Clinical and Molecular Hepatology

"Young Chang"

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

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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

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Special Issue

Steatotic liver disease

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, on behalf of The Korean Association for the Study of the Liver (KASL); Clin Mol Hepatol 2025;31(Suppl):S1-S31.
Published online February 19, 2025; DOI: https://doi.org/10.3350/cmh.2025.0045

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Metabolic Dysfunction-Associated Steatotic Liver Disease, Recent Revision of Terminology and Its Implications
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Erdenetsogt Dungubat, Kohei Fujikura, Masahiko Kuroda, Toshio Fukusato, Yoshihisa Takahashi
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Ralf Weiskirchen, Amedeo Lonardo
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Donghoon Kang, Ji Won Han, Kenneth R. Muir, Artitaya Lophatananon, Jongin Lee
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Implication of the Androgen Receptor in Muscle–Liver Crosstalk: An Overlooked Mechanistic Link in Lean-MASLD
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Original Articles

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

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

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Acute liver injury and Acute liver failure

Dynamic analysis of acute deterioration in chronic liver disease patients using modified quick sequential organ failure assessment: Do Seon Song, Hee Yeon Kim, Young Kul Jung, Tae Hyung Kim, Hyung Joon Yim, Eileen L Yoon, Ki Tae Suk, Jeong-ju Yoo, Sang Gyune Kim, Moon Young Kim, Young Chang, Soung Won Jeong, Jae Young Jang, Sung-Eun Kim, Jung-Hee Kim, Jung Gil Park, Won Kim, Jin Mo Yang, Dong Joon Kim, Korean Acute-on-Chronic Liver Failure (KACLiF) study group, Ashok Kumar Choudhury, Vinod Arora, Shiv Kumar Sarin, APASL ACLF Research Consortium (AARC) for APASL ACLF working party; Clin Mol Hepatol 2024;30(3):388-405.
Published online April 11, 2024; DOI: https://doi.org/10.3350/cmh.2023.0563

Background/Aims
Quick sequential organ failure assessment (qSOFA) is believed to identify patients at risk of poor outcomes in those with suspected infection. We aimed to evaluate the ability of modified qSOFA (m-qSOFA) to identify high-risk patients among those with acutely deteriorated chronic liver disease (CLD), especially those with acute-onchronic liver failure (ACLF).
Methods
We used data from both the Korean Acute-on-Chronic Liver Failure (KACLiF) and the Asian Pacific Association for the Study of the Liver ACLF Research Consortium (AARC) cohorts. qSOFA was modified by replacing the Glasgow Coma Scale with hepatic encephalopathy, and an m-qSOFA ≥2 was considered high.
Results
Patients with high m-qSOFA had a significantly lower 1-month transplant-free survival (TFS) in both cohorts and higher organ failure development in KACLiF than those with low m-qSOFA (Ps<0.05). Subgroup analysis by ACLF showed that patients with high m-qSOFA had lower TFS than those with low m-qSOFA. m-qSOFA was an independent prognostic factor (hazard ratios, HR=2.604, 95% confidence interval, CI 1.353–5.013, P=0.004 in KACLiF and HR=1.904, 95% CI 1.484– 2.442, P<0.001 in AARC). The patients with low m-qSOFA at baseline but high m-qSOFA on day 7 had a significantly lower 1-month TFS than those with high m-qSOFA at baseline but low m-qSOFA on day 7 (52.6% vs. 89.4%, P<0.001 in KACLiF and 26.9% vs. 61.5%, P<0.001 in AARC).
Conclusions
Baseline and dynamic changes in m-qSOFA may identify patients with a high risk of developing organ failure and short-term mortality among CLD patients with acute deterioration.

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Acute-on-chronic liver failure: pathophysiological mechanisms and clinical management
S. K. Sarin, Ashok Choudhury, Anupam Kumar, Nadim Mahmud, G. H. Lee, Qin Ning, Soek-Siam Tan, Kessarin Thanapirom, Vinod Arora, Nobuaki Nakayama, Jun Li, Constantine J. Karvellas
Nature Reviews Gastroenterology & Hepatology.2026;[Epub] CrossRef
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Correspondence to editorial on “Dynamic analysis of acute deterioration in chronic liver disease patients using modified quick sequential organ failure assessment”
Do Seon Song, Dong Joon Kim
Clinical and Molecular Hepatology.2024; 30(4): 1012. CrossRef
Modified quick-SOFA score: Can it enhance prognostic assessment for hospitalized patients with chronic liver diseases?: Editorial on “Dynamic analysis of acute deterioration in chronic liver disease patients using modified quick sequential organ failure a
Simone Incicco, Salvatore Piano
Clinical and Molecular Hepatology.2024; 30(4): 695. CrossRef
Revisiting septic shock in cirrhosis: a call for personalized management
Vishnu Girish, Rakhi Maiwall
Expert Review of Gastroenterology & Hepatology.2024; 18(12): 795. CrossRef

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Snapshot

Steatotic liver disease

Recent updates on pharmacologic therapy in non-alcoholic fatty liver disease: Young Chang, Soung Won Jeong, Jae Young Jang; Clin Mol Hepatol 2024;30(1):129-133.
Published online October 13, 2023; DOI: https://doi.org/10.3350/cmh.2023.0356

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Original Article

Viral hepatitis

Core indicators related to the elimination of hepatitis B and C virus infection in South Korea: A nationwide study: Chang Hun Lee, Gwang Hyeon Choi, Hwa Young Choi, Sojung Han, Eun Sun Jang, Young Eun Chon, Young Chang, Kyung-Ah Kim, Do Young Kim, Hyung Joon Yim, Hye-Lin Kim, Sook-Hyang Jeong, In Hee Kim; Clin Mol Hepatol 2023;29(3):779-793.
Published online May 15, 2023; DOI: https://doi.org/10.3350/cmh.2023.0110

Background/Aims
To eliminate hepatitis B virus (HBV) and hepatitis C virus (HCV) according to the World Health Organization (WHO) criteria in 2021, this study investigated the national core indicators representing the current status of viral hepatitis B and C in South Korea.
Methods
We analyzed the incidence, linkage-to-care, treatment, and mortality rates of HBV and HCV infection using the integrated nationwide big data of South Korea.
Results
According to data from 2018–2020, the incidence of acute HBV infection in South Korea was 0.71 cases per 100,000 population; tthe linkage-to-care rate was only 39.4%. Among those who need hepatitis B treatment, the treatment rate was 67.3%, which was less than 80% reported in the WHO program index. The annual liver-related mortality due to HBV was 18.85 cases per 100,000 population, exceeding the WHO target of four; the most frequent cause of death was liver cancer (54.1%). The annual incidence of newly diagnosed HCV infection was 11.9 cases per 100,000 population, which was higher than the WHO impact target of five. Among HCV-infected patients, the linkage-to-care rate was 65.5% while the treatment rate was 56.8%, which were below the targets of 90% and 80%, respectively. The liver-related annual mortality rate due to HCV infection was 2.02 cases per 100,000 population.
Conclusions
Many of the current indicators identified in the Korean population did not satisfy the WHO criteria for validation of viral hepatitis elimination. Hence, a comprehensive national strategy should be urgently developed with continuous monitoring of the targets in South Korea.

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Review

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

Abstract
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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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Original Article

Association of non-alcoholic fatty liver disease with incident dementia later in life among elder adults: Seogsong Jeong, Yun Hwan Oh, Seulggie Choi, Jooyoung Chang, Sung Min Kim, Joung Sik Son, Gyeongsil Lee, Joseph C Ahn, Dong Hyeon Lee, Bo Kyung Koo, Won Kim, Sang Min Park; Clin Mol Hepatol 2022;28(3):510-521.
Published online March 17, 2022; DOI: https://doi.org/10.3350/cmh.2021.0332

Background/Aims
Accumulating evidence suggests a link between non-alcoholic fatty liver disease (NAFLD) and brain health. However, population-based evidence on the association between NAFLD and dementia remains unclear. This study was conducted to determine the association between NAFLD and incident dementia.
Methods
The study population included 608,994 adults aged ≥60 years who underwent health examinations between 2009 and 2010. Data were collected from the Korean National Health Insurance Service database. NAFLD was assessed using the fatty liver index (FLI). A Cox proportional hazards regression model was used to determine the association between NAFLD and dementia.
Results
During the 6,495,352 person-years of follow-up, 48,538 participants (8.0%) developed incident dementia. The participants were classified into low (FLI <30), intermediate (FLI ≥30 and <60), and high (FLI ≥60) groups. In the overall study population, the FLI groups were associated with a risk of dementia (P for trend <0.001). After propensity score matching, a low FLI was associated with a reduced risk of dementia (adjusted hazard ration [aHR], 0.96; 95% confidence interval [CI], 0.93–0.98; P=0.002), whereas a high FLI (NAFLD) was associated with an increased risk of dementia (aHR, 1.05; 95% CI, 1.02–1.08; P=0.001). A higher risk of dementia in the high FLI group than in the intermediate FLI group was attributed to Alzheimer’s disease (aHR, 1.04; 95% CI, 1.01–1.07; P=0.004) rather than vascular dementia (aHR, 0.94; 95% CI, 0.75–1.18; P=0.602).
Conclusions
NAFLD was associated with an increased risk of dementia, which was attributed to an increased risk of Alzheimer’s disease.

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Review

Viral hepatitis

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

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

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Burden of liver cancer due to hepatitis C from 1990 to 2019 at the global, regional, and national levels
Jie Wei, Guoqing Ouyang, Guozhen Huang, Yong Wang, Shuangjiang Li, Jiaping Liu, Yanhong Zhang, Guandou Yuan, Songqing He
Frontiers in Oncology.2023;[Epub] CrossRef
Real-life experience of ledipasvir and sofosbuvir for HCV infected Korean patients: a multicenter cohort study
Soon Kyu Lee, Sung Won Lee, Hae Lim Lee, Hee Yeon Kim, Chang Wook Kim, Do Seon Song, U Im Chang, Jin Mo Yang, Sun Hong Yoo, Jung Hyun Kwon, Soon Woo Nam, Seok-Hwan Kim, Myeong Jun Song, Jaejun Lee, Hyun Yang, Si Hyun Bae, Ji Won Han, Heechul Nam, Pil Soo
The Korean Journal of Internal Medicine.2022; 37(6): 1167. CrossRef

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Original Articles

Liver fibrosis, cirrhosis, and portal hypertension

The cut-off value of transient elastography to the value of hepatic venous pressure gradient in alcoholic cirrhosis: Se Ri Ryu, Jeong-Ju Yoo, Seong Hee Kang, Soung Won Jeong, Moon Young Kim, Young Kyu Cho, Young Chang, Sang Gyune Kim, Jae Young Jang, Young Seok Kim, Soon Koo Baik, Yong Jae Kim, Su Yeon Park, Baigal Baymbajav; Clin Mol Hepatol 2021;27(1):197-206.
Published online December 3, 2020; DOI: https://doi.org/10.3350/cmh.2020.0171

Background/Aims
The hepatic venous pressure gradient (HVPG) reflects portal hypertension, but its measurement is invasive. Transient elastography (TE) is a noninvasive method for evaluating liver stiffness (LS). We investigated the correlation between the value of LS, LS to platelet ratio (LPR), LS-spleen diameter-to-platelet ratio score (LSPS) and HVPG according to the etiology of cirrhosis, especially focused on alcoholic cirrhosis.
Methods
Between January 2008 and March 2017, 556 patients who underwent HVPG and TE were consecutively enrolled. We evaluated LS, LPR, and LSPS according to the etiology of cirrhosis and analyzed their correlations with HVPG.
Results
The LS value was higher in patients with alcoholic cirrhosis than viral cirrhosis based on the HVPG (43.5 vs. 32.0 kPa, P<0.001). There were no significant differences in the LPR or LSPS between alcoholic and viral cirrhosis groups, and the areas under the curves for the LPR and LSPS in subgroups according to HVPG levels were not superior to that for LS. In alcoholic cirrhosis, the LS cutoff value for predicting an HVPG ≥10 mmHg was 32.2 kPa with positive predictive value (PPV) of 94.5% and 36.6 kPa for HVPG ≥12 mmHg with PPV of 91.0%.
Conclusions
The LS cutoff value should be determined separately for patients with alcoholic and viral cirrhosis. In alcoholic cirrhosis, the LS cutoff values were 32.2 and 36.6 kPa for predicting an HVPG ≥10 and ≥12 mmHg, respectively. However, there were no significant differences in the LPR or LSPS between alcoholic and viral cirrhosis groups.

Citations

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Liver and spleen stiffness as assessed by vibration-controlled transient elastography for diagnosing clinically significant portal hypertension in comparison with other elastography-based techniques in adults with chronic liver disease
Luka Vranić, Tin Nadarević, Davor Štimac, Mirella Fraquelli, Cristina Manzotti, Giovanni Casazza, Agostino Colli
Cochrane Database of Systematic Reviews.2026;[Epub] CrossRef
Assessment of liver stiffness measurement-related markers in predicting liver-related events in viral cirrhosis with clinically significant portal hypertension
Yan-Qiu Li, Yong-Qi Li, Jin-Ze Li, Bing-Bing Zhu, Yu Lu, Ying Feng, Xian-Bo Wang
World Journal of Hepatology.2025;[Epub] CrossRef
Effect of tenofovir alafenamide on immune function and long-term prognosis in patients with chronic hepatitis B-related liver cirrhosis using two-dimensional ultrasound evaluation
Yueran Wu, Xia Li, Xiaopeng Yang, Lijun Lin, Biying Zou, Yulin Chen
Journal of Radiation Research and Applied Sciences.2025; 18(4): 102041. CrossRef
Analysis of Factors Influencing Prognosis and Assessment of 60 Cases of Decompensated Cirrhotic Patients with Portal Hypertension
Xue Li, Shi Liu, Jin Li, Ning Liu, Hui Li, An Ge, Liang Wang, Xie Dong, Hui Wang, Ju Liu, Lin Zhang, Hao Dong Zhang, Wei Gou
International Journal of General Medicine.2024; Volume 17: 1493. CrossRef
Enhancing liver cirrhosis varices and CSPH risk prediction with spleen stiffness measurement using 100-Hz probe
Jeong-Ju Yoo, Sun Ah Maeng, Young Chang, Sae Hwan Lee, Soung Won Jeong, Jae Young Jang, Gab Jin Cheon, Young Seok Kim, Hong Soo Kim, Sang Gyune Kim
Scientific Reports.2024;[Epub] CrossRef
Non-invasive tests-based risk stratification: Baveno VII and beyond
Georg Semmler, Mathias Jachs, Mattias Mandorfer
Clinical and Molecular Hepatology.2023; 29(1): 105. CrossRef
The rise of non-invasive tools in the diagnosis of portal hypertension: Validation of the Baveno VII consensus
Jeong-Ju Yoo, Sang Gyune Kim
Clinical and Molecular Hepatology.2023; 29(1): 102. CrossRef
Noninvasive risk assessment of hepatic decompensation in patients with hepatitis B virus‐related liver cirrhosis
David Sooik Kim, Beom Kyung Kim, Jae Seung Lee, Hye Won Lee, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Nikolaos Pyrsopoulos, Seung Up Kim
Journal of Gastroenterology and Hepatology.2023; 38(8): 1372. CrossRef
Validation of non‐invasive diagnosis of CSPH in patients with compensated advanced chronic liver disease according to Baveno VII
Byeong Geun Song, Myung Ji Goh, Wonseok Kang, Geum‐Youn Gwak, Yong‐Han Paik, Moon Seok Choi, Joon Hyeok Lee, Seung Woon Paik, Dong Hyun Sinn
Liver International.2023; 43(9): 1966. CrossRef
Methods for assessing portal hypertension
S.M. Chooklin, S.S. Chuklin
EMERGENCY MEDICINE.2023; 19(6): 393. CrossRef
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
Diagnostic accuracy of transient elastography in diagnosing clinically significant portal hypertension in patients with chronic liver disease: a systematic review and meta-analysis
Ashish Kumar, Hitoshi Maruyama, Anil Arora, Praveen Sharma, Shrihari Anil Anikhindi, Naresh Bansal, Mandhir Kumar, Piyush Ranjan, Munish Sachdeva, Shivam Khare
Journal of Medical Ultrasonics.2022; 49(3): 333. CrossRef
Influence of portal vein occlusion on portal flow and liver elasticity in an animal model
Simon Chatelin, Raoul Pop, Céline Giraudeau, Khalid Ambarki, Ning Jin, François Séverac, Elodie Breton, Jonathan Vappou
NMR in Biomedicine.2021;[Epub] CrossRef
The Diagnostic Accuracy of LOGIQ S8 and E9 Shear Wave Elastography for Staging Hepatic Fibrosis, in Comparison with Transient Elastography
Jeong-Ju Yoo, Sang Gyune Kim, Young Seok Kim
Diagnostics.2021; 11(10): 1817. CrossRef

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Cholestatic liver disease

Clinical application of ultrasonography-guided percutaneous liver biopsy and its safety over 18 years: Young Chang, Jun Il Kim, Bora Lee, Sang Gyune Kim, Min Jung Jung, Young Seok Kim, Soung Won Jeong, Jae Young Jang, Jeong-Ju Yoo; Clin Mol Hepatol 2020;26(3):318-327.
Published online May 25, 2020; DOI: https://doi.org/10.3350/cmh.2019.0019n

Abstract
PDF

Background/Aims
Liver biopsy (LB) remains the gold standard for the evaluation of liver disease. However, over the past two decades, many noninvasive tests have been developed and utilized in clinical practice as alternatives to LB. The aim of this study was to evaluate the clinical use and safety of LB in the era of noninvasive assessment of liver fibrosis.
Methods
This retrospective study included 1,944 consecutive cases of LB performed between 2001 and 2018 in a tertiary hospital. All of the LBs were conducted under ultrasonography guidance with 18-gauge cutting needles.
Results
LBs were performed an average of approximately 108 times per year during the study period. Chronic hepatitis B (25.3%) and suspected malignancy (20.5%) were the two most common indications for LB. The use of LB for nonalcoholic fatty liver disease increased from 8.1% to 17.2% in the past 5 years compared to the last 10 years, while that for viral hepatitis decreased from 40.3% to 18.9%. Discordance rate between the suspected diagnosis and the final diagnosis was 2.6% (51 cases). The overall rate of major adverse events was 0.05% (one case), which involved delayed bleeding at the biopsy site. Liver cirrhosis was observed in 563 cases (28.9%), and the presence of cirrhosis did not affect the frequency of complications (P=0.289).
Conclusions
LB is widely used in clinical practice as an irreplaceable diagnostic tool, even in the era of noninvasiveness. Ultrasonography-guided LB can be performed safely in patients with liver cirrhosis.

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Surgeon-led Point-of-care Ultrasound-guided Thoracic Biopsy: A new paradigm in efficient diagnosis and resource-sparing care
Vaibhav Gupta, Stephen D. Gowing, Rudra Pandya, Lawrence Tan, Richard Y. Liu, Sadeesh K. Srinathan, Biniam Kidane
The Journal of Thoracic and Cardiovascular Surgery.2025; 170(2): 369. CrossRef
Current Trends and Impact of Liver Biopsy on Survival in Hepatocellular Carcinoma: A Korean Multicenter Analysis
Seong Joon Chun, Jeong-Ju Yoo, Sang Gyune Kim, Young-Seok Kim
Diagnostics.2025; 15(7): 818. CrossRef
Association of preablation tumor biopsy and long-term outcomes of colorectal liver oligometastases
Wenqi Chen, Jianming Li, Lu Li, Rui Cui, Guangjian Liu, Ping Liang, Jie Yu
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Yongde Zhang, Jiabin Yang, Xuequan Huang, Chuang He
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Mardava R. Gubbi, Muyinatu A. Lediju Bell
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La radiologia medica.2025; 130(8): 1297. CrossRef
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Nhi H. Vo, Mehmet A. Sari, Elena Grimaldi, Emmanuel Berchmans, Michael P. Curry, Muneeb Ahmed, Bettina Siewert, Alexander Brook, Olga R. Brook
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Ruifang Shi, Fan Yang, Hongli Wu, Yonggang Liu
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Jae Sung Yoo, Min Kyu Kang
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Long-term prognosis and the need for histologic assessment of chronic hepatitis B in the serological immune-tolerant phase
Jeong-Ju Yoo, Soo Young Park, Ji Eun Moon, Yu Rim Lee, Han Ah Lee, Jieun Lee, Young Seok Kim, Yeon Seok Seo, Sang Gyune Kim
Clinical and Molecular Hepatology.2023; 29(2): 482. CrossRef
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Sunyoung Lee, Kyoung Won Kim, So Yeon Kim, Nieun Seo, Gi-Won Song, Sung-Gyu Lee
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Yu Rim Shin, Seung Up Kim, Sak Lee, Jae Young Choi, Han Ki Park, Jeong Eun Yoo, Young Nyun Park
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Circulating miRNA is a useful diagnostic biomarker for nonalcoholic steatohepatitis in nonalcoholic fatty liver disease
Tae Hyung Kim, Yoonseok Lee, Young-Sun Lee, Jeong-An Gim, Eunjung Ko, Sun Young Yim, Young Kul Jung, SeongHee Kang, Moon Young Kim, Hayeon Kim, Baek-hui Kim, Ji Hoon Kim, Yeon Seok Seo, Hyung Joon Yim, Jong Eun Yeon, Soon Ho Um, Kwan Soo Byun
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Jeong-An Gim, Soo Min Bang, Young-Sun Lee, Yoonseok Lee, Sun Young Yim, Young Kul Jung, Hayeon Kim, Baek-Hui Kim, Ji Hoon Kim, Yeon Seok Seo, Hyung Joon Yim, Jong Eun Yeon, Soon Ho Um, Kwan Soo Byun, Matias A. Avila
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Min Kyu Kang, Joon Hyuk Choi
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Joo Hyun Oh, Hye Won Lee, Dong Hyun Sinn, Jun Yong Park, Beom Kyung Kim, Seung Up Kim, Do Young Kim, Sang Hoon Ahn, Wonseok Kang, Geum-Youn Gwak, Moon Seok Choi, Joon Hyeok Lee, Kwang Cheol Koh, Seung Woon Paik, Yong-Han Paik
Hepatology International.2021; 15(4): 892. CrossRef
The Diagnostic Accuracy of LOGIQ S8 and E9 Shear Wave Elastography for Staging Hepatic Fibrosis, in Comparison with Transient Elastography
Jeong-Ju Yoo, Sang Gyune Kim, Young Seok Kim
Diagnostics.2021; 11(10): 1817. CrossRef
Risk assessment of hepatocellular carcinoma and liver‐related events using ultrasonography and transient elastography in patients with chronic hepatitis B
Sung Hwan Yoo, Tae Seop Lim, Hyun Woong Lee, Ja Kyung Kim, Jae Seung Lee, Hye Won Lee, Beom Kyung Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Jung Il Lee, Kwan Sik Lee, Seung Up Kim
Journal of Viral Hepatitis.2021; 28(10): 1362. CrossRef
Liver stiffness by magnetic resonance elastography is associated with increased risk of cardiovascular disease in patients with non‐alcoholic fatty liver disease
Jung Gil Park, Jinho Jung, Kritin K. Verma, Min Kyu Kang, Egbert Madamba, Scarlett Lopez, Aed Qas Yonan, Amy Liu, Ricki Bettencourt, Claude Sirlin, Rohit Loomba
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Tae Seop Lim, Ja Kyung Kim
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Viral hepatitis

Spontaneous HBsAg loss in Korean patients: relevance of viral genotypes, S gene mutations, and covalently closed circular DNA copy numbers: Kyun-Hwan Kim, Hye-Young Chang, Jun Yong Park, Eun-Sook Park, Yong Kwang Park, Kwang-Hyub Han, Sang Hoon Ahn; Clin Mol Hepatol 2014;20(3):251-260.
Published online September 25, 2014; DOI: https://doi.org/10.3350/cmh.2014.20.3.251

Abstract
PDF

Background/Aims

Occult HBV infection can persist following HBsAg loss and be transmitted, but the virological features are not well defined.

Methods

Here we investigated 25 Korean patients who lost HBsAg during follow up, either spontaneously or subsequent to therapy.

Results

Whereas subtype adr (genotype C) was found in 96% of HBsAg positive patients, 75 % of patients who lost HBsAg spontaneously were seemed to be infected with the ayw subtype with sequence similar to genotype D. Mutations in the major hydrophilic region (MHR) of HBsAg were found in 7 patients who lost HBsAg spontaneously. The mutations include T123S, M125I/N, C139R, D144E, V177A, L192F, and W196L, some of which have not been reported before. Functional analysis via transfection experiments indicate that the C139R and D144E mutations drastically reduced HBsAg antigenicity, while the Y225del mutation found in one interferon-treated patient impaired HBsAg secretion.

Conclusions

Lack of detectable HBsAg in patient serum could be explained by low level of ccc DNA in liver tissue, low antigenicity of the surface protein, or its secretion defect.

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Yu. V. Ostankova, A. V. Semenov, Kh. N. Faizullaev, E. I. Kazakova, A. V. Kozlov, E. I. Musabaev, A. A. Totolyan
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Occult hepatitis B virus infection: clearance or disguise?
Jin-Wook Kim
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