Clinical and Molecular Hepatology

"Hee Yeon Kim"

Review

Emerging therapies and real-world application of metabolic dysfunction-associated steatotic liver disease treatment: Hee Yeon Kim, Mary E. Rinella; Clin Mol Hepatol 2025;31(3):753-770.
Published online April 2, 2025; DOI: https://doi.org/10.3350/cmh.2025.0083

Abstract
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Metabolic dysfunction-associated steatotic liver disease, formerly referred to as non-alcoholic fatty liver disease, is the most common liver disease in Western countries and has emerged as the leading indication for liver transplantation. Metabolic dysfunction-associated steatohepatitis (MASH), a more advanced stage, carries a high risk of progression to liver fibrosis, cirrhosis, liver failure, and hepatocellular carcinoma. Until recently, lifestyle intervention remained the mainstay of MASH management, with no pharmacological treatments specifically approved. However, advances in understanding its pathophysiological mechanisms have fueled numerous clinical trials, culminating in the Food and Drug Administration’s (FDA) approval of resmetirom as the first treatment for MASH in 2024. Additionally, many investigational drugs are nearing FDA approval or progressing through late-stage clinical trials. This review examines the current therapeutic landscape, highlights strategies for identifying patients suitable for liver-directed therapies in real-world settings, and discusses the challenges that remain.

Citations

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Quzhou-sourced Fructus Aurantii ameliorates MASLD by modulating glycolysis-dependent M1 polarization in hepatic macrophages
Junbin Yan, Yunmeng Nie, Menglu Ding, Mi Zhou, Tingyuan Li, Sumei Xu, Shuo Zhang
Phytomedicine.2026; 150: 157572. CrossRef
Stimuli-responsive nanomedicines for hepatic diseases: mechanism, design, recent advances, and clinical translation
Leyi Wang, Xue Zhang, Yinggang Li, Min Zhao, Gang Xu, Zhenyu Duan, Qiyong Gong, Kui Luo
Journal of Controlled Release.2026; 390: 114522. CrossRef
Convergent Metabolic Pathways in MASH Therapeutics: An AMPK‐Centric Analysis
Seungchan Choi, Jin‐Seok Jung, Yie‐sung Seo, Sungmin Song, Jeehye Ham, Hannah Chung, Yousef Ramadan, Kangchan Choi
Journal of Cellular and Molecular Medicine.2026;[Epub] CrossRef
Steatotic Liver Disease in Older Adults: Clinical Implications and Unmet Needs
Daniel Clayton-Chubb, William W. Kemp, Ammar Majeed, Peter W. Lange, Jessica A. Fitzpatrick, Karl Vaz, John S. Lubel, Alexander D. Hodge, Joanne Ryan, John J. McNeil, Alice J. Owen, Robyn L. Woods, Stuart K. Roberts
Nutrients.2025; 17(13): 2189. CrossRef
Tirzepatide in metabolic dysfunction-associated steatotic liver disease and steatohepatitis: a novel star on the horizon?
Amedeo Lonardo, Ralf Weiskirchen
Exploration of Drug Science.2025;[Epub] CrossRef
Timosaponin AIII from Anemarrhena asphodeloides binds and inhibits S100A8-mediated neutrophil infiltration and NET formation ameliorates MASH
Yunfan Bai, Jingxin Ju, Ruishi Xie, Jing Li, Xinyi Zhao, Xiaoxue Fang, Ming Zhu, Xintian Lan, Haoming Luo
International Immunopharmacology.2025; 166: 115539. CrossRef
Full Active Nanoplatform Restores ROS Homeostasis for Synergistic Therapy of Fatty Liver Disease via Dual Endogenous–Exogenous Pathways
Ziyi Lin, Peng Xu, Yuehai Xu, Yixin Zheng, Huimin Li, Zixin Chen, Zhe Wang, Shaochen Song, Yuhao Liu, Zhao Yang, Ju Cui, Heyun Shen
ACS Applied Materials & Interfaces.2025;[Epub] CrossRef
From mechanisms to management: Early detection and improved treatment of MASLD and its related hepatocellular carcinoma
Dingwu Li, Xiang Zhang
Hepatology Communications.2025;[Epub] CrossRef
Editorial: Combination Therapies for MASH: A Step Forward or More Complexity?
Xiao‐Dong Zhou, Yusuf Yilmaz, Mazen Noureddin, Hung N. Luu, Ming‐Hua Zheng
Alimentary Pharmacology & Therapeutics.2025;[Epub] CrossRef
Combination therapies for metabolic dysfunction-associated steatohepatitis: challenges and opportunities
Xiao-Dong Zhou, Qiong-Yue Fan, Christopher D Byrne, Giovanni Targher, Mark D Muthiah, Daniel Q Huang, Qin-Fen Chen, Mazen Noureddin, Wenhao Li, Vlad Ratziu, Rohit Loomba, Sven M Francque, Arun J Sanyal, Ming-Hua Zheng
Gut.2025; : gutjnl-2025-337431. CrossRef

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Correspondences

Liver fibrosis, cirrhosis, and portal hypertension

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; Clin Mol Hepatol 2025;31(1):e105-e107.
Published online November 4, 2024; DOI: https://doi.org/10.3350/cmh.2024.0937

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Liver fibrosis, cirrhosis, and portal hypertension

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; Clin Mol Hepatol 2025;31(1):e48-e51.
Published online September 11, 2024; DOI: https://doi.org/10.3350/cmh.2024.0777

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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

Critical considerations in evaluating the therapeutic potential of HK-660S for primary sclerosing cholangitis: Letter to the editor on “Safety and efficacy of HK-660S in patients with primary sclerosing cholangitis: a randomized double-blind phase 2a tria
Yizi He, Haifeng He, Qi Liang, Yongzhi Xie
Clinical and Molecular Hepatology.2026; 32(1): e1. CrossRef
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
Transient Elastography and Fibroscan: Stethoscope of a Hepatologist in Today’s World
Sajid Jalil, Mangesh Pagadala, Nicholas Dunn, Hanna Blaney, Mohamed Elfeki, Nimish Thakral, Ashwani K. Singal
Current Hepatology Reports.2025;[Epub] CrossRef

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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

Non-invasive Risk-based Surveillance Strategy for Hepatocellular Carcinoma in Patients with Metabolic Dysfunction-associated Steatotic Liver Disease
Ji Won Han
The Korean Journal of Gastroenterology.2026; 86(1): 62. CrossRef
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
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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; 19(12): 1299. CrossRef
Transient Elastography and Fibroscan: Stethoscope of a Hepatologist in Today’s World
Sajid Jalil, Mangesh Pagadala, Nicholas Dunn, Hanna Blaney, Mohamed Elfeki, Nimish Thakral, Ashwani K. Singal
Current Hepatology Reports.2025;[Epub] CrossRef
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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

Comparison of HCC patients with and without MASLD after surgical resection
Chia-Jung Ho, Hao-Jan Lei, Chun-Ting Ho, Gar-Yang Chau, Shu-Cheng Chou, Elise Chia-Hui Tan, Pei-Chang Lee, Yi-Hsiang Huang, Ying-Ying Yang, Teh-Ia Huo, Ming-Chih Hou, Jaw-Ching Wu, Chien-Wei Su
JHEP Reports.2026; : 101768. 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

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Special Issue

Liver fibrosis, cirrhosis, and portal hypertension

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

Citations

Citations to this article as recorded by

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Clinical and Molecular Hepatology.2026; 32(1): 400. CrossRef
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Jung Hwan Yu
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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

17,863 View
329 Download
29 Web of Science
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Original Articles

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

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2025 KASL clinical practice guidelines for management of hepatitis C
Eun Sun Jang, Nae Yun Heo, Jae Yoon Jeong, Jung Gil Park, Do Seon Song, Eun Ju Cho, Chang Hun Lee, Jae Seung Lee, Jae Hyun Yoon, Seul Ki Han, Young Kul Jung
Clinical and Molecular Hepatology.2026; 32(1): 1. CrossRef
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
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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
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Han Ah Lee
Clinical Ultrasound.2024; 9(2): 70. CrossRef

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5 Web of Science
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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.

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Eileen L. Yoon, Jeong-Yeon Cho, Huiyul Park, Mimi Kim, Ji-Hyeon Park, Hye-Lin Kim, Dae Won Jun
Clinical and Molecular Hepatology.2026; 32(1): 276. CrossRef
The Regulatory Role of Iron Transporter SLC39A13 in Liver Fibrosis
Shanshan Guo, Yalin Wang, Binyu Lu, Yu Zhang, David M. Frazer, Bing Zhou
Advanced Science.2026;[Epub] CrossRef
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Clinical and Molecular Hepatology.2025; 31(1): 256. CrossRef
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Hee Yeon Kim, Miyoung Choi, Dae Won Jun
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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
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Hee Yeon Kim, Miyoung Choi, Dae Won Jun
Clinical and Molecular Hepatology.2025; 31(1): e105. CrossRef
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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
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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
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Yawei Kong, Zhengyang Chen, Zhentian Nie, Wei Chen
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Anqi Lin, Minying Xiong, Bufu Tang, Aimin Jiang, Junyi Shen, Zaoqu Liu, Quan Cheng, Jian Zhang, Peng Luo
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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
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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.

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Yuping Chen, Bingtian Dong, Xinrui Jin, Chuan Liu, Ming-Hua Zheng, Xiao Liang, Yameng Sun, Hye Won Lee, Huapeng Lin, Emmanuel Tsochatzis, Salvatore Petta, Elisabetta Bugianesi, Masato Yoneda, Hannes Hagström, Jérôme Boursier, José Luis Calleja, George Boo
Gut.2026; : gutjnl-2025-337506. CrossRef
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Prognostic value of the FIB-4 index in patients with myocardial infarction with non-obstructive coronary arteries
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Moon Haeng Hur, Jeong-Hoon Lee
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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
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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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Chronic Hepatitis B Infection: Patient Guidance
Lung‐Yi Mak, Jimmy Che‐To Lai, Ken Liu, Rashid Lui, Sakkarin Chirapongsathorn, Kuo Chao Yew, Mara Teresa Panlilio, Cosmas Rinaldi Adithya Lesmana, Ruveena Bhavani Rajaram, Liang Shen, Desmond Cheung, Lung‐Fai Wong, Hye Won Lee, Madhumita Premkumar, Anand
Journal of Gastroenterology and Hepatology.2026; 41(1): 61. CrossRef
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
Vibration-Controlled Transient Elastography in Chronic Liver Disease: Current Research Insights
Ho Soo Chun
Clinical Ultrasound.2025; 10(2): 69. 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

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6 Web of Science
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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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Transient Elastography and Fibroscan: Stethoscope of a Hepatologist in Today’s World
Sajid Jalil, Mangesh Pagadala, Nicholas Dunn, Hanna Blaney, Mohamed Elfeki, Nimish Thakral, Ashwani K. Singal
Current Hepatology Reports.2025;[Epub] 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
Outcomes of Highly Urgent ABO-Incompatible Living Donor Liver Transplantation in National Databases
Jongman Kim, Sang Jin Kim, Boram Park, Kyunga Kim, YoungRok Choi, Geun Hong, Jun Yong Park, Young Seok Han, Nam-Joon Yi, Seung Heui Hong, Soon-Young Kim, Jungbun Park, Youngwon Hwang, Dong-Hwan Jung
Journal of Korean Medical Science.2026;[Epub] CrossRef
Emergency living donor liver transplantation
Jongman Kim
Annals of Liver Transplantation.2025; 5(1): 27. CrossRef
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Hankil Lee, Sang Hoon Ahn, Beom Kyung Kim
Yonsei Medical Journal.2025; 66(11): 713. CrossRef
Living versus deceased donor liver transplantation in highly urgent patients using Korean national data
Jongman Kim, Sang Jin Kim, Kyunga Kim, YoungRok Choi, Geun Hong, Jun Yong Park, Young Seok Han, Nam-Joon Yi, Soon-Young Kim, Jung-Bun Park, Youngwon Hwang, Dong-Hwan Jung
Annals of Liver Transplantation.2025; 5(2): 115. CrossRef
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Sang Jin Kim, Jongman Kim, Kyunga Kim, Soon-Young Kim, Jung-Bun Park, Youngwon Hwang, Dong-Hwan Jung
Annals of Liver Transplantation.2025; 5(2): 107. CrossRef
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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Acute liver injury and Acute liver failure

Acute-on-chronic liver failure as a major predictive factor for mortality in patients with variceal bleeding: Jongbeom Shin, Jung Hwan Yu, Young-Joo Jin, Hyung Joon Yim, Young Kul Jung, Jin Mo Yang, Do Seon Song, Young Seok Kim, Sang Gyune Kim, Dong Joon Kim, Ki Tae Suk, Eileen L. Yoon, Sang Soo Lee, Chang Wook Kim, Hee Yeon Kim, Jae Young Jang, Soung Won Jeong, on Behalf of the Korean Acute-onChronic Liver Failure (KACLiF) Study Group; Clin Mol Hepatol 2020;26(4):540-553.
Published online September 17, 2020; DOI: https://doi.org/10.3350/cmh.2020.0034

Background/Aims
This study examined the risk factors associated with mortality in cirrhotic patients hospitalized with variceal bleeding, and evaluated the effects of acute-on-chronic liver failure (ACLF) on the prognosis of these patients.
Methods
This study was retrospectively conducted on patients registered in the Korean acute-on-chronic liver failure study cohort, and on 474 consecutive cirrhotic patients hospitalized with variceal bleeding from January 2013 to December 2013 at 21 university hospitals. ACLF was defined as described by the European Association for the Study of Liver-Chronic Liver Failure Consortium.
Results
Among a total of 474 patients, 61 patients were diagnosed with ACLF. The cumulative overall survival (OS) rate was lower in the patients with ACLF than in those without (P<0.001), and patients with higher ACLF grades had a lower OS rate (P<0.001). The chronic liver failure-sequential organ failure assessment (CLIF-SOFA) score was identified as a significant prognostic factor in patients hospitalized with variceal bleeding (hazard ratio [HR], 1.40; 95% confidence interval [CI], 1.30–1.50; P<0.001), even in ACLF patients with variceal bleeding (HR, 1.32; 95% CI, 1.19–1.46, P<0.001). Concerning the prediction of the mortality risk at 28- and 90-day using CLIF-SOFA scores, c-statistics were 0.895 (95% CI, 0.829–0.962) and 0.897 (95% CI, 0.842–0.951), respectively, and the optimal cut-off values were 6.5 and 6.5, respectively.
Conclusions
In cirrhotic patients hospitalized with variceal bleeding, the prognosis was poor when accompanied by ACLF, especially depending upon CLIF-SOFA score. CLIF-SOFA model well predicted the 28-day or 90-day mortality for cirrhotic patients who experienced variceal bleeding.

Citations

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Sugan Panneerselvam, Jayakrishna Pamarthi, Joy Varghese, Rajesh Nanda, Janardanan S. Kumar, Madhumitha Haridoss
Journal of Clinical and Experimental Hepatology.2026; 16(1): 103193. CrossRef
Predicting the gastrointestinal bleeding of HBV-related acute-on-chronic liver failure based on machine learning
Jiwei Fu, Ahao Wu, Ziwei Zhou, Ting Deng, Pei Shi, Wentao Zhu, Mengyu Tao, Yuyu Zeng, Yuchen Peng, Yuna Wang, Xiaoping Wu
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New prognostic model for hospitalized patients with alcoholic cirrhosis and Maddrey’s discriminant function <32
Tae Hyung Kim, Hyung Joon Yim, Young Kul Jung, Do Seon Song, Eileen L. Yoon, Hee Yeon Kim, Seong Hee Kang, Young Chang, Jeong-Ju Yoo, Baek Gyu Jun, Sung Won Lee, Jung Gil Park, Ji Won Park, Sung-Eun Kim, Tae Yeob Kim, Soung Won Jeong, Ki Tae Suk, Moon You
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Fatima Hafsa, Zao Iman Chaudary, Owais Tariq, Zainab Riaz, Aamir Shehzad, Muhammad Irfan Jamil, Iqra Naeem
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V. L. Korobka, Yu. V. Khoronko, V. D. Pasechnikov, R. V. Korobka, M. V. Malevanny, E. S. Pak, D. V. Pasechnikov
Transplantologiya. The Russian Journal of Transplantation.2024; 16(4): 507. CrossRef
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Alexander German Ponce-Esparza, Fabián Andrés Sánchez-Castillo, Mariana Rada-Rada, Juliana Noguera-Fonseca, Laura Daniela Pinzón-Rodríguez, Tania Julieth Ávila-Espitia
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Jie Chen, Sha Luo, Feng Tang, Ming Han, Jie Zheng, Mingming Deng, Gang Luo
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Socrate Pallio, Giuseppinella Melita, Endrit Shahini, Alessandro Vitello, Emanuele Sinagra, Barbara Lattanzi, Antonio Facciorusso, Daryl Ramai, Marcello Maida
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Acute-on-chronic liver failure is independently associated with higher mortality for cirrhotic patients with acute esophageal variceal hemorrhage: Retrospective cohort study
Alana Zulian Terres, Rafael Sartori Balbinot, Ana Laura Facco Muscope, Morgana Luisa Longen, Bruna Schena, Bruna Teston Cini, Gilberto Luis Rost Jr, Juline Isabel Leichtweis Balensiefer, Louise Zanotto Eberhardt, Raul Angelo Balbinot, Silvana Sartori Balb
World Journal of Clinical Cases.2023; 11(17): 4003. CrossRef
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Cristina Maria Marginean, Denisa Pirscoveanu, Mihaela Popescu, Corina Maria Vasile, Anca Oana Docea, Radu Mitruț, Iulia Cristina Mărginean, George Alexandru Iacob, Dan Mihai Firu, Paul Mitruț
Biomedicines.2023; 11(7): 1840. CrossRef
To TIPS or Not to TIPS in High Risk of Variceal Rebleeding and Acute-on-Chronic Liver Failure
Wenyi Gu, Markus Kimmann, Wim Laleman, Michael Praktiknjo, Jonel Trebicka
Seminars in Liver Disease.2023; 43(02): 189. 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
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Victoria T. Mücke, Kai-Henrik- Peiffer, Johanna Kessel, Katharina M. Schwarzkopf, Jörg Bojunga, Stefan Zeuzem, Fabian Finkelmeier, Marcus M. Mücke, Pavel Strnad
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Ji Hyun Kim, Baek Gyu Jun, Minjong Lee, Hye Ah Lee, Tae Suk Kim, Jeong Won Heo, Da Hye Moon, Seong Hee Kang, Ki Tae Suk, Moon Young Kim, Young Don Kim, Gab Jin Cheon, Soon Koo Baik, Dong Joon Kim, Dae Hee Choi
Clinical and Molecular Hepatology.2022; 28(3): 540. CrossRef
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Portal Hypertension & Cirrhosis.2022; 1(2): 90. CrossRef
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Ji Won Han, Jong Young Choi, Pil Soo Sung
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Journal of Viral Hepatitis.2021; 28(6): 951. CrossRef
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Ki Tae Yoon, Hongqun Liu, Samuel S. Lee
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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
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Viral hepatitis

Effect of antiviral therapy in reducing perinatal transmission of hepatitis B virus and maternal outcomes after discontinuing them: Kwang Il Seo, Si Hyun Bae, Pil Soo Sung, Chung-Hwa Park, Hae Lim Lee, Hee Yeon Kim, Hye Ji Kim, Bo Hyun Jang, Jeong Won Jang, Seung Kew Yoon, Jong Young Choi, In-Yang Park, Juyoung Lee, Hyun Seung Lee, Sa-Jin Kim, Jung Hyun Kwon, U Im Chang, Chang Wook Kim, Se Hyun Jo, Young Lee, Fisseha Tekle, Jong-Hyun Kim; Clin Mol Hepatol 2018;24(4):374-383.
Published online June 26, 2018; DOI: https://doi.org/10.3350/cmh.2017.0082

Abstract
PDF

Background/Aims
There have been numerous efforts to reduce mother-to-child transmission (MTCT) of hepatitis B virus (HBV) with antiviral agents during pregnancy. However, there are limited data regarding the outcomes of pregnant women after delivery. This study was performed to evaluate the efficacy of antiviral agents in preventing MTCT of HBV and maternal long-term outcomes.
Methods
The HBV-infected pregnant women treated with antiviral agents to prevent MTCT were retrospectively reviewed. Forty-one pregnant women who received telbivudine or tenofovir during late pregnancy (28-34 week) were analyzed. Hepatitis B virus surface antibody (HBsAb) positivity was tested in 43 infants after 7 months of birth. Eleven mothers were followed >1 year after delivery.
Results
The mean HBV DNA titer before antiviral therapy was 8.67 (6.60–9.49) log copies/mL, and the median age at delivery was 32 years (range, 22–40). Eleven patients were treated with tenofovir and 30 with telbivudine. The median duration was 57 days (range, 23–100), and the median HBV DNA titer at birth was 5.06 log copies/mL (range, 2.06–6.50). Antiviral treatments were associated with significant HBV DNA reduction (P<0.001). Among 43 infants (two cases of twins), HBsAb was not detected in two, subsequently confirmed to have HBV infection. Biochemical flare was observed in two of 11 mothers followed >12 months, and an antiviral agent was administered.
Conclusions
Antiviral treatment during late pregnancy effectively reduced MTCT. Long-term follow-up should be required in such cases. In addition, given that maternal biochemical flare occurred in 18% of mothers, re-administration of antiviral agents might be required.

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Case Report

Infectious liver disease

Hepatogastric fistula as a rare complication of pyogenic liver abscess: Kyu Won Lee, Hee Yeon Kim, Chang Wook Kim, Young Ki Kim, Ohbeom Kwon, Min Ah Kim, Youngyun Cho, Keungmo Yang; Clin Mol Hepatol 2017;23(1):87-90.
Published online March 9, 2017; DOI: https://doi.org/10.3350/cmh.2016.0029

Abstract
PDF

Hepatogastric fistula following a pyogenic liver abscess is extremely rare, and only a handful of cases have been reported. An 88-year-old female presented with generalized weakness, fever and chills. An abdominal computed tomography scan revealed a 5cm-sized hypodense lesion with internal septa in the left lateral section of the liver. Due to initial suspicion of early liver abscess, she was treated with empirical intravenous antibiotics. Initially, aspiration or drainage of the liver abscess was not performed due to immature lesion characteristics. An ultrasonography-guided percutaneous drainage of the liver abscess was performed 17 days after hospitalization due to a more mature lesion appearance on follow-up imaging. On tubography, contrast media leakage through the fistulous tract was visualized. Surgical management was performed, and she was discharged 2 weeks after surgery.

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Hepatogastric Fistula as a Rare Complication of Pyogenic Liver Abscess: A Case Report
Mohammad Kazem Amirbeigy, Amir Pasha Amel Shahbaz, Zahra Sekandari, Shahab Sheikhalishahi
Clinical Case Reports.2025;[Epub] CrossRef
Hepatogastric fistula: A rare complication of liver abscess
Sayan Malakar, Akash Mathur, Anshuman Elhence, Uday C. Ghoshal
Indian Journal of Gastroenterology.2024; 43(4): 854. CrossRef
Double Trouble: Synchronous Hepatoduodenal and Hepatocolic Fistulisation in a Case of Untreated Liver Abscess
Saket Dadhich, Vijay Vatvani, Hitakshi Chahal, Richa Jain, Hanuman R Khoja
Cureus.2024;[Epub] CrossRef
Hepatogastric fistula: a complication of pyogenic liver abscess in a patient with the Brugarda syndrome – A rare case report
Santosh Dev, Radheshyam Yadav, Birendra Sah, Ashok Kumar Sah, Bikal Ghimire, Jayant Kumar Shah
Annals of Medicine & Surgery.2023; 85(6): 3098. CrossRef
A Population-Based Study of Unfavorable Prognostic Factors Associated With Pyogenic Liver Abscess
Anna Bläckberg, Astrid Jönsson, Emma Svensson, Torgny Sunnerhagen, Ali Kiasat, Oskar Ljungquist
Open Forum Infectious Diseases.2023;[Epub] CrossRef
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Chase Tenewitz, Taylor S Harmon, Mika Matteo, Sanjay Lamsal, Jerry Matteo
Cureus.2021;[Epub] CrossRef
Malignant hepatogastric fistula with associated secondary liver abscess: a rare complication of an occult gastric adenocarcinoma
Alexander Mimery, Nicolas Ramly, Amitabha Das, Kheman Rajkomar
BMJ Case Reports.2021; 14(8): e240238. CrossRef
A RARE CASE OF COMPLICATED LIVER ABSCESS WITH MIDDLE HEPATIC VEIN THROMBOSIS: A CASE REPORT AND REVIEW OF LITERATURE
V.P.S. Punia, Praveen Raman Mishra, Shaavi Mittal, Akash Bharti, Prem Kumar, Mahek Lamba
GLOBAL JOURNAL FOR RESEARCH ANALYSIS.2021; : 1. CrossRef
Gastric cancer and adenomatous colorectal polyp concomitant with pyogenic liver abscess and bacteremia
Min Kyu Kang, Hee Jung Kwon, Min Cheol Kim
Yeungnam University Journal of Medicine.2020; 37(3): 246. CrossRef
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Amtoj Singh Lamba, Bhavneet Singh, Monica Gupta, Swati Dahiya, Ruchika Saini
Cureus.2020;[Epub] CrossRef

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Original Articles

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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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
2022 KLCA-NCC Korea practice guidelines for the management of hepatocellular carcinoma

Journal of Liver Cancer.2023; 23(1): 1. CrossRef
2022 KLCA-NCC Korea Practice Guidelines for the Management of Hepatocellular Carcinoma

Korean Journal of Radiology.2022; 23(12): 1126. CrossRef
2022 KLCA-NCC Korea practice guidelines for the management of hepatocellular carcinoma

Clinical and Molecular Hepatology.2022; 28(4): 583. CrossRef
AISF position paper on HCV in immunocompromised patients
Alfredo Marzano, Emanuele Angelucci, Marco Astegiano, Chiara Baratelli, Luigi Biancone, Paolo Bironzo, Giuseppina Brancaccio, Maurizia Rossana Brunetto, Raffaele Bruno, Patrizia Burra, Maria Giuseppina Cabras, Paolo Caraceni, Claudia Chialà, Maria Grazia
Digestive and Liver Disease.2019; 51(1): 10. CrossRef
2018 Korean Liver Cancer Association–National Cancer Center Korea Practice Guidelines for the Management of Hepatocellular Carcinoma
KLCA Korean Liver Cancer Association, NCC National Cancer Center
Gut and Liver.2019; 13(3): 227. CrossRef
2018 Korean Liver Cancer Association–National Cancer Center Korea Practice Guidelines for the Management of Hepatocellular Carcinoma

Korean Journal of Radiology.2019; 20(7): 1042. CrossRef
Reactivation of Hepatitis C Virus and Its Clinical Outcomes in Patients Treated with Systemic Chemotherapy or Immunosuppressive Therapy
Hae Lim Lee, Si Hyun Bae, Bohyun Jang, Seawon Hwang, Hyun Yang, Hee Chul Nam, Pil Soo Sung, Sung Won Lee, Jeong Won Jang, Jong Young Choi, Nam Ik Han, Byung Joo Song, Jong Wook Lee, Seung Kew Yoon
Gut and Liver.2017; 11(6): 870. CrossRef
2014 Korean Liver Cancer Study Group-National Cancer Center Korea Practice Guideline for the Management of Hepatocellular Carcinoma

Korean Journal of Radiology.2015; 16(3): 465. CrossRef
Management of viral hepatitis in patients with hepatocellular carcinoma
Jeong Won Jang
Journal of the Korean Medical Association.2013; 56(11): 1001. CrossRef

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Crossref

A comparative study of high-dose hepatic arterial infusion chemotherapy and transarterial chemoembolization using doxorubicin for intractable, advanced hepatocellular carcinoma: Hee Yeon Kim, Jin Dong Kim, Si Hyun Bae, Jun Yong Park, Kwang Hyub Han, Hyun Young Woo, Jong Young Choi, Seung Kew Yoon, Byoung Kuk Jang, Jae Seok Hwang, Sang Gyune Kim, Young Seok Kim, Yeon Seok Seo, Hyung Joon Yim, Soon Ho Um, Korean Liver Cancer Study Group; Korean J Hepatol 2010;16(4):355-361.
Published online December 31, 2010; DOI: https://doi.org/10.3350/kjhep.2010.16.4.355

Abstract
PDF

Background/Aims

Transarterial chemoembolization (TACE) has long been used as a palliative therapy for unresectable hepatocellular carcinoma (HCC). High-dose hepatic arterial infusion chemotherapy (HAIC) has showed favorable outcomes in patients with intractable, advanced HCC. The aim of this study was to compare the effectiveness and safety of high-dose HAIC and conventional TACE using doxorubicin for advanced HCC.

Methods

The high-dose HAIC group comprised 36 patients who were enrolled prospectively from six institutions. The enrollment criteria were good liver function, main portal vein invasion (including vascular shunt), infiltrative type, bilobar involvement, and/or refractory to prior conventional treatment (TACE, radiofrequency ablation, or percutaneous ethanol injection), and documented progressive disease. Patients received 5-fluorouracil (500 mg/m² on days 1~3) and cisplatin (60 mg/m² on day 2 every 4 weeks) via an implantable port system. In the TACE group, 31 patients with characteristics similar to those in the high-dose HAIC group were recruited retrospectively from a single center. Patients underwent a transarterial infusion of doxorubicin every 4~8 weeks.

Results

Overall, 6 patients (8.9%) achieved a partial response and 20 patients (29.8%) had stable disease. The
objective
response rate (complete response+partial response) was significantly better in the high-dose HAIC group than in the TACE group (16.7% vs. 0%, P=0.030). Overall survival was longer in the high-dose HAIC group than in the TACE group (median survival, 193 vs. 119 days; P=0.026). There were no serious adverse effects in the high-dose HAIC group, while hepatic complications occurred more often in the TACE group.

Conclusions

High-dose HAIC appears to improve the tumor response and survival outcome compared to conventional TACE using doxorubicin in patients with intractable, advanced HCC.

Citations

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