Clinical and Molecular Hepatology

"Lilian Yan Liang"

Editorial

Viral hepatitis

Moving toward hepatitis B virus functional cure - the impact of on-treatment kinetics of serum viral markers: Lilian Yan Liang, Vincent Wai-Sun Wong, Grace Lai-Hung Wong, Terry Cheuk-Fung Yip; Clin Mol Hepatol 2023;29(1):113-117.
Published online October 31, 2022; DOI: https://doi.org/10.3350/cmh.2022.0333

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Risk of Hepatocellular Carcinoma Decreases After Antiviral Therapy–Induced HBsAg Seroclearance
Han Ah. Lee, Hyun Woong Lee, Yeon Seok Seo, Dong Hyun Sinn, Sang Hoon Ahn, Beom Kyung Kim, Seung Up Kim
Journal of Gastroenterology and Hepatology.2025; 40(7): 1675. CrossRef
Long-Term Safety and Efficacy of Tenofovir Alafenamide in Chronic Hepatitis B: Raising the Need for Studies on Functional Cure—Editorial on “Long-Term Real-World Outcomes of Tenofovir Alafenamide in Chronic Hepatitis B”
Soon Kyu Lee
The Korean Journal of Gastroenterology.2025; 85(3): 245. CrossRef
Hepatocellular carcinoma surveillance after HBsAg seroclearance
Jimmy Che-To Lai, Vicki Wing-Ki Hui, Grace Lai-Hung Wong, Vincent Wai-Sun Wong, Terry Cheuk-Fung Yip
Exploration of Digestive Diseases.2024; : 175. CrossRef
Rapid monophasic HBsAg decline during nucleic-acid polymer–based therapy predicts functional cure
Leeor Hershkovich, Louis Shekhtman, Michel Bazinet, Victor Pântea, Gheorge Placinta, Scott J. Cotler, Andrew Vaillant, Harel Dahari
Hepatology Communications.2023;[Epub] CrossRef
Correspondence on Editorial regarding “HBV pgRNA and HBcrAg reductions at week 4 predict favourable HBsAg response upon long-term nucleos(t)ide analogue in CHB”
Lung-Yi Mak, Wai-Kay Seto, Man-Fung Yuen
Clinical and Molecular Hepatology.2023; 29(1): 191. CrossRef
Hepatitis B and Hepatitis D Viruses: A Comprehensive Update with an Immunological Focus
Daniel G. Sausen, Oren Shechter, William Bietsch, Zhenzhen Shi, Samantha M. Miller, Elisa S. Gallo, Harel Dahari, Ronen Borenstein
International Journal of Molecular Sciences.2022; 23(24): 15973. CrossRef

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Original Article

Hepatic neoplasm

Serum fibrosis index-based risk score predicts hepatocellular carcinoma in untreated patients with chronic hepatitis B: Lilian Yan Liang, Hye Won Lee, Vincent Wai-Sun Wong, Terry Cheuk-Fung Yip, Yee-Kit Tse, Vicki Wing-Ki Hui, Grace Chung-Yan Lui, Henry Lik-Yuen Chan, Grace Lai-Hung Wong; Clin Mol Hepatol 2021;27(3):499-509.
Published online February 26, 2021; DOI: https://doi.org/10.3350/cmh.2020.0333

Background/Aims
Serum fibrosis scores comprised of common laboratory tests have high utility to assess severity of liver fibrosis. We aimed to derive and validate a hepatocellular carcinoma (HCC) risk score based on serum fibrosis scores to predict HCC in treatment-naïve chronic hepatitis B (CHB) patients.
Methods
Fifteen thousand one hundred eighty-seven treatment-naïve adult CHB patients were identified to form the training cohort in this retrospective study. Individual fibrosis score was included to construct a new HCC prediction score. The score was externally validated in an independent treatment-naïve Korean CHB cohort.
Results
180/15,187 patients (1.2%) in training cohort and 47/4,286 patients (1.1%) in validation cohort developed HCC during a mean follow-up of 52 and 50 months, respectively. The newly developed HCC risk score, Liang score, is composed of gender, age, hepatitis B virus DNA, fibrosis-4 (FIB-4) index, and ranges from 0 to 22. Area under the time-dependent receiