clin Mol Hepatol 2025;31(1):e61-e63.
Published online October 15, 2024
DOI: https://doi.org/10.3350/cmh.2024.0878
  • 4,546 View
  • 39 Download

Viral hepatitis

Correspondence to editorial on “Risk assessment of hepatitis B virus-related hepatocellular carcinoma development using vibration-controlled transient elastography: Systematic review and meta-analysis”
Young-Joo Jin, Seung Up Kim
Clin Mol Hepatol 2025;31(1):e55-e57.
Published online October 7, 2024
DOI: https://doi.org/10.3350/cmh.2024.0846

Citations

Citations to this article as recorded by  Crossref logo
  • Reply to correspondence on “Risk assessment of hepatitis B virus-related hepatocellular carcinoma development using vibration-controlled transient elastography: Systematic review and meta-analysis”
    Mirko Zoncapè, Emmanuel A. Tsochatzis
    Clinical and Molecular Hepatology.2025; 31(1): e117.     CrossRef
  • 4,112 View
  • 30 Download
  • 1 Web of Science
  • Crossref

Steatotic liver disease

Correspondence to editorial on “Optimal cutoffs of vibration-controlled transient elastography and magnetic resonance elastography in diagnosing advanced liver fibrosis in patients with nonalcoholic fatty liver disease: A systematic review and meta-analysis”
Jung Hwan Yu, Seung Up Kim
Clin Mol Hepatol 2025;31(1):e52-e54.
Published online September 24, 2024
DOI: https://doi.org/10.3350/cmh.2024.0815
  • 6,139 View
  • 37 Download

Original Articles

Autoimmune liver disease

Diagnostic accuracy of vibration-controlled transient elastography for staging liver fibrosis in autoimmune liver diseases: A systematic review and meta-analysis
Jihyun An, Young Eun Chon, Gunho Kim, Mi Na Kim, Hee Yeon Kim, Han Ah Lee, Jung Hwan Yu, Miyoung Choi, Dae Won Jun, Seung Up Kim, Ji Won Han, Young-Joo Jin
Clin Mol Hepatol 2024;30(Suppl):S134-S146.
Published online August 21, 2024
DOI: https://doi.org/10.3350/cmh.2024.0586
Background/Aims
The assessment of liver fibrosis is crucial for managing autoimmune liver diseases such as primary biliary cholangitis (PBC), autoimmune hepatitis (AIH), and primary sclerosing cholangitis (PSC). However, data on the efficacy of noninvasive tests for these diseases are limited. This meta-analysis evaluated the diagnostic accuracy of vibration-controlled transient elastography (VCTE) for staging fibrosis in patients with autoimmune liver disease.
Methods
Searches were conducted in PubMed, Embase, CINAHL, Web of Science, and Cochrane Library databases to assess the diagnostic accuracy of VCTE against histology as the reference standard in adult patients with autoimmune liver disease. The summary area under the curve (sAUC) and diagnostic odds ratio were calculated for significant fibrosis (SF), advanced fibrosis (AF), and cirrhosis, according to liver biopsy.
Results
Fourteen articles were included, comprising 559 PBC patients from six studies, 388 AIH patients from five studies, and 151 PSC patients from three studies. VCTE demonstrated good performance for fibrosis staging in PBC, AIH, and PSC. In PBC, sAUCs of VCTE were 0.87, 0.89, and 0.99 for staging SF, AF, and cirrhosis, respectively. In AIH, the sAUCs were 0.88, 0.88, and 0.92, respectively, while in PSC, they were 0.88, 0.95, and 0.92, respectively. The cutoff values for AF were 7.5–17.9 kPa in PBC, 8.18–12.1 kPa in AIH, and 9.6 kPa in PSC.
Conclusions
VCTE shows high diagnostic accuracy for staging liver fibrosis in patients with autoimmune liver diseases. This non-invasive method serves as a valuable tool for the evaluation and monitoring of fibrosis in these lifelong diseases.

Citations

Citations to this article as recorded by  Crossref logo
  • Transient elastography for assessing liver fibrosis in autoimmune liver diseases: Excellent performance but limited details: Editorial on “Diagnostic accuracy of vibration-controlled transient elastography for staging liver fibrosis in autoimmune liver di
    Kyung-Ah Kim
    Clinical and Molecular Hepatology.2025; 31(1): 275.     CrossRef
  • Diagnostic value of serum Golgi protein 73 in liver fibrosis and inflammation in patients with autoimmune hepatitis
    Yazhen Zhang, Aifang Xu, Yujiao Jin, Jing Gao, Jiahui He
    Medicine.2025; 104(26): e43064.     CrossRef
  • Targeting endoplasmic reticulum proteostasis in liver fibrosis: From signaling mechanisms to therapeutic opportunities
    Yawei Kong, Zhengyang Chen, Zhentian Nie, Wei Chen
    Pharmacological Research.2025; 217: 107823.     CrossRef
  • Diagnostic Performance of SWE and Predictive Models Based on SWE for Post-Hepatectomy Liver Failure: A Systematic Review and Meta-analysis
    Jiaxu Liang, Fukun Shi, Lan Zhang, Suo Yin, Yong Chen
    Current Medical Imaging Formerly Current Medical Imaging Reviews.2025;[Epub]     CrossRef
  • Hidden weaknesses and biological insights in machine learning models of fibrosis in autoimmune hepatitis
    Shiuan-Chih Chen, Chun-Chieh Chen
    QJM: An International Journal of Medicine.2025;[Epub]     CrossRef
  • 7,436 View
  • 165 Download
  • 6 Web of Science
  • Crossref

Steatotic liver disease

Optimal cut-offs of vibration-controlled transient elastography and magnetic resonance elastography in diagnosing advanced liver fibrosis in patients with nonalcoholic fatty liver disease: A systematic review and meta-analysis
Young Eun Chon, Young-Joo Jin, Jihyun An, Hee Yeon Kim, Miyoung Choi, Dae Won Jun, Mi Na Kim, Ji Won Han, Han Ah Lee, Jung Hwan Yu, Seung Up Kim
Clin Mol Hepatol 2024;30(Suppl):S117-S133.
Published online August 21, 2024
DOI: https://doi.org/10.3350/cmh.2024.0392
Background/aims
Opinions differ regarding vibration-controlled transient elastography and magnetic resonance elastography (VCTE/MRE) cut-offs for diagnosing advanced fibrosis (AF) in patients with non-alcoholic fatty liver disease (NAFLD). We investigated the diagnostic performance and optimal cut-off values of VCTE and MRE for diagnosing AF.
Methods
Literature databases, including Medline, EMBASE, Cochrane Library, and KoreaMed, were used to identify relevant studies published up to June 13, 2023. We selected studies evaluating VCTE and MRE regarding the degree of liver fibrosis using liver biopsy as the reference. The sensitivity, specificity, and area under receiver operating characteristics curves (AUCs) of the pooled data for VCTE and MRE for each fibrosis stage and optimal cut-offs for AF were investigated.
Results
A total of 19,199 patients from 63 studies using VCTE showed diagnostic AUC of 0.83 (95% confidence interval: 0.80–0.86), 0.83 (0.80–0.86), 0.87 (0.84–0.90), and 0.94 (0.91–0.96) for ≥F1, ≥F2, ≥F3, and F4 stages, respectively. Similarly, 1,484 patients from 14 studies using MRE showed diagnostic AUC of 0.89 (0.86–0.92), 0.92 (0.89–0.94), 0.89 (0.86–0.92), and 0.94 (0.91–0.96) for ≥F1, ≥F2, ≥F3, and F4 stages, respectively. The diagnostic AUC for AF using VCTE was highest at 0.90 with a cut-off of 7.1–7.9 kPa, and that of MRE was highest at 0.94 with a cut-off of 3.62–3.8 kPa.
Conclusions
VCTE (7.1–7.9 kPa) and MRE (3.62–3.8 kPa) with the suggested cut-offs showed favorable accuracy for diagnosing AF in patients with NAFLD. This result will serve as a basis for clinical guidelines for non-invasive tests and differential diagnosis of AF.

Citations

Citations to this article as recorded by  Crossref logo
  • Correspondence to editorial on “Optimal cut-offs of vibration-controlled transient elastography and magnetic resonance elastography in diagnosing advanced liver fibrosis in patients with nonalcoholic fatty liver disease: a systematic review and meta-analy
    Young Eun Chon, Jung Hwan Yu, Seung Up Kim
    Clinical and Molecular Hepatology.2025; 31(1): e61.     CrossRef
  • Essential tools for assessing advanced fibrosis in metabolic dysfunction-associated steatotic liver disease: Editorial on “Optimal cut-offs of vibration-controlled transient elastography and magnetic resonance elastography in diagnosing advanced liver fib
    Won Sohn
    Clinical and Molecular Hepatology.2025; 31(1): 277.     CrossRef
  • Correspondence to editorial on “Optimal cutoffs of vibration-controlled transient elastography and magnetic resonance elastography in diagnosing advanced liver fibrosis in patients with nonalcoholic fatty liver disease: A systematic review and meta-analys
    Jung Hwan Yu, Seung Up Kim
    Clinical and Molecular Hepatology.2025; 31(1): e52.     CrossRef
  • Towards unification of liver stiffness measurement cutoffs: Editorial on “Optimal cut-offs of vibration-controlled transient elastography and magnetic resonance elastography in diagnosing advanced liver fibrosis in patients with nonalcoholic fatty liver d
    Yangyue Zhang, Vincent Wai-Sun Wong
    Clinical and Molecular Hepatology.2025; 31(1): 264.     CrossRef
  • Sustainability of General Population Screening for Steatotic Liver Disease: A Proof-of-Concept Study
    Laura De Rosa, Gabriele Ricco, Maurizia Rossana Brunetto, Ferruccio Bonino, Francesco Faita
    Healthcare.2025; 13(7): 759.     CrossRef
  • Therapeutic Efficacy of Silymarin, Vitamin E, and Essential Phospholipid Combination Therapy on Hepatic Steatosis, Fibrosis, and Metabolic Parameters in MASLD Patients: A Prospective Clinical Study
    Dan-Ionuț Gheonea, Cristina Tocia, Victor-Mihai Sacerdoțianu, Alexandra-Georgiana Bocioagă, Irina-Paula Doica, Nicolae Cătălin Manea, Adina Turcu-Știolică, Carmen-Nicoleta Oancea, Eugen Dumitru
    International Journal of Molecular Sciences.2025; 26(12): 5427.     CrossRef
  • Deep learning radiomics of elastography for diagnosing compensated advanced chronic liver disease: an international multicenter study
    Xue Lu, Haoyan Zhang, Hidekatsu Kuroda, Matteo Garcovich, Victor de Ledinghen, Ivica Grgurević, Runze Linghu, Hong Ding, Jiandong Chang, Min Wu, Cheng Feng, Xinping Ren, Changzhu Liu, Tao Song, Fankun Meng, Yao Zhang, Ye Fang, Sumei Ma, Jinfen Wang, Xiaol
    Visual Computing for Industry, Biomedicine, and Art.2025;[Epub]     CrossRef
  • Liver disease in people with latent autoimmune diabetes in adults (LADA): A cross-sectional study using magnetic resonance elastography
    Ernesto Maddaloni, Marta Zerunian, Vincenzo Cardinale, Annalisa Zurru, Rocco Amendolara, Daniela Luverà, Renata Risi, Luca D’Onofrio, Benedetta Masci, Francesco Covotta, Damiano Caruso, Domenico Alvaro, Andrea Laghi, Raffaella Buzzetti
    Diabetes Research and Clinical Practice.2025; 229: 112465.     CrossRef
  • Paired snRNA-seq and scRNA-seq analysis of MASLD patients to identify early-stage markers for disease progression
    Suebin Park, Su-Hyeon Lee, Se-eun Han, Beom Kyung Kim, Byungjin Hwang
    Hepatology Communications.2025;[Epub]     CrossRef
  • Even Lower Alcohol Intake Might Be Harmful for East Asian Males With MASLD Spectrum
    Byungyoon Yun, Juyeon Oh, Heejoo Park, Jian Lee, Beom Kyung Kim, Jin-Ha Yoon
    Clinical Gastroenterology and Hepatology.2025;[Epub]     CrossRef
  • Lean Metabolic Dysfunction‐Associated Steatotic Liver Disease: A Wolf in Sheep's Clothing
    Xixi Fang, Chenhao Xu, Jun Lu, Runzhou Zhuang, Xiao Xu, Xuyong Wei
    Cell Biochemistry and Function.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; : 1.     CrossRef
  • 8,255 View
  • 197 Download
  • 12 Web of Science
  • Crossref

Hepatic neoplasm

Assessment of the postoperative prognosis in patients with hepatocellular carcinoma using vibration-controlled transient elastography: A systemic review and meta-analysis
Jung Hwan Yu, Ji Won Han, Young Ju Suh, Young Eun Chon, Hee Yeon Kim, Ji Hyun An, Young-Joo Jin, Miyoung Choi, Seung Up Kim, Dae Won Jun, Han Ah Lee, Mi Na Kim
Clin Mol Hepatol 2024;30(Suppl):S186-S198.
Published online August 21, 2024
DOI: https://doi.org/10.3350/cmh.2024.0366
Backgrounds/Aims
This meta-analysis examined whether preoperative vibration-controlled transient elastography (VCTE) can predict postoperative complications and recurrence in patients undergoing hepatic resection for hepatocellular carcinoma (HCC).
Methods
A systematic literature search was conducted using Ovid-Medline, EMBASE, Cochrane, and KoreaMed databases. Out of 431 individual studies, thirteen published between 2008 and 2022 were included. Five studies focused on HCC recurrence, while eight examined postoperative complications.
Results
The meta-analysis of five studies on HCC recurrence showed that the high-risk group with a high VCTE score had a significantly increased recurrence rate after hepatic resection (hazard ratio 2.14). The cutoff value of VCTE in the high-risk group of HCC recurrence was 7.4–13.4 kPa, the sensitivity was 0.60 (95% confidence interval [CI] 0.47–0.72), and the specificity was 0.60 (95% CI 0.46–0.72). The area under the receiver operating characteristic curve (AUC) of the liver stiffness measured by VCTE to predict the HCC recurrence was 0.63 (95% CI 0.59–0.67). The meta-analysis on the postoperative complications revealed a significantly increased risk of postoperative complications in the high-risk group (12–25.6 kPa) with a high VCTE value (odds ratio [OR], 8.32). The AUC of the liver stiffness measured by VCTE to predict the postoperative complications was 0.87 (95% CI 0.84–0.90), the sensitivity was 0.76 (95% CI 0.55–0.89) and the specificity was 0.85 (95% CI 0.73–0.92).
Conclusions
This meta-analysis suggests that preoperative VCTE in patients undergoing hepatic resection for HCC is useful in identifying individuals at a high risk of postoperative complications and HCC recurrence.

Citations

Citations to this article as recorded by  Crossref logo
  • Recent Trends in Noninvasive Tests for Assessing Hepatic Fibrosis in Patients with Chronic Liver Disease
    Jung Hwan Yu
    The Korean Journal of Medicine.2024; 99(5): 232.     CrossRef
  • 4,947 View
  • 109 Download
  • 1 Web of Science
  • Crossref

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  Crossref logo
  • Correspondence to editorial on “Prevalence of clinically significant liver fibrosis in the general population: A systematic review and meta-analysis”
    Hee Yeon Kim, Miyoung Choi, Dae Won Jun
    Clinical and Molecular Hepatology.2025; 31(1): e48.     CrossRef
  • Non-Invasive Liver Fibrosis Test Using Shear Wave Elastography
    Ji Won Han
    The Korean Journal of Medicine.2025; 100(1): 26.     CrossRef
  • Influence of Sex in the Development of Liver Diseases
    Jie-Wen Zhang, Nan Zhang, Yi Lyu, Xu-Feng Zhang
    Seminars in Liver Disease.2025; 45(01): 015.     CrossRef
  • KASL clinical practice guidelines for the management of metabolic dysfunction-associated steatotic liver disease 2025
    Won Sohn, Young-Sun Lee, Soon Sun Kim, Jung Hee Kim, Young-Joo Jin, Gi-Ae Kim, Pil Soo Sung, Jeong-Ju Yoo, Young Chang, Eun Joo Lee, Hye Won Lee, Miyoung Choi, Su Jong Yu, Young Kul Jung, Byoung Kuk Jang
    Clinical and Molecular Hepatology.2025; 31(Suppl): S1.     CrossRef
  • Noninvasive identification of metabolic dysfunction–associated steatohepatitis (INFORM MASH): a retrospective cohort and disease modeling study
    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
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    Haiyu Wang, Jinjun Chen
    Clinical and Molecular Hepatology.2025;[Epub]     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
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    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
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    Brian Lee, Ussama Ghumman, Lisa D. Pedicone, Andres Gomez Aldana, Eric Lawitz
    Clinical and Molecular Hepatology.2025; 31(4): 1167.     CrossRef
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    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
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    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; : 1.     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
  • Recent Trends in Noninvasive Tests for Assessing Hepatic Fibrosis in Patients with Chronic Liver Disease
    Jung Hwan Yu
    The Korean Journal of Medicine.2024; 99(5): 232.     CrossRef
  • Noninvasive Imaging Test to Assess Liver Fibrosis: Vibration-controlled Transient Elastography
    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
  • 12,786 View
  • 301 Download
  • 24 Web of Science
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Original Article

Hepatic neoplasm

Non-invasive prediction of post-sustained virological response hepatocellular carcinoma in hepatitis C virus: A systematic review and meta-analysis
Han Ah Lee, Mi Na Kim, Hye Ah Lee, Miyoung Choi, Jung Hwan Yu, Young-Joo Jin, Hee Yeon Kim, Ji Won Han, Seung Up Kim, Jihyun An, Young Eun Chon
Clin Mol Hepatol 2024;30(Suppl):S172-S185.
Published online August 12, 2024
DOI: https://doi.org/10.3350/cmh.2024.0262
Backgrounds/Aims
Despite advances in antiviral therapy for hepatitis C virus (HCV) infection, hepatocellular carcinoma (HCC) still develops even after sustained viral response (SVR) in patients with advanced liver fibrosis or cirrhosis. This meta-analysis investigated the predictive performance of vibration-controlled transient elastography (VCTE) and fibrosis 4-index (FIB-4) for the development of HCC after SVR.
Methods
We searched PubMed, MEDLINE, EMBASE, and the Cochrane Library for studies examining the predictive performance of these tests in adult patients with HCV. Two authors independently screened the studies’ methodological quality and extracted data. Pooled estimates of sensitivity, specificity, and area under the curve (AUC) were calculated for HCC development using random-effects bivariate logit normal and linear-mixed effect models.
Results
We included 27 studies (169,911 patients). Meta-analysis of HCC after SVR was possible in nine VCTE and 15 FIB-4 studies. Regarding the prediction of HCC development after SVR, the pooled AUCs of pre-treatment VCTE >9.2–13 kPa and FIB-4 >3.25 were 0.79 and 0.73, respectively. VCTE >8.4–11 kPa and FIB-4 >3.25 measured after SVR maintained good predictive performance, albeit slightly reduced (pooled AUCs: 0.77 and 0.70, respectively). The identified optimal cut-off value for HCC development after SVR was 12.6 kPa for pre-treatment VCTE. That of VCTE measured after the SVR was 11.2 kPa.
Conclusions
VCTE and FIB-4 showed acceptable predictive performance for HCC development in patients with HCV who achieved SVR, underscoring their utility in clinical practice for guiding surveillance strategies. Future studies are needed to validate these findings prospectively and validate their clinical impact.

