Clinical and Molecular Hepatology

"Sun Hong Yoo"

Original Articles

Hepatic neoplasm

Preemptive antiviral therapy with entecavir can reduce acute deterioration of hepatic function following transarterial chemoembolization: Sun Hong Yoo, Jeong Won Jang, Jung Hyun Kwon, Seung Min Jung, Bohyun Jang, Jong Young Choi; Clin Mol Hepatol 2016;22(4):458-465.
Published online December 25, 2016; DOI: https://doi.org/10.3350/cmh.2016.0054

Abstract
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Background/Aims
Hepatic damage during transarterial chemoembolization (TACE) is a critical complication in patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC). Apart from its role in preventing HBV reactivation, there is some evidence for the benefits of preemptive antiviral therapy in TACE. This study evaluated the effect of preemptive antiviral therapy on acute hepatic deterioration following TACE.
Methods
This retrospective observational study included a prospectively collected cohort of 108 patients with HBV-related HCC who underwent TACE between January 2007 and January 2013. Acute hepatic deterioration following TACE was evaluated. Treatment-related hepatic decompensation was defined as newly developed encephalopathy, ascites, variceal bleeding, elevation of the bilirubin level, prolongation of prothrombin time, or elevation of the Child-Pugh score by ≥2 within 2 weeks following TACE. Univariate and multivariate analyses were conducted to identify factors influencing treatment-related decompensation. Preemptive antiviral therapy involves directing prophylaxis only toward high-risk chronic hepatitis B patients in an attempt to prevent the progression of liver disease. We regarded at least 6 months as a significant duration of preemptive antiviral treatment before diagnosis of HCC.
Results
Of the 108 patients, 30 (27.8%) patients received preemptive antiviral therapy. Treatment-related decompensation was observed in 25 (23.1%) patients during the follow-up period. Treatment-related decompensation following TACE was observed more frequently in the nonpreemptive group than in the preemptive group (29.5% vs. 6.7%, P=0.008). In the multivariate analysis, higher serum total bilirubin (Hazard ratio [HR] =3.425, P=0.013), hypoalbuminemia (HR=3.990, P=0.015), and absence of antiviral therapy (HR=7.597, P=0.006) were significantly associated with treatment-related hepatic decompensation.
Conclusions
Our findings suggest that preemptive antiviral therapy significantly reduces the risk of acute hepatic deterioration. Preventing hepatic deterioration during TACE by applying such a preemptive approach may facilitate the continuation of anticancer therapy and thus improve long-term outcomes.

Citations

Citations to this article as recorded by

Microbial metabolism dysfunction induced by transarterial chemoembolization aggravates postprocedural liver injury in HCC
Rui Li, Jianxin Liu, Feilong Ye, Siqin He, Jingjun Huang, Mengdan Zhou, Qifeng Xie, Zhile Liu, Wei Cheng, Guodong Wang, Wei Deng, Xiaobin Wang, Tingqi Yang, Zhengyang Liang, Feiyan Hu, Wensou Huang, Mingyue Cai, Lulu Xie, Wen Zhang, Shenhai Gong, Yun Chen
Journal of Hepatology.2026; 84(4): 808. CrossRef
Impact of frailty on the long-term prognosis of the elderly with hepatocellular carcinoma treated with transarterial chemoembolization
Yu-Fei Shao, Ya-Nan Zu, Xiang-Qi Yin, Jin-Chang Xiao, Yu-Ming Gu
Scientific Reports.2025;[Epub] CrossRef
EASL Clinical Practice Guidelines on the management of hepatitis B virus infection
Markus Cornberg, Lisa Sandmann, Jerzy Jaroszewicz, Patrick Kennedy, Pietro Lampertico, Maud Lemoine, Sabela Lens, Barbara Testoni, Grace Lai-Hung Wong, Francesco Paolo Russo
Journal of Hepatology.2025; 83(2): 502. CrossRef
5-FU promotes HBV replication through oxidative stress-induced autophagy dysfunction
Jing Yang, Luyan Zheng, Zhenggang Yang, Zhiqiang Wei, Jiajia Shao, Yina Zhang, Jiping Yao, Minwei Li, Xueyu Wang, Min Zheng
Free Radical Biology and Medicine.2024; 213: 233. CrossRef
Liver Injury and Its Impact on Prognosis in Patients with HBV-Related Hepatocellular Carcinoma Undergoing Transarterial Chemoembolization Combined with Tyrosine Kinase Inhibitors Plus Immune Checkpoint Inhibitors
Jiaming Shen, Xia Wang, Guangde Yang, Li Li, Juanjuan Fu, Wei Xu, Qingqiao Zhang, Xiucheng Pan
Journal of Hepatocellular Carcinoma.2024; Volume 11: 207. CrossRef
Sorafenib plus transcatheter arterial chemoembolization with or without camrelizumab for the treatment of intermediate and advanced hepatocellular carcinoma
Bo Sun, Lei Chen, Yu Lei, Lijie Zhang, Tao Sun, Yiming Liu, Chuansheng Zheng
British Journal of Radiology.2024; 97(1159): 1320. CrossRef
TACE versus TACE + entecavir versus TACE + tenofovir in the treatment of HBV associated hepatocellular carcinoma
Haohao Lu, Chuansheng Zheng, Bin Xiong, Xiangwen Xia
BMC Cancer.2023;[Epub] CrossRef
S3-Leitlinie der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) zur Prophylaxe, Diagnostik und Therapie der Hepatitis-B-Virusinfektion – (AWMF-Register-Nr. 021-11)
Markus Cornberg, Lisa Sandmann, Ulrike Protzer, Claus Niederau, Frank Tacke, Thomas Berg, Dieter Glebe, Wolfgang Jilg, Heiner Wedemeyer, Stefan Wirth, Christoph Höner zu Siederdissen, Petra Lynen-Jansen, Pia van Leeuwen, Jörg Petersen
Zeitschrift für Gastroenterologie.2021; 59(07): 691. CrossRef
Association of Prophylactic Anti–Hepatitis B Virus Therapy With Improved Long-term Survival in Patients With Hepatocellular Carcinoma Undergoing Transarterial Therapy
Jeong Won Jang, Sun Hong Yoo, Hee Chul Nam, Bo Hyun Jang, Pil Soo Sung, Sung, Won Lee, Jung Hyun Kwon, Soon Woo Nam, Si Hyun Bae, Seung Kew Yoon, Jong Young Choi
Clinical Infectious Diseases.2020; 71(3): 546. CrossRef
Nucleos(t)ide analogues and Hepatitis B virus-related hepatocellular carcinoma: A literature review
Mohamed A Abd El Aziz, Rodolfo Sacco, Antonio Facciorusso
Antiviral Chemistry and Chemotherapy.2020; 28: 204020662092133. CrossRef
Efficacy of microwave ablation and entecavir as a combination treatment for primary liver cancer and their effects on hepatitis B virus and liver function
Hong Xu, Qiang Zhang, Yu-Lin Tan, Yang Zhang, Jian-Zhu Wei, Ling-Ling Wang, Bo Xie
All Life.2020; 13(1): 524. CrossRef
Effects of TACE and preventive antiviral therapy on HBV reactivation and subsequent hepatitis in hepatocellular carcinoma: a meta-analysis
Su-Su Zhang, Jin-Xia Liu, Jing Zhu, Ming-Bing Xiao, Cui-Hua Lu, Run-Zhou Ni, Li-Shuai Qu
Japanese Journal of Clinical Oncology.2019; 49(7): 646. CrossRef
Hepatitis B virus reactivation after radiotherapy for hepatocellular carcinoma and efficacy of antiviral treatment: A multicenter study
Baek Gyu Jun, Young Don Kim, Sang Gyune Kim, Young Seok Kim, Soung Won Jeong, Jae Young Jang, Sae Hwan Lee, Hong Soo Kim, Seong Hee Kang, Moon Young Kim, Soon Koo Baik, Minjong Lee, Tae-Suk Kim, Dae Hee Choi, Sang-Hyeon Choi, Ki Tae Suk, Dong Joon Kim, Ga
PLOS ONE.2018; 13(7): e0201316. CrossRef

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Hepatic neoplasm

Obesity and hepatocellular carcinoma in patients receiving entecavir for chronic hepatitis B: Jaemin Lee, Sun Hong Yoo, Won Sohn, Hyung Woo Kim, Yong Sun Choi, Jung Ho Won, Jin Young Heo, Sang Jong Park, Young Min Park; Clin Mol Hepatol 2016;22(3):339-349.
Published online September 25, 2016; DOI: https://doi.org/10.3350/cmh.2016.0021

Abstract
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Background/Aims
This study aimed to clarify the effect of obesity on the development of hepatocellular carcinoma (HCC) in chronic hepatitis B (CHB) patients receiving antiviral treatment.
Methods
This study applied a retrospective analysis to a historical cohort in Bundang Jesaeng Hospital. In total, 102 CHB patients were treated with entecavir as an initial treatment for CHB and checked for obesity using a body composition analyzer. Hepatic steatosis was measured semiquantitatively using Hamaguchi’s scoring system in ultrasonography. Risk factors for the development of HCC were analyzed, including obesity-related factors (body mass index [BMI], waist circumference [WC], waist-to-hip ratio [WHR], visceral fat area [VFA], and hepatic steatosis).
Results
The median follow-up duration of the patients was 45.2 months (interquartile range: 36.0-58.3 months). The cumulative incidence rates of HCC at 1 year, 3 years, and 5 years were 0%, 5.3%, and 9.0%, respectively. Univariable analysis revealed that the risk factors for HCC development were a platelet count of <120,000 /mm² (hazard ratio [HR]=5.21, P=0.031), HBeAg negativity (HR=5.61, P=0.039), and liver cirrhosis (HR=10.26, P=0.031). Multivariable analysis showed that the significant risk factor for HCC development was liver cirrhosis (HR=9.07, P=0.042). However, none of the obesity-related risk factors were significantly associated with HCC: BMI ≥25 kg/m² (HR=0.90, P=0.894), WC ≥90 cm (HR=1.10, P=0.912), WHR ≥0.9 (HR=1.94, P=0.386), VFA ≥100 cm² (HR=1.69, P=0.495), and hepatic steatosis (HR=0.57, P=0.602).
Conclusions
HCC development is associated with liver cirrhosis but not obesity-related factors in CHB patients receiving entecavir.

Citations

Citations to this article as recorded by

Impact of Metabolic Dysfunction-Associated Fatty/Steatotic Liver Disease on Hepatocellular Carcinoma Incidence and Long-Term Prognosis Post-Liver Resection: A Systematic Review and Meta-Analysis
Qingyan Kong, Diao Kong, Bei Li, Wei Peng, Zheyu Chen
Academic Radiology.2025; 32(11): 6514. CrossRef
The outcomes and mechanisms of chronic hepatitis B complicated by metabolic dysfunction-associated steatotic liver disease
Mao-Ping Li, Kai-Zhong Luo
Hepatobiliary & Pancreatic Diseases International.2025; 24(5): 476. CrossRef
Chronic hepatitis B and metabolic dysfunction-associated steatotic liver disease: Metabolic risk factors are key drivers of hepatocellular carcinoma
Gupse Adali, Huseyin Aykut, Nermin Mutlu Bilgic, Yusuf Yilmaz
Heliyon.2024; 10(18): e37990. CrossRef
Deep learning assisted biomarker development in patients with chronic hepatitis B: Editorial on “Prognostic role of computed tomography analysis using deep learning algorithm in patients with chronic hepatitis B viral infection”
Yong Eun Chung
Clinical and Molecular Hepatology.2024; 30(4): 669. CrossRef
Impact of fatty liver on long-term outcomes in chronic hepatitis B: a systematic review and matched analysis of individual patient data meta-analysis
Yu Jun Wong, Vy H. Nguyen, Hwai-I Yang, Jie Li, Michael Huan Le, Wan-Jung Wu, Nicole Xinrong Han, Khi Yung Fong, Elizebeth Chen, Connie Wong, Fajuan Rui, Xiaoming Xu, Qi Xue, Xin Yu Hu, Wei Qiang Leow, George Boon-Bee Goh, Ramsey Cheung, Grace Wong, Vince
Clinical and Molecular Hepatology.2023; 29(3): 705. CrossRef
Steatosis, HBV‐related HCC, cirrhosis, and HBsAg seroclearance: A systematic review and meta‐analysis
Xianhua Mao, Ka Shing Cheung, Chengzhi Peng, Lung‐Yi Mak, Ho Ming Cheng, James Fung, Noam Peleg, Howard H.‐W. Leung, Rajneesh Kumar, Jeong‐Hoon Lee, Amir Shlomai, Man‐Fung Yuen, Wai‐Kay Seto
Hepatology.2023; 77(5): 1735. CrossRef
The association of fatty liver and risk of hepatocellular carcinoma in HBV or HCV infected individuals: a systematic review and meta-analysis
Cheng-Long Han, Bao-Wen Tian, Chun-Cheng Yang, Ya-Fei Yang, Yun-Long Ma, Zi-Niu Ding, Lun-Jie Yan, Hui Liu, Zhao-Ru Dong, Zhi-Qiang Chen, Jian-Guo Hong, Dong-Xu Wang, Tao Li
Expert Review of Gastroenterology & Hepatology.2023; 17(2): 189. CrossRef
Anthropometric indicators of adiposity and risk of primary liver cancer: A systematic review and dose–response meta-analysis
Lun-Jie Yan, Long-Shan Yang, Yu-Chuan Yan, Si-Yu Tan, Zi-Niu Ding, Hui Liu, Dong-Xu Wang, Zhao-Ru Dong, Tao Li
European Journal of Cancer.2023; 185: 150. CrossRef
Hepatitis B virus infection combined with nonalcoholic fatty liver disease: Interaction and prognosis
Lili Liu, Hong Li, Yang Zhang, Jing Zhang, Zhenhuan Cao
Heliyon.2023; 9(1): e13113. CrossRef
Risk of hepatocellular carcinoma in antiviral treatment-naïve chronic hepatitis B patients treated with entecavir or tenofovir disoproxil fumarate: a network meta-analysis
Ze-Hong Huang, Gui-Yang Lu, Ling-Xian Qiu, Guo-Hua Zhong, Yue Huang, Xing-Mei Yao, Xiao-Hui Liu, Shou-Jie Huang, Ting Wu, Quan Yuan, Ying-Bin Wang, Ying-Ying Su, Jun Zhang, Ning-Shao Xia
BMC Cancer.2022;[Epub] CrossRef
Impact of diabetes, obesity, and dyslipidemia on the risk of hepatocellular carcinoma in patients with chronic liver diseases
Hwang Sik Shin, Baek Gyu Jun, Sang-Wook Yi
Clinical and Molecular Hepatology.2022; 28(4): 773. CrossRef
Ginseng Consumption Possible Effect on Liver Cancer: A Meta-Analysis
Chenhong Zhu, Jingyi Wang, Weinan Liu, Lei Chen, Mohamed EA Abdelrahim, Liping Ren
Nutrition and Cancer.2021; 73(9): 1581. CrossRef
Risk factors for the development of hepatocellular carcinoma (HCC) in chronic hepatitis B virus (HBV) infection: a systematic review and meta‐analysis
Cori Campbell, Tingyan Wang, Anna L. McNaughton, Eleanor Barnes, Philippa C. Matthews
Journal of Viral Hepatitis.2021; 28(3): 493. CrossRef
Abnormal Metabolism in the Progression of Nonalcoholic Fatty Liver Disease to Hepatocellular Carcinoma: Mechanistic Insights to Chemoprevention
Danny Orabi, Nathan A. Berger, J. Mark Brown
Cancers.2021; 13(14): 3473. CrossRef
Relationship Between Platelet to White Blood Cell Ratio and 30-Day Prognosis of Patients with Acute-on-Chronic Liver Failure
Xiang Xu, Chen Li, Jing Chen, Xiaoyan Liu, Haibin Su, Jingjing Tong, Jinhua Hu
Hepatitis Monthly.2021;[Epub] CrossRef
Association of aspirin therapy with risk of hepatocellular carcinoma: A systematic review and dose-response analysis of cohort studies with 2.5 million participants
Shuijing Wang, Yan Yu, Paul M. Ryan, Minyan Dang, Cain Clark, Vasileios Kontogiannis, Jamal Rahmani, Hamed Kord Varkaneh, Ammar Salehisahlabadi, Andrew S. Day, Yong Zhang
Pharmacological Research.2020; 151: 104585. CrossRef
Magnitude of and prediction for risk of hepatocellular carcinoma in patients with chronic hepatitis B taking entecavir or tenofovir therapy: A systematic review
Cheng‐Hao Tseng, Chao‐Ming Tseng, Jia‐Ling Wu, Yao‐Chun Hsu, Hashem B. El-Serag
Journal of Gastroenterology and Hepatology.2020; 35(10): 1684. CrossRef
Efficacy of microwave ablation and entecavir as a combination treatment for primary liver cancer and their effects on hepatitis B virus and liver function
Hong Xu, Qiang Zhang, Yu-Lin Tan, Yang Zhang, Jian-Zhu Wei, Ling-Ling Wang, Bo Xie
All Life.2020; 13(1): 524. CrossRef
Hepatocellular carcinoma incidence with tenofovir versus entecavir in chronic hepatitis B: a systematic review and meta-analysis
Cheng-Hao Tseng, Yao-Chun Hsu, Tzu-Haw Chen, Fanpu Ji, I-Sung Chen, Ying-Nan Tsai, Hoang Hai, Le Thi Thanh Thuy, Tetsuya Hosaka, Hitomi Sezaki, John A Borghi, Ramsey Cheung, Masaru Enomoto, Mindie H Nguyen
The Lancet Gastroenterology & Hepatology.2020; 5(12): 1039. CrossRef
Waist Circumference and Risk of Liver Cancer: A Systematic Review and Meta-Analysis of over 2 Million Cohort Study Participants
Jamal Rahmani, Hamed Kord Varkaneh, Vasileios Kontogiannis, Paul M. Ryan, Hiba Bawadi, Somaye Fatahi, Yong Zhang
Liver Cancer.2020; 9(1): 6. CrossRef
Association of metabolic syndrome with the risk of developing liver disease in chronic hepatitis B patients
Julius Dongsogo, Christopher Larbie
African Journal of Biochemistry Research.2019; 13(2): 23. CrossRef
Effect of Korean Red Ginseng in chronic liver disease
Tae Young Park, Meegun Hong, Hotaik Sung, Sangyeol Kim, Ki Tae Suk
Journal of Ginseng Research.2017; 41(4): 450. CrossRef
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Jian-Gao Fan, Seung-Up Kim, Vincent Wai-Sun Wong
Journal of Hepatology.2017; 67(4): 862. CrossRef

15,790 View
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Case Reports

Liver fibrosis, cirrhosis, and portal hypertension

A case of portal hypertension by presumed as plexiform neurofibroma at the hepatic hilum: Kyung Han Lee, Sun Hong Yoo, Gi Tark Noh, Won Suk Heo, Byung Seong Ko, Jung Ah Chio, Hyo Jin Cho, Jin Young Choi, Hee Jun Kim, Won Sohn, Sang Jong Park, Young Min Park; Clin Mol Hepatol 2016;22(2):276-280.
Published online May 20, 2016; DOI: https://doi.org/10.3350/cmh.2015.0021

Abstract
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Neurofibromas can occur anywhere in the body, but they usually involve the head, neck, pelvis, and extremities. Abdominal visceral involvement is rare, and intrahepatic involvement is even less common. We describe a patient who suffered from plexiform neurofibromatosis with liver involvement. A 49-year-old man, who had previously been diagnosed with neurofibromatosis, underwent esophagogastroduodenoscopy and abdominal ultrasonography for screening purposes. Esophagogastroduodenoscopy showed grade 2 esophageal varices and abdominal ultrasonography showed conglomerated nodules with echogenic appearances in the perihepatic space. Magnetic resonance imaging showed presumed plexiform neurofibroma involving the lesser sac and hepatic hilum and encasing the common hepatic artery celiac trunk and superior mesenteric artery left portal triad. We report an unusual case of portal hypertension attributed to the compressive narrowing of the portal vein by presumed as plexiform neurofibroma at the lesser sac and hepatic hilum.

Citations

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Yasin Durmuş, Mustafa Koray Kırdağ, Kıvanç Yılmaz, Emre Aydın, Mesut Ozturk, Özlem Sezer
International Journal of Gynecology & Obstetrics.2025; 171(1): 202. CrossRef
Neurofibromatosis Type 1 with a Giant Diffuse Plexiform Neurofibroma Invading the Liver
Yuko Yokogawa, Tomohiro Suzuki, Hiroyuki Suzuki, Rena Nemoto, Hiroshi Shimizu, Tsuyoshi Ueda, Daiki Uchihara, Yoshinori Okubo, Osamu Ichii, Mayumi Tai, Yutaka Ejiri, Masaru Harada
Internal Medicine.2023; 62(20): 2971. CrossRef
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Joanna Ashworth, Vasco Sousa Abreu, Isabel Couto Guerra, Susana Almeida, Catarina Cunha, Helena Moreira Silva, Ermelinda Santos Silva
American Journal of Medical Genetics Part A.2023; 191(7): 1963. CrossRef
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Huang, MS Danqing, Tang, MS Min, Li, MD Aimei, Yu, MD Decai, Chen, MD Jun, Wu, MS Min, Wang, MD Wenping, Kong, MD Wentao
ADVANCED ULTRASOUND IN DIAGNOSIS AND THERAPY.2022; 6(1): 29. CrossRef
A rare case of plexiform neurofibroma of the liver in a patient without neurofibromatosis type 1
Hiroko Nebiki, Shinsuke Hiramatsu, Yuhei Sakata, Takehisa Suekane, Tomoaki Yamasaki, Takashi Nakai, Yoichi Koda, Akishige Kanazawa, Takeshi Inoue
Clinical Journal of Gastroenterology.2020; 13(6): 1297. CrossRef
The concept of type 2 segmental mosaicism, expanding from dermatology to general medicine
R. Happle
Journal of the European Academy of Dermatology and Venereology.2018; 32(7): 1075. CrossRef
Nonoperative Management May Be a Viable Approach to Plexiform Neurofibroma of the Porta Hepatis in Patients with Neurofibromatosis-1
Natesh Yepuri, Rana Naous, Camille Richards, Dilip Kittur, Ajay Jain, Mashaal Dhir
HPB Surgery.2018; 2018: 1. CrossRef
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Nada Garrouche, Amel Ben Abdallah, Nadia Arifa, Ibtissem Hasni, Yasser Ben Cheikh, Waad Ben Farhat, Sana Ben Amor, Hela Jemni
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Rare triad of periampullary carcinoid, duodenal gastrointestinal stromal tumor and plexiform neurofibroma at hepatic hilum in neurofibromatosis type 1: a case report
Nihed Abdessayed, Rahul Gupta, Sarra Mestiri, Ahlem Bdioui, Mounir Trimech, Moncef Mokni
BMC Cancer.2017;[Epub] CrossRef

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Drug induced liver injury

Liver dysfunction induced by systemic hypersensitivity reaction to lamotrigine: case report: Sung Gyu Im, Sun Hong Yoo, Young Min Park, Sang Jin Lee, Sun Kyung Jang, Dong Ok Jeon, Hyo Jin Cho, Mi Jung Oh; Clin Mol Hepatol 2015;21(2):180-182.
Published online June 26, 2015; DOI: https://doi.org/10.3350/cmh.2015.21.2.180

Abstract
PDF

Lamotrigine is an anticonvulsant drug used to treat partial and generalized seizure disorders. Hypersensitivity to lamotrigine usually causes mild symptoms such as fever, rash, and slight invasion of internal organs. However, a 33-year-old male patient who was admitted with Stevens-Johnson syndrome after taking lamotrigine for 15 days experienced hepatic failure and died 5 days after admission. This case demonstrates the importance of realizing that lamotrigine can lead to fatal hepatic failure, and that tests for the normal liver function should be performed when administering lamotrigine.

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Lamotrigine-induced Stevens–Johnson syndrome: a systematic review of case reports and case series
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Concurrent moxifloxacin-induced liver injury and toxic epidermal necrolysis after immune checkpoint inhibition: a case report and literature review
Qiangsheng Li, Long Wang, Han Xu, Ting Huang, Haining Hong, Xiang Ji, Jun Liu
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High serum unconjugated bilirubin levels following successful treatment of antiepileptic drug-induced bullosa epidermolysis: a case report and review of the literature
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Antiepileptic Drugs and Liver Disease
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Lamotrigine

Reactions Weekly.2015; 1562(1): 117. CrossRef

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9 Web of Science
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Original Article

Differences in the patterns and outcomes of enhanced viral replication between hepatitis C virus and hepatitis B virus in patients with hepatocellular carcinoma during transarterial chemolipiodolization: Pil Soo Sung, Si Hyun Bae, Jeong Won Jang, Do Seon Song, Hee Yeon Kim, Sun Hong Yoo, Chung-Hwa Park, Jung Hyun Kwon, Myeong Jun Song, Chan Ran You, Jong Young Choi, Seung Kew Yoon; Korean J Hepatol 2011;17(4):299-306.
Published online December 26, 2011; DOI: https://doi.org/10.3350/kjhep.2011.17.4.299

Abstract
PDF

Background/Aims

Enhanced replication of hepatitis C virus (HCV) is well described in the setting of moderate to severe immunosuppression. The aims of this retrospective study were to determine the incidence of enhanced HCV replication in hepatocellular carcinoma (HCC) patients undergoing transarterial chemolipiodolization (TACL) and to identify the factors associated with enhanced replication of HCV. The clinical pattern of enhanced HCV replication was compared with hepatitis B virus (HBV) reactivation during TACL.

Methods

This study enrolled 49 anti-HCV-seropositive patients who were diagnosed with HCC between January 2005 and December 2010 and who underwent TACL using epirubicin and/or cisplatin with consecutive HCV RNA copies checked. For comparison, 46 hepatitis B surface antigen¹-positive patients with HCC who were treated with TACL were also enrolled. The frequency, associated factors, and clinical outcomes of enhanced HCV replication were analyzed and compared with those of HBV reactivation during TACL.

Results

Enhanced replication of HCV occurred in 13 (26.5%) of the 49 anti-HCV-seropositive patients during TACL. Of these 13 patients, 4 developed hepatitis, but none of the subjects developed decompensation due to the hepatitis. No significant clinical factors for enhanced HCV replication during TACL were found. Compared with HBV reactivation, the frequency of hepatitis attributed to enhanced HCV replication was significantly lower than that for HBV reactivation (8.2% vs. 23.9%, P=0.036).

Conclusions

TACL can enhance HCV replication; however, the likelihood of hepatitis and decompensation stemming from enhanced HCV replication was lower than that for HBV reactivation in patients undergoing TACL.

Citations

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