Citations

Citations to this article as recorded by  Crossref logo
  • Comment: Non-invasive prediction of post-sustained virological response hepatocellular carcinoma in hepatitis C virus
    Xinpu Miao, Haidong Wu, Jinrong Xu, Wei Cheng
    Clinical and Molecular Hepatology.2025; 31(1): e23.     CrossRef
  • Hepatocellular carcinoma surveillance after sustained virological response in chronic hepatitis C: Editorial on “Non-invasive prediction of post-sustained virological response hepatocellular carcinoma in hepatitis C virus: A systematic review and meta-ana
    Ho Soo Chun, Minjong Lee
    Clinical and Molecular Hepatology.2025; 31(1): 261.     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
  • Precision Strategy for Hepatocellular Carcinoma Surveillance after Hepatitis C Cure: Debates across Guidelines
    Masaaki Mino, Eiji Kakazu, Tatsuya Kanto
    Gut and Liver.2025; 19(5): 651.     CrossRef
  • Liver Stiffness Measurements After Oral Antivirals Effectively Predict the Risk of HCC in Patients With Chronic Hepatitis C
    Yu Rim Lee, Hyun Young Woo, Young Oh. Kweon, Won Young Tak, Se Young Jang, Jung Gil Park, Min Kyu Kang, Jeong Eun Song, Byoung Kuk Jang, Changhyeong Lee, Byung Seok Kim, Jae Seok Hwang, Woo Jin Chung, Jeong Heo, Nae‐Yun Heo, Seung Ha Park, Jun Sik Yoon, J
    Journal of Gastroenterology and Hepatology.2025; 40(10): 2568.     CrossRef
  • Diagnostic possibilities of perfusion computed tomography in assessing fibrosis regression in patients with chronic viral hepatitis C: a prospective study
    E. A. Ioppa, O. S. Tonkikh, I. Yu. Degtyarev, V. D. Zavadovskaya, E. S. Garganeeva
    Diagnostic radiology and radiotherapy.2025; 16(3): 65.     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
  • 6,216 View
  • 164 Download
  • 4 Web of Science
  • Crossref

Editorial

Preface
Seung Up Kim
Clin Mol Hepatol 2024;30(Suppl):S3-S3.
Published online August 8, 2024
DOI: https://doi.org/10.3350/cmh.2024.0595
  • 2,706 View
  • 23 Download

Original Articles

Liver fibrosis, cirrhosis, and portal hypertension

Prevalence of clinically significant liver fibrosis in the general population: A systematic review and meta-analysis
Hee Yeon Kim, Jung Hwan Yu, Young Eun Chon, Seung Up Kim, Mi Na Kim, Ji Won Han, Han Ah Lee, Young-Joo Jin, Jihyun An, Miyoung Choi, Dae Won Jun
Clin Mol Hepatol 2024;30(Suppl):S199-S213.
Published online July 30, 2024
DOI: https://doi.org/10.3350/cmh.2024.0351
Background/Aims
Although important, clinically significant liver fibrosis is often overlooked in the general population. We aimed to examine the prevalence of clinically significant liver fibrosis using noninvasive tests (NITs) in the general population.
Methods
We collected data from four databases (MEDLINE, Embase, Cochrane Library, and KoreaMed) from inception to June 13, 2023. Original articles reporting the prevalence of clinically significant liver fibrosis in the general population were included. The Stata metaprop function was used to obtain the pooled prevalence of liver fibrosis with NITs in the general population.
Results
We screened 6,429 articles and included 45 eligible studies that reported the prevalence of clinically significant liver fibrosis in the general population. The prevalence of advanced liver fibrosis, using the high probability cutoff of the fibrosis-4 (FIB-4) index, was 2.3% (95% confidence interval [CI], 1.2–3.7%). The prevalence of significant liver fibrosis, advanced liver fibrosis, and liver cirrhosis, assessed using vibration-controlled transient elastography (VCTE) among the general population, was 7.3% (95% CI, 5.9–8.8%), 3.5% (95% CI, 2.7–4.5), and 1.2% (95% CI, 0.8–1.8%), respectively. Region-based subgroup analysis revealed that the highest prevalence of advanced fibrosis using the high probability cutoff of the FIB-4 index was observed in the American region. Furthermore, the American region exhibited the highest prevalence of significant liver fibrosis, advanced liver fibrosis, and liver cirrhosis, using VCTE.
Conclusions
Previously undiagnosed clinically significant liver fibrosis is found in the general population through NITs. Future research is necessary to stratify the risk in the general population.

Citations

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  • Spotting undiagnosed significant liver fibrosis in the general population: impact on subsequent clinical care: Editorial on “Prevalence of clinically significant liver fibrosis in the general population: A systematic review and meta-analysis”
    Nana Peng, Mary Yue Wang, Sherlot Juan Song, Terry Cheuk-Fung Yip
    Clinical and Molecular Hepatology.2025; 31(1): 256.     CrossRef
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    Hee Yeon Kim, Miyoung Choi, Dae Won Jun
    Clinical and Molecular Hepatology.2025; 31(1): e48.     CrossRef
  • Letter regarding “Prevalence of clinically significant liver fibrosis in the general population”
    Wei Feng, Qile Wang, Qingwang Ye
    Clinical and Molecular Hepatology.2025; 31(1): e21.     CrossRef
  • Correspondence to letter to the editor on “Prevalence of clinically significant liver fibrosis in the general population: A systematic review and meta-analysis”
    Hee Yeon Kim, Miyoung Choi, Dae Won Jun
    Clinical and Molecular Hepatology.2025; 31(1): e105.     CrossRef
  • Hypoxia-inducible factor-1 alpha (HIF-1α) inhibitor AMSP-30 m attenuates CCl4-induced liver fibrosis in mice by inhibiting the sonic hedgehog pathway
    Lili Lu, Yuchen Ma, Qing Tao, Jing Xie, Xiao Liu, Yongkang Wu, Yang Zhang, Xiuli Xie, Mingming Liu, Yong Jin
    Chemico-Biological Interactions.2025; 413: 111480.     CrossRef
  • Vibration-controlled transient elastography in shaping the epidemiology and management of steatotic liver disease: Editorial on “Current burden of steatotic liver disease and fibrosis among adults in the United States, 2017–2023”
    Xiao-Dong Zhou, Terry Cheuk-Fung Yip, Daniel Q Huang, Mark Dhinesh Muthiah, Mazen Noureddin, Ming-Hua Zheng
    Clinical and Molecular Hepatology.2025; 31(2): 620.     CrossRef
  • Simple Clinical Prediction Rules for Identifying Significant Liver Fibrosis: Evaluation of Established Scores and Development of the Aspartate Aminotransferase-Thrombocytopenia-Albumin (ATA) Score
    Puwitch Charoenchue, Jiraporn Khorana, Apichat Tantraworasin, Suwalee Pojchamarnwiputh, Wittanee Na Chiangmai, Amonlaya Amantakul, Taned Chitapanarux, Nakarin Inmutto
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    Yawei Kong, Zhengyang Chen, Zhentian Nie, Wei Chen
    Pharmacological Research.2025; 217: 107823.     CrossRef
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    Anqi Lin, Minying Xiong, Bufu Tang, Aimin Jiang, Junyi Shen, Zaoqu Liu, Quan Cheng, Jian Zhang, Peng Luo
    Hepatology International.2025; 19(4): 732.     CrossRef
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    Huiyul Park, Eileen L. Yoon, Mimi Kim, Ji-hyeon Park, Ramsey Cheung, Jeong-Yeon Cho, Hye-Lin Kim, Dae Won Jun
    Scientific Reports.2025;[Epub]     CrossRef
  • Senkyunolide I targets CXCR4 to attenuate liver fibrosis via suppression of the NLRP3/GSDMD pathway
    Kexin Wang, Yuxin Yang, Bingjie Yue, Mengyang Li, Chu Chen, Junrong Du, Fangyi Long
    International Immunopharmacology.2025; 164: 115348.     CrossRef
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    Asmaa Ellaithy, Aya Serageldeen, Alhareth Alhusban, Mariam Emad Seif, Mahmoud Essam Abdelhamid, Bushra Al-Shaikh, Asmaa Sayed Ibrahim, Eslam Mohamed Elshennawy, Ibrahim Ellaithy
    Annals of Medicine & Surgery.2025; 87(8): 4742.     CrossRef
  • PREVALENCE OF VARIOUS ETIOPATHOGENIC VARIANTS OF CHRONIC DIFFUSE LIVER DISEASES
    B. Sakhova, A. Oshibayeva, N. Nuskabayeva, E. Iskandirova, Zh. Rsalieva, N. Karabayev, L. Karimova, L. Ozbakyr
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    Tan‐Tzu Lo, Wan‐Ting Huang, Chia‐Lung Shih, Pensee Wu
    International Journal of Gynecology & Obstetrics.2025;[Epub]     CrossRef
  • Modified FIB-4 Index in Type 2 Diabetes Mellitus with Steatosis: A Non-Linear Predictive Model for Advanced Hepatic Fibrosis
    Jonghyun Kim, Takanori Ito, Taeang Arai, Masanori Atsukawa, Miwa Kawanaka, Hidenori Toyoda, Takashi Honda, Ming-Lung Yu, Eileen L. Yoon, Dae Won Jun, Kyungjoon Cha, Mindie H. Nguyen
    Diagnostics.2024; 14(22): 2500.     CrossRef
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  • 200 Download
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Steatotic liver disease

Diagnostic accuracy of the Fibrosis-4 index for advanced liver fibrosis in nonalcoholic fatty liver disease with type 2 diabetes: A systematic review and meta-analysis
Ji Won Han, Hee Yeon Kim, Jung Hwan Yu, Mi Na Kim, Young Eun Chon, Ji Hyun An, Young-Joo Jin, Miyoung Choi, Seung Up Kim, Han Ah Lee, Dae Won Jun
Clin Mol Hepatol 2024;30(Suppl):S147-S158.
Published online July 25, 2024
DOI: https://doi.org/10.3350/cmh.2024.0330
Background/Aims
The Fibrosis-4 index (FIB-4) is a noninvasive test widely used to rule out advanced liver fibrosis (AF) in patients with nonalcoholic fatty liver disease (NAFLD). However, its diagnostic accuracy in NAFLD patients with type 2 diabetes mellitus (T2DM) is controversial due to the high prevalence of AF in this population.
Methods
Research focusing on the diagnostic accuracy of FIB-4 for liver fibrosis as validated by liver histology in NAFLD patients with T2DM was included, and 12 studies (n=5,624) were finally included in the meta-analysis. Sensitivity, specificity, hierarchical summary receiver operating characteristic (HSROC), positive predictive values (PPVs), and negative predictive values (NPVs) at low cutoffs (1.3–1.67) and high cutoffs (2.67–3.25) for ruling in and out AF were calculated.
Results
At low cutoffs, the meta-analysis revealed a sensitivity of 0.74, specificity of 0.62, and HSROC of 0.75. At high cutoffs, the analysis showed a sensitivity of 0.33, specificity of 0.92, and HSROC of 0.85, suggesting FIB-4 as useful for identifying or excluding AF. In subgroup analyses, high mean age and F3 prevalence were associated with lower sensitivity. The calculated NPV and PPV were 0.82 and 0.49 at low cutoffs, whereas the NPV was 0.28 and the PPV was 0.70 at high cutoffs. There were insufficient estimated NPVs <0.90 at a hypothesized prevalence of AF >30% at an FIB-4 cutoff range of 1.3–1.67.
Conclusions
Collectively, FIB-4 has moderate diagnostic accuracy for identifying or excluding AF in NAFLD patients with T2DM, but more evidence must be accumulated due to the limited number of currently reported studies and their heterogeneity.

Citations

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  • Prognostic value of the FIB-4 index in patients with myocardial infarction with non-obstructive coronary arteries
    Wei Zhang, Yuqi Chen, Liu Zhu, Siliang Peng, Mengchao Jin, Jiayu Yin
    International Journal of Cardiology.2026; 445: 134045.     CrossRef
  • Reply to: “A machine learning model to predict liver-related outcomes after the functional cure of chronic hepatitis B: Is cirrhosis driving the performance?”
    Moon Haeng Hur, Jeong-Hoon Lee
    Journal of Hepatology.2025; 82(3): e143.     CrossRef
  • The fibrosis-4 index for advanced liver fibrosis in NAFLD with T2DM: Half a loaf is better than no bread
    Zeyu Wang, Dong Wan, Meidong Xu, Yong Jiang
    Clinical and Molecular Hepatology.2025; 31(1): e25.     CrossRef
  • Non-Invasive Liver Fibrosis Test Using Shear Wave Elastography
    Ji Won Han
    The Korean Journal of Medicine.2025; 100(1): 26.     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
  • Targeting endoplasmic reticulum proteostasis in liver fibrosis: From signaling mechanisms to therapeutic opportunities
    Yawei Kong, Zhengyang Chen, Zhentian Nie, Wei Chen
    Pharmacological Research.2025; 217: 107823.     CrossRef
  • Comparison of FIB-4, APRI and AST/ALT ratio with FibroScan in patients with NAFLD and type 2 diabetes: a single-center study from Bangladesh
    Muhammad Shah Alam, Syeda Tanzina Kalam, Monirul Islam Khan, Jabed Ahmed, Rahul Saha, A. B. M. Kamrul-Hasan
    Egyptian Liver Journal.2025;[Epub]     CrossRef
  • Part 2: CAR Metabolic Dysfunction-Associated Steatotic Liver Disease Working Group Recommendations for Risk Stratifying Patients With MASLD
    Mitchell P. Wilson, Gavin Low, Abdel-Aziz Shaheen, Andreu F. Costa, An Tang, Emily Pang, Silvia Chang, Alexandra Medellin, Jérémy Dana, Noam Millo, Ania Kielar, Li Xin Zhang, Toni Whitaker, Mark Swain, Victoria Leung, Daisy Fung, Casey Hurrell, Christophe
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  • Impact of a high dietary fiber cereal meal intervention on the progression of liver fibrosis in T2DM with MASLD
    Xi-Shuang Chen, Hui-Zhen Liu, Fang Huang, Jian Meng, Jing-Xian Fang, Yu Han, Hui-Ming Zou, Qing Gu, Xue Hu, Qian-Wen Ma, Yue-Xia Han, Sui-Jun Wang
    Frontiers in Endocrinology.2025;[Epub]     CrossRef
  • Association between fibrosis-4 index and coronary heart disease: a population-based study
    Pan Jia, Mamajan Annamyradova, Genhao Fan, Qizhen Zhang, Yankun Song, Qiaozhi Li, Minghao Liu, Zuoying Xing, Yongxia Wang
    BMC Cardiovascular Disorders.2025;[Epub]     CrossRef
  • Forns index and fatty liver index, but not FIB-4, are associated with indices of glycaemia, pre-diabetes and type 2 diabetes: analysis of The Maastricht Study
    Leen Heyens, Hanna Kenjic, Pieter Dagnelie, Casper Schalkwijk, Coen Stehouwer, Steven Meex, Jeroen Kooman, Otto Bekers, Marleen van Greevenbroek, Hans Savelberg, Geert Robaeys, Bastiaan de Galan, Annemarie Koster, Martien van Dongen, Simone Eussen, Ger Ko
    BMJ Open Gastroenterology.2024; 11(1): e001466.     CrossRef
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  • 177 Download
  • 10 Web of Science
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Viral hepatitis

Vibration-controlled transient elastography for significant fibrosis in treatment-naïve chronic hepatitis B patients: A systematic review and meta-analysis
Mi Na Kim, Jihyun An, Eun Hwa Kim, Hee Yeon Kim, Han Ah Lee, Jung Hwan Yu, Young-Joo Jin, Young Eun Chon, Seung Up Kim, Dae Won Jun, Ji Won Han, Miyoung Choi
Clin Mol Hepatol 2024;30(Suppl):S106-S116.
Published online July 23, 2024
DOI: https://doi.org/10.3350/cmh.2024.0371
Backgrounds/Aims
Accurate diagnosis of significant liver fibrosis in patients with chronic hepatitis B (CHB) is crucial when determining whether to initiate antiviral treatment (AVT). We conduct a meta-analysis to assess the diagnostic performance of vibration-controlled transient elastography (VCTE) for significant liver fibrosis in AVT-naïve CHB patients with serum alanine transaminase (ALT) levels within 5-fold the upper limit of normal (ULN).
Methods
The Ovid-Medline, EMBASE, Cochrane, and KoreaMed databases were searched to identify studies that compared the performance of VCTE and liver biopsy (reference standard) when diagnosing significant liver fibrosis (≥F2) in AVT-naïve CHB patients with ALT within 5-fold the ULN. A hierarchical summary receiver operating characteristic curve (HSROC) and bivariate model were performed to evaluate the diagnostic performance of VCTE in the meta-analysis.
Results
Eight studies (2,003 patients) were included. The summary sensitivity and specificity for diagnosis of significant liver fibrosis were 0.78 (95% confidence interval [CI], 0.66–0.86) and 0.72 (95% CI, 0.60–0.82), respectively. The HSROC for the diagnosis of significant liver fibrosis was 0.81 (95% CI, 0.72–0.86). The optimal cutoff value of VCTE for diagnosis of significant liver fibrosis was 7.7 kPa with a sensitivity of 0.64 (95% CI, 0.50–0.76) and specificity of 0.83 (95% CI, 0.72–0.90).
Conclusions
Our study demonstrated that VCTE has an acceptable diagnostic performance for significant liver fibrosis in AVT-naïve CHB patients with ALT within 5-fold the ULN.

Citations

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  • Unraveling Demographic Patterns in Hepatitis B Clinical and Laboratory Profiles: Insights From a Ghanaian Cohort: A Retrospective Study
    Napoleon Bellua Sam, Saeed Folorunsho Majeed, Adams Dramani
    Health Science Reports.2025;[Epub]     CrossRef
  • Head‐to‐Head Comparison of Long‐Term HCC Risk of Antivirals‐Treated Versus Untreated Low‐Level Viremia in HBV‐Compensated Cirrhosis
    Nobuharu Tamaki, Daniel Q. Huang, Hyung Woong Lee, Soo Young Park, Yu Rim Lee, Dong Hyun Sinn, Tae Seop Lim, Hiroyuki Marusawa, Seng Gee Lim, Hironori Ochi, Masahiko Kondo, Yasushi Uchida, Haruhiko Kobashi, Koichiro Furuta, Masayuki Kurosaki, Beom Kyung K
    Journal of Gastroenterology and Hepatology.2025; 40(6): 1595.     CrossRef
  • Assessing Liver Fibrosis in Chronic Hepatitis B: Liver Biopsy or Non-Invasive Fibrosis Markers?
    Deniz Borcak, Zuhal Yesilbag, Yusuf Emre Ozdemir, Adile Sevde Demir, Esra Salim Dogdas, Aysegul Inci Sezen, Esra Canbolat Unlu, Sevtap Senoglu, Hayat Kumbasar Karaosmanoglu, Kadriye Kart Yasar
    Journal of Clinical Medicine.2025; 14(22): 8164.     CrossRef
  • Recent Trends in Noninvasive Tests for Assessing Hepatic Fibrosis in Patients with Chronic Liver Disease
    Jung Hwan Yu
    The Korean Journal of Medicine.2024; 99(5): 232.     CrossRef
  • Noninvasive Imaging Test to Assess Liver Fibrosis: Vibration-controlled Transient Elastography
    Mi Na Kim
    The Korean Journal of Gastroenterology.2024; 84(5): 201.     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
  • 5,134 View
  • 127 Download
  • 5 Web of Science
  • Crossref

Risk assessment of hepatitis B virus-related hepatocellular carcinoma development using vibration-controlled transient elastography: Systematic review and meta-analysis
Young-Joo Jin, Hee Yeon Kim, Young Ju Suh, Chae Hyeon Lee, Jung Hwan Yu, Mi Na Kim, Ji Won Han, Han Ah Lee, Jihyun An, Young Eun Chon, Dae Won Jun, Miyoung Choi, Seung Up Kim
Clin Mol Hepatol 2024;30(Suppl):S159-S171.
Published online July 23, 2024
DOI: https://doi.org/10.3350/cmh.2024.0163
Backgrounds/Aims
Liver stiffness measurement (LSM) using vibration-controlled transient elastography (VCTE) can assess fibrotic burden in chronic liver diseases. The systematic review and meta-analysis was conducted to determine whether LSM using VCTE can predict the risk of development of hepatocellular carcinoma (HCC) in chronic hepatitis B (CHB) patients.
Methods
A systematic literature search of the Ovid-Medline, EMBASE, Cochrane, and KoreaMed databases (from January 2010 to June 2023) was conducted. Of the 1,345 individual studies identified, 10 studies that used VCTE were finally registered. Hazard ratios (HRs) and the 95% confidence intervals (CIs) were considered summary estimates of treatment effect sizes of ≥11 kilopascal (kPa) standard for HCC development. Meta-analysis was performed using the restricted Maximum Likelihood random effects model.
Results
Among the ten studies, data for risk ratios for HCC development could be obtained from nine studies. When analyzed for the nine studies, the HR for HCC development was high at 3.33 (95% CI, 2.45–4.54) in CHB patients with a baseline LSM of ≥11 kPa compared to patients who did not. In ten studies included, LSM of ≥11 kPa showed the sensitivity and specificity for predicting HCC development were 61% (95% CI, 50–71%) and 78% (95% CI, 66–86%), respectively, and the diagnostic accuracy was 0.74 (95% CI, 0.70–0.77).
Conclusions
The risk of HCC development was elevated in CHB patients with VCTE-determined LSM of ≥11 kPa. This finding suggests that VCTE-determined LSM values may aid the risk prediction of HCC development in CHB patients.

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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.

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Preface
Seung Up Kim
Clin Mol Hepatol 2023;29(Suppl):S3-S3.
Published online February 17, 2023
DOI: https://doi.org/10.3350/cmh.2023.0014

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Special thanks
Seung Up Kim
Clin Mol Hepatol 2023;29(Suppl):S4-S4.
Published online February 17, 2023
DOI: https://doi.org/10.3350/cmh.2023.0010
  • 4,143 View
  • 46 Download

Original Article

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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Reviews

Steatotic liver disease

Noninvasive imaging biomarkers for liver fibrosis in nonalcoholic fatty liver disease: current and future
Jung Hwan Yu, Han Ah Lee, Seung Up Kim
Clin Mol Hepatol 2023;29(Suppl):S136-S149.
Published online December 12, 2022
DOI: https://doi.org/10.3350/cmh.2022.0436
Nonalcoholic fatty liver disease (NAFLD) is increasingly prevalent worldwide and becoming a major cause of liver disease-related morbidity and mortality. The presence of liver fibrosis in patients with NAFLD is closely related to prognosis, including the development of hepatocellular carcinoma and other complications of cirrhosis. Therefore, assessment of the presence of significant or advanced liver fibrosis is crucial. Although liver biopsy has been considered the “gold standard” method for evaluating the degree of liver fibrosis, it is not suitable for extensive use in all patients with NAFLD owing to its invasiveness and high cost. Therefore, noninvasive biochemical and imaging biomarkers have been developed to overcome the limitations of liver biopsy. Imaging biomarkers for the stratification of liver fibrosis have been evaluated in patients with NAFLD using different imaging techniques, such as transient elastography, shear wave elastography, and magnetic resonance elastography. Furthermore, artificial intelligence and deep learning methods are increasingly being applied to improve the diagnostic accuracy of imaging techniques and overcome the pitfalls of existing imaging biomarkers. In this review, we describe the usefulness and future prospects of noninvasive imaging biomarkers that have been studied and used to evaluate the degree of liver fibrosis in patients with NAFLD.

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Therapeutic mechanisms and beneficial effects of non-antidiabetic drugs in chronic liver diseases
Han Ah Lee, Young Chang, Pil Soo Sung, Eileen L. Yoon, Hye Won Lee, Jeong-Ju Yoo, Young-Sun Lee, Jihyun An, Do Seon Song, Young Youn Cho, Seung Up Kim, Yoon Jun Kim
Clin Mol Hepatol 2022;28(3):425-472.
Published online July 1, 2022
DOI: https://doi.org/10.3350/cmh.2022.0186
The global burden of chronic liver disease (CLD) is substantial. Due to the limited indication of and accessibility to antiviral therapy in viral hepatitis and lack of effective pharmacological treatment in nonalcoholic fatty liver disease, the beneficial effects of antidiabetics and non–antidiabetics in clinical practice have been continuously investigated in patients with CLD. In this narrative review, we focused on non-antidiabetic drugs, including ursodeoxycholic acid, silymarin, dimethyl4,4’-dimethoxy-5,6,5’,6’-dimethylenedixoybiphenyl-2,2’-dicarboxylate, L-ornithine L-aspartate, branched chain amino acids, statin, probiotics, vitamin E, and aspirin, and summarized their beneficial effects in CLD. Based on the antioxidant, anti-inflammatory properties, and regulatory functions in glucose or lipid metabolism, several non–antidiabetic drugs have shown beneficial effects in improving liver histology, aminotransferase level, and metabolic parameters and reducing risks of hepatocellular carcinoma and mortality, without significant safety concerns, in patients with CLD. Although the effect as the centerpiece management in patients with CLD is not robust, the use of these non-antidiabetic drugs might be potentially beneficial as an adjuvant or combined treatment strategy.

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Viral hepatitis

Entecavir versus tenofovir in patients with chronic hepatitis B: Enemies or partners in the prevention of hepatocellular carcinoma
Sung Won Lee, Jonggi Choi, Seung Up Kim, Young-Suk Lim
Clin Mol Hepatol 2021;27(3):402-412.
Published online June 23, 2021
DOI: https://doi.org/10.3350/cmh.2021.0179
Over the past several decades, entecavir (ETV) and tenofovir disoproxil fumarate (TDF) have remained the first-line antiviral agents in several international guidelines. These two antiviral agents have shown similar short to intermediateterm efficacy, including virologic, biochemical, serologic, and histologic responses. However, huge controversies regarding the antiviral efficacy of ETV and TDF in preventing the development of hepatocellular carcinoma (HCC) still exist. In this review, we summarized recent studies that compared the treatment efficacy of ETV and TDF in terms of HCC development.

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Guideline

Steatotic liver disease

KASL clinical practice guidelines: Management of nonalcoholic fatty liver disease
Seong Hee Kang, Hye Won Lee, Jeong-Ju Yoo, Yuri Cho, Seung Up Kim, Tae Hee Lee, Byoung Kuk Jang, Sang Gyune Kim, Sang Bong Ahn, Haeryoung Kim, Dae Won Jun, Joon-Il Choi, Do Seon Song, Won Kim, Soung Won Jeong, Moon Young Kim, Hong Koh, Sujin Jeong, Jin-Woo Lee, Yong Kyun Cho, on behalf of The Korean Association for the Study of the Liver (KASL)
Clin Mol Hepatol 2021;27(3):363-401.
Published online June 22, 2021
DOI: https://doi.org/10.3350/cmh.2021.0178

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Review

Steatotic liver disease

From nonalcoholic fatty liver disease to metabolic-associated fatty liver disease: Big wave or ripple?
Seong Hee Kang, Yuri Cho, Soung Won Jeong, Seung Up Kim, Jin-Woo Lee, On behalf of Korean NAFLD Study Group
Clin Mol Hepatol 2021;27(2):257-269.
Published online March 22, 2021
DOI: https://doi.org/10.3350/cmh.2021.0067
There is some dissatisfaction with the term “nonalcoholic fatty liver disease (NAFLD),” which overemphasizes alcohol and underemphasizes the importance of metabolic risk factors in this disease. Recently, a consensus recommended “metabolic (dysfunction)-associated fatty liver disease (MAFLD)” as a more appropriate term to describe fatty liver diseases (FLD) associated with metabolic dysfunction. During the definition change from NAFLD to MAFLD, subjects with FLD and metabolic abnormalities, together with other etiologies of liver diseases such as alcohol, virus, or medication who have been excluded from the NAFLD criteria, were added to the MAFLD criteria, while subjects with FLD but without metabolic abnormality, who have been included in the NAFLD criteria, were excluded from the MAFLD criteria. This means that there is an emphasis on the metabolic dysfunction in MAFLD which may underestimate the prognostic value of hepatic steatosis itself, whereas the MAFLD criteria might better identify subjects who are at a higher risk of hepatic or cardiovascular outcomes. However, non-metabolic risk NAFLD subjects who are excluded from the MAFLD criteria are missed from the diagnosis, and their potential risk can be the cause of future diseases. Although huge controversies remain, this review focused on summarizing recent studies that compared the clinical and prognostic characteristics between subjects with NAFLD and MAFLD.

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Original Articles

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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  • Negligible risk of hepatocellular carcinoma in chronic hepatitis B patients in immune-tolerant phase: Myth or fact
    Terry Cheuk-Fung Yip, Grace Lai-Hung Wong, Vincent Wai-Sun Wong
    Clinical and Molecular Hepatology.2021; 27(2): 273.     CrossRef
  • Association of Physical Activity with the Risk of Hepatocellular Carcinoma in Patients with Chronic Hepatitis B
    Ho Soo Chun, Sojeong Park, Minjong Lee, Yuri Cho, Ha Sung Kim, A Reum Choe, Hwi Young Kim, Kwon Yoo, Tae Hun Kim
    Cancers.2021; 13(14): 3424.     CrossRef
  • 8,838 View
  • 225 Download
  • 25 Web of Science
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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.

Citations

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  • Glycomics as prognostic biomarkers of hepatocellular carcinoma: A systematic review
    Nicky Somers, Emma Butaye, Lorenz Grossar, Nele Pauwels, Anja Geerts, Sarah Raevens, Sander Lefere, Lindsey Devisscher, Leander Meuris, Nico Callewaert, Hans Van Vlierberghe, Xavier Verhelst
    Oncology Letters.2024;[Epub]     CrossRef
  • Prognostic value of preoperative systemic immune-inflammation index/albumin for patients with hepatocellular carcinoma undergoing curative resection
    Kun-Lin Chen, Yi-Wen Qiu, Ming Yang, Tao Wang, Yi Yang, Hai-Zhou Qiu, Ting Sun, Wen-Tao Wang
    World Journal of Gastroenterology.2024; 30(48): 5130.     CrossRef
  • Post-operative recurrence of liver cancer according to antiviral therapy for detectable hepatitis B viremia: A nationwide study
    Byungyoon Yun, Sang Hoon Ahn, Juyeon Oh, Jin-Ha Yoon, Beom Kyung Kim
    European Journal of Internal Medicine.2023; 107: 66.     CrossRef
  • Comparable Mortality Between Asian Patients with Chronic Hepatitis B Under Long-Term Antiviral Therapy vs Matched Control: A Population-Based Study
    Byungyoon Yun, Juyeon Oh, Sang Hoon Ahn, Jin-Ha Yoon, Beom Kyung Kim
    American Journal of Gastroenterology.2023; 118(6): 1001.     CrossRef
  • Outcome of untreated low-level viremia versus antiviral therapy-induced or spontaneous undetectable HBV-DNA in compensated cirrhosis
    Daniel Q. Huang, Nobuharu Tamaki, Hyung Woong Lee, Soo Young Park, Yu Rim Lee, Hye Won Lee, Seng Gee Lim, Tae Seop Lim, Masayuki Kurosaki, Hiroyuki Marusawa, Toshie Mashiba, Masahiko Kondo, Yasushi Uchida, Haruhiko Kobashi, Koichiro Furuta, Namiki Izumi,
    Hepatology.2023; 77(5): 1746.     CrossRef
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    Ziming He, Di Tang
    Frontiers in Oncology.2023;[Epub]     CrossRef
  • Serum wisteria floribunda agglutinin-positive human Mac-2 binding protein is unsuitable as a diagnostic marker of occult hepatocellular carcinoma in end-stage liver cirrhosis
    Kantoku Nagakawa, Masaaki Hidaka, Takanobu Hara, Hajime Matsushima, Hajime Imamura, Takayuki Tanaka, Tomohiko Adachi, Akihiko Soyama, Kengo Kanetaka, Susumu Eguchi, Jincheng Wang
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  • Validation of PH and Varices Risk Scores for Prediction of High-Risk Esophageal Varix and Bleeding in Patients with B-Viral Cirrhosis
    Seunghwan Shin, Seung Up Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Beom Kyung Kim
    Diagnostics.2022; 12(2): 441.     CrossRef
  • Mac-2 binding protein glycosylation isomer (M2BPGi) to evaluate liver fibrosis and cancer in HBV-infected patients in West Africa
    Jeanne Perpétue Vincent, Gibril Ndow, Shintaro Ogawa, Amie Ceesay, Ramou Njie, Bakary Sanneh, Ignatius Baldeh, Umberto D’Alessandro, Maimuna Mendy, Mark Thursz, Isabelle Chemin, Yasuhito Tanaka, Maud Lemoine, Yusuke Shimakawa
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  • A Mac-2 Binding Protein Glycosylation Isomer-Based Risk Model Predicts Hepatocellular Carcinoma in HBV-Related Cirrhotic Patients on Antiviral Therapy
    Chien-Hung Chen, Tsung-Hui Hu, Jing-Houng Wang, Hsueh-Chou Lai, Chao-Hung Hung, Sheng-Nan Lu, Cheng-Yuan Peng
    Cancers.2022; 14(20): 5063.     CrossRef
  • External validation of CAGE‐B and SAGE‐B scores for Asian chronic hepatitis B patients with well‐controlled viremia by antivirals
    Jung Hyun Ji, Soo Young Park, Won Jeong Son, Hye Jung Shin, Hyein Lee, Hye Won Lee, Jae Seung Lee, Seung Up Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Beom Kyung Kim
    Journal of Viral Hepatitis.2021; 28(6): 951.     CrossRef
  • Treatment efficacy by hepatic arterial infusion chemotherapy vs. sorafenib after liver-directed concurrent chemoradiotherapy for advanced hepatocellular carcinoma
    Sojung Han, Hye Jin Choi, Seung-Hoon Beom, Hye Rim Kim, Hyein Lee, Jae Seung Lee, Hye Won Lee, Jun Yong Park, Seung Up Kim, Do Young Kim, Sang Hoon Ahn, Kwang-Hyub Han, Jinsil Seong, Jong Yun Won, Beom Kyung Kim
    Journal of Cancer Research and Clinical Oncology.2021; 147(10): 3123.     CrossRef
  • Effect of tenofovir alafenamide vs. tenofovir disoproxil fumarate on hepatocellular carcinoma risk in chronic hepatitis B
    Hye Won Lee, Young Youn Cho, Hyein Lee, Jae Seung Lee, Seung Up Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Beom Kyung Kim, Soo Young Park
    Journal of Viral Hepatitis.2021; 28(11): 1570.     CrossRef
  • Novel Liver Stiffness-Based Nomogram for Predicting Hepatocellular Carcinoma Risk in Patients with Chronic Hepatitis B Virus Infection Initiating Antiviral Therapy
    Jae Seung Lee, Hyun Woong Lee, Tae Seop Lim, Hye Jung Shin, Hye Won Lee, Seung Up Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Beom Kyung Kim
    Cancers.2021; 13(23): 5892.     CrossRef
  • Usefulness of Mac-2 binding protein glycosylation isomer in non-invasive probing liver disease in the Vietnamese population
    Thuy Thi Thu Pham, Dat Tan Ho, Toan Nguyen
    World Journal of Hepatology.2020; 12(5): 210.     CrossRef
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    Shu Feng, Zhonghao Wang, Yanhua Zhao, Chuanmin Tao
    Scientific Reports.2020;[Epub]     CrossRef
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    Takako Inoue, Yasuhito Tanaka
    Clinical and Molecular Hepatology.2020; 26(3): 261.     CrossRef
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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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  • Comparison between Nivolumab and Regorafenib as Second-line Systemic Therapies after Sorafenib Failure in Patients with Hepatocellular Carcinoma
    Hong Jun Lee, Jae Seung Lee, Hyesung So, Ja Kyung Yoon, Jin-Young Choi, Hye Won Lee, Beom Kyung Kim, Seung Up Kim, Jun Yong Park, Sang Hoon Ahn, Do Young Kim
    Yonsei Medical Journal.2024; 65(7): 371.     CrossRef
  • Post-operative recurrence of liver cancer according to antiviral therapy for detectable hepatitis B viremia: A nationwide study
    Byungyoon Yun, Sang Hoon Ahn, Juyeon Oh, Jin-Ha Yoon, Beom Kyung Kim
    European Journal of Internal Medicine.2023; 107: 66.     CrossRef
  • Early Detection of Hepatocarcinogenicity in Rats Using MRI with Ferric–Tannic Nanoparticles
    Jannarong Intakhad, Arpamas Vachiraarunwong, Jantira Sanit, Aiyarin Kittilukkana, Sarawut Kongkarnka, Rawiwan Wongpoomchai, Chalermchai Pilapong
    Analytical Chemistry.2023; 95(27): 10241.     CrossRef
  • Cysteine‐rich intestinal protein 1 enhances the progression of hepatocellular carcinoma via Ras signaling
    Hong‐Yu He, Li Hu
    The Kaohsiung Journal of Medical Sciences.2022; 38(1): 49.     CrossRef
  • Episodic Detectable Viremia Does Not Affect Prognosis in Untreated Compensated Cirrhosis With Serum Hepatitis B Virus DNA <2,000 IU/mL
    Hye Won Lee, Soo Young Park, Yu Rim Lee, Hyein Lee, Jae Seung Lee, Seung Up Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Beom Kyung Kim
    American Journal of Gastroenterology.2022; 117(2): 288.     CrossRef
  • Long‐term renal safety between patients with chronic hepatitis B receiving tenofovir vs. entecavir therapy: A multicenter study
    Young Eun Chon, Soo Young Park, Seung Up Kim, Han Pyo Hong, Jae Seung Lee, Hye Won Lee, Mi Na Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Beom Kyung Kim
    Journal of Viral Hepatitis.2022; 29(4): 289.     CrossRef
  • Expression Profiles and Prognostic Value of Multiple Inhibitory Checkpoints in Head and Neck Lymphoepithelioma-Like Carcinoma
    Wen-Qing Zou, Wei-Jie Luo, Yan-Fen Feng, Fang Liu, Shao-Bo Liang, Xue-Liang Fang, Ye-Lin Liang, Na Liu, Ya-Qin Wang, Yan-Ping Mao
    Frontiers in Immunology.2022;[Epub]     CrossRef
  • External Validation of the FSAC Model Using On-Therapy Changes in Noninvasive Fibrosis Markers in Patients with Chronic Hepatitis B: A Multicenter Study
    Jae Seung Lee, Hyun Woong Lee, Tae Seop Lim, In Kyung Min, Hye Won Lee, Seung Up Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Beom Kyung Kim
    Cancers.2022; 14(3): 711.     CrossRef
  • Validation of risk prediction scores for hepatocellular carcinoma in patients with chronic hepatitis B treated with entecavir or tenofovir
    Jin Won Chang, Jae Seung Lee, Hye Won Lee, Beom Kyung Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Yeon Seok Seo, Han Ah Lee, Mi Na Kim, Yu Rim Lee, Seong Gyu Hwang, Kyu Sung Rim, Soon Ho Um, Won Young Tak, Young Oh Kweon, Soo Young Park, Seung Up Kim
    Journal of Viral Hepatitis.2021; 28(1): 95.     CrossRef
  • Lenvatinib is independently associated with the reduced risk of progressive disease when compared with sorafenib in patients with advanced hepatocellular carcinoma
    Soojin Kim, Kyung Hyun Kim, Beom Kyung Kim, Jun Yong Park, Sang Hoon Ahn, Do Young Kim, Seung Up Kim
    Journal of Gastroenterology and Hepatology.2021; 36(5): 1317.     CrossRef
  • Validation of the HCC‐RESCUE score to predict hepatocellular carcinoma risk in Caucasian chronic hepatitis B patients under entecavir or tenofovir therapy
    Fatih Güzelbulut, Pınar Gökçen, Güray Can, Gupse Adalı, Ayça Gökçen Değirmenci Saltürk, Özgür Bahadır, Kamil Özdil, Hamdi Levent Doğanay
    Journal of Viral Hepatitis.2021; 28(5): 826.     CrossRef
  • Predictors of Complete Response in Patients with Hepatocellular Carcinoma Treated with Trans-Arterial Radioembolization
    Yuna Kim, Jae Seung Lee, Hye Won Lee, Beom Kyung Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Seung Up Kim
    Current Oncology.2021; 28(1): 965.     CrossRef
  • External validation of CAGE‐B and SAGE‐B scores for Asian chronic hepatitis B patients with well‐controlled viremia by antivirals
    Jung Hyun Ji, Soo Young Park, Won Jeong Son, Hye Jung Shin, Hyein Lee, Hye Won Lee, Jae Seung Lee, Seung Up Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Beom Kyung Kim
    Journal of Viral Hepatitis.2021; 28(6): 951.     CrossRef
  • Effect of antiviral therapy in patients with low HBV DNA level on transarterial chemoembolization for hepatocellular carcinoma
    Myung Pyo Kim, Jae Kook Yang, Baek Gyu Jun, Young Don Kim, Gab Jin Cheon, Hee Jae Jung, Jeong‐Ju Yoo, Sang Gyune Kim, Young Seok Kim, Soung Won Jeong, Jae Young Jang, Hong Soo Kim, Sae Hwan Lee
    Journal of Viral Hepatitis.2021; 28(7): 1011.     CrossRef
  • Treatment efficacy by hepatic arterial infusion chemotherapy vs. sorafenib after liver-directed concurrent chemoradiotherapy for advanced hepatocellular carcinoma
    Sojung Han, Hye Jin Choi, Seung-Hoon Beom, Hye Rim Kim, Hyein Lee, Jae Seung Lee, Hye Won Lee, Jun Yong Park, Seung Up Kim, Do Young Kim, Sang Hoon Ahn, Kwang-Hyub Han, Jinsil Seong, Jong Yun Won, Beom Kyung Kim
    Journal of Cancer Research and Clinical Oncology.2021; 147(10): 3123.     CrossRef
  • Individualized surveillance of chronic hepatitis B patients according to hepatocellular carcinoma risk based on PAGE-B scores
    Ji Hyun Kim, Seong Hee Kang, Minjong Lee, Hoon Sung Choi, Baek Gyu Jun, Tae Suk Kim, Dae Hee Choi, Ki Tae Suk, Moon Young Kim, Young Don Kim, Gab Jin Cheon, Soon Koo Baik, Dong Joon Kim
    European Journal of Gastroenterology & Hepatology.2021; 33(12): 1564.     CrossRef
  • Effect of tenofovir alafenamide vs. tenofovir disoproxil fumarate on hepatocellular carcinoma risk in chronic hepatitis B
    Hye Won Lee, Young Youn Cho, Hyein Lee, Jae Seung Lee, Seung Up Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Beom Kyung Kim, Soo Young Park
    Journal of Viral Hepatitis.2021; 28(11): 1570.     CrossRef
  • Metformin and Dichloroacetate Suppress Proliferation of Liver Cancer Cells by Inhibiting mTOR Complex 1
    Tae Suk Kim, Minjong Lee, Minji Park, Sae Yun Kim, Min Suk Shim, Chea Yeon Lee, Dae Hee Choi, Yuri Cho
    International Journal of Molecular Sciences.2021; 22(18): 10027.     CrossRef
  • Novel Liver Stiffness-Based Nomogram for Predicting Hepatocellular Carcinoma Risk in Patients with Chronic Hepatitis B Virus Infection Initiating Antiviral Therapy
    Jae Seung Lee, Hyun Woong Lee, Tae Seop Lim, Hye Jung Shin, Hye Won Lee, Seung Up Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Beom Kyung Kim
    Cancers.2021; 13(23): 5892.     CrossRef
  • Improved detection of hepatocellular carcinoma by dynamic computed tomography in cirrhotic patients with chronic hepatitis B: A multicenter study
    Ji Hyun Kim, Seong Hee Kang, Minjong Lee, Hoon Sung Choi, Baek Gyu Jun, Tae Suk Kim, Dae Hee Choi, Ki Tae Suk, Moon Young Kim, Young Don Kim, Gab Jin Cheon, Soon Koo Baik, Dong Joon Kim
    Journal of Gastroenterology and Hepatology.2020; 35(10): 1795.     CrossRef
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  • 152 Download
  • 20 Web of Science
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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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    Hye Yeon Chon, Han Ah Lee, Sang Jun Suh, Jung Il Lee, Byung Seok Kim, In Hee Kim, Chang Hyeong Lee, Byoung Kuk Jang, Hyun Woong Lee, Jae Seok Hwang, Chang Hun Lee, Jin‐Woo Lee, Jung Hwan Yu, Yeon Seok Seo, Hyung Joon Yim, Seung Up Kim
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  • 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
    Clinical and Molecular Hepatology.2021; 27(2): 295.     CrossRef
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    Han Ah Lee, Hyun Woong Lee, In Hee Kim, Soo Young Park, Dong Hyun Sinn, Jung Hwan Yu, Yeon Seok Seo, Soon Ho Um, Jung Il Lee, Kwan Sik Lee, Chang Hun Lee, Won Young Tak, Young Oh Kweon, Wonseok Kang, Yong‐Han Paik, Jin‐Woo Lee, Sang Jun Suh, Young Kul Jun
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Original Article

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
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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Editorial

Steatotic liver disease

Chasing after novel non-invasive markers to identify advanced fibrosis in NAFLD
Wonseok Kang, Seung Up Kim
Clin Mol Hepatol 2013;19(3):255-257.
Published online September 30, 2013
DOI: https://doi.org/10.3350/cmh.2013.19.3.255

Citations

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  • Prevalence and Predictors of Significant Fibrosis Among Subjects with Transient Elastography-Defined Nonalcoholic Fatty Liver Disease
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Original Article

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
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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  • ALT Is Not Associated With Achieving Subcirrhotic Liver Stiffness and HCC During Entecavir Therapy in HBV-Related Cirrhosis
    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
    David Sooik Kim, Soo Young Park, Beom Kyung Kim, Jun Yong Park, Do Young Kim, Kwang-Hyub Han, Yu Rim Lee, Won Young Tak, Young Oh Kweon, Inkyung Jung, Minkyung Han, Eun Hwa Kim, Sang Hoon Ahn, Seung Up Kim
    Journal of Korean Medical Science.2021;[Epub]     CrossRef
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    Aoran Luo, Xiaoyan Jiang, Hong Ren
    Medicine.2018; 97(51): e13596.     CrossRef
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Reviews

Current consensus and guidelines of contrast enhanced ultrasound for the characterization of focal liver lesions
Jae Young Jang, Moon Young Kim, Soung Won Jeong, Tae Yeob Kim, Seung Up Kim, Sae Hwan Lee, Ki Tae Suk, Soo Young Park, Hyun Young Woo, Sang Gyune Kim, Jeong Heo, Soon Koo Baik, Hong Soo Kim, Won Young Tak
Korean J Hepatol 2013;19(1):1-16.
Published online March 25, 2013
DOI: https://doi.org/10.3350/cmh.2013.19.1.1

The application of ultrasound contrast agents (UCAs) is considered essential when evaluating focal liver lesions (FLLs) using ultrasonography (US). Microbubble UCAs are easy to use and robust; their use poses no risk of nephrotoxicity and requires no ionizing radiation. The unique features of contrast enhanced US (CEUS) are not only noninvasiveness but also real-time assessing of liver perfusion throughout the vascular phases. The later feature has led to dramatic improvement in the diagnostic accuracy of US for detection and characterization of FLLs as well as the guidance to therapeutic procedures and evaluation of response to treatment. This article describes the current consensus and guidelines for the use of UCAs for the FLLs that are commonly encountered in US. After a brief description of the bases of different CEUS techniques, contrast-enhancement patterns of different types of benign and malignant FLLs and other clinical applications are described and discussed on the basis of our experience and the literature data.

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Liver fibrosis, cirrhosis, and portal hypertension

Clinical applications of transient elastography
Kyu Sik Jung, Seung Up Kim
Korean J Hepatol 2012;18(2):163-173.
Published online June 26, 2012
DOI: https://doi.org/10.3350/cmh.2012.18.2.163

Chronic liver disease represents a major public health problem, accounting for significant morbidity and mortality worldwide. As prognosis and management depend mainly on the amount and progression of liver fibrosis, accurate quantification of liver fibrosis is essential for therapeutic decision-making and follow-up of chronic liver diseases. Even though liver biopsy is the gold standard for evaluation of liver fibrosis, non-invasive methods that could substitute for invasive procedures have been investigated during past decades. Transient elastography (TE, FibroScan®) is a novel non-invasive method for assessment of liver fibrosis with chronic liver disease. TE can be performed in the outpatient clinic with immediate results and excellent reproducibility. Its diagnostic accuracy for assessment of liver fibrosis has been demonstrated in patients with chronic viral hepatitis; as a result, unnecessary liver biopsy could be avoided in some patients. Moreover, due to its excellent patient acceptance, TE could be used for monitoring disease progression or predicting development of liver-related complications. This review aims at discussing the usefulness of TE in clinical practice.

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Revision and update on clinical practice guideline for liver cirrhosis
Ki Tae Suk, Soon Koo Baik, Jung Hwan Yoon, Jae Youn Cheong, Yong Han Paik, Chang Hyeong Lee, Young Seok Kim, Jin Woo Lee, Dong Joon Kim, Sung Won Cho, Seong Gyu Hwang, Joo Hyun Sohn, Moon Young Kim, Young Bae Kim, Jae Geun Kim, Yong Kyun Cho, Moon Seok Choi, Hyung Joon Kim, Hyun Woong Lee, Seung Up Kim, Ja Kyung Kim, Jin Young Choi, Dae Won Jun, Won Young Tak, Byung Seok Lee, Byoung Kuk Jang, Woo Jin Chung, Hong Soo Kim, Jae Young Jang, Soung Won Jeong, Sang Gyune Kim, Oh Sang Kwon, Young Kul Jung, Won Hyeok Choe, June Sung Lee, In Hee Kim, Jae Jun Shim, Gab Jin Cheon, Si Hyun Bae, Yeon Seok Seo, Dae Hee Choi, Se Jin Jang
Korean J Hepatol 2012;18(1):1-21.
Published online March 22, 2012
DOI: https://doi.org/10.3350/kjhep.2012.18.1.1

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Original Article

Clinical features of acute viral hepatitis B in Korea: a multi-center study
Hye Jin Choi, Soon Young Ko, Won Hyeok Choe, Yeon Seok Seo, Ji Hoon Kim, Kwan Soo Byun, Young Seok Kim, Seung Up Kim, Soon Koo Baik, Jae Youn Cheong, Tae Yeob Kim, Oh Sang Kwon, Jeong Han Kim, Chang Hong Lee, So Young Kwon
Korean J Hepatol 2011;17(4):307-312.
Published online December 26, 2011
DOI: https://doi.org/10.3350/kjhep.2011.17.4.307
Background/Aims

The incidence of Hepatitis B has significantly declined since the introduction of an HBV vaccination program. The aim of this study was to investigate recent clinical features of acute viral hepatitis B (AVH-B) in Korea.

Methods

A total of 2241 patients with acute viral hepatitis were enrolled and their data were collected from nine medical-centers between January 2006 and December 2009.

Results

One hundred nineteen (5.3%) of the 2241 were diagnosed as AVH-B. Among 78 patients with AVH-B whose data were analyzed, 50 were male, and the mean age was 38.6 years. In an initial test, mean AST, ALT and total-bilirubin levels were 1296.2 IU/L, 2109.6 IU/L and 9.3 mg/dl, respectively. Positivity frequencies for HBeAg and anti-HBe were 55.1% and 67.9%, respectively, and the mean HBV DNA level was 5.2 log10 copies/ml. The mean length of hospitalization was 11.6 days. During follow-up, AST, ALT and total bilirubin levels were normalized or near-normalized in all patients without serious complications. Sixty-three of 66 (95.4%) patients showed HBsAg loss and 37 (56.1%) patients showed HBsAg seroconversion. Only 3 patients (4.5%) showed persistent hepatitis B viremia. There was no case of death or liver transplantation. Nine patients (11.3%) had received anti-viral agents and their clinical outcomes were not significantly different from those of patients treated without antiviral agents.

Conclusions

The prevalence of AVH-B among acute hepatitis patients is relatively low in Korea. AVH-B infection can be cured without complications in almost all patients, regardless of antiviral treatment.

Citations

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Case Report
Hepatogastric fistula caused by direct invasion of hepatocellular carcinoma after transarterial chemoembolization and radiotherapy
Hana Park, Seung Up Kim, Junjeong Choi, Jun Yong Park, Sang Hoon Ahn, Kwang-Hyub Han, Chae Yoon Chon, Young Nyun Park, Do Young Kim
Korean J Hepatol 2010;16(4):401-404.
Published online December 31, 2010
DOI: https://doi.org/10.3350/kjhep.2010.16.4.401

A 63-year-old man with a history of hepatitis-B-related hepatocellular carcinoma (HCC) in the left lateral portion of the liver received repeated transcatheter arterial chemoembolization (TACE) and salvage radiotherapy. Two months after completing radiotherapy, he presented with dysphagia, epigastric pain, and a protruding abdominal mass. Computed tomography showed that the bulging mass was directly invading the adjacent stomach. Endoscopy revealed a fistula from the HCC invading the stomach. Although the size of the mass had decreased with the drainage through the fistula, and his symptoms had gradually improved, he died of cancer-related bleeding and hepatic failure. This represents a case in which an HCC invaded the stomach and caused a hepatogastric fistula after repeated TACE and salvage radiotherapy.

Citations

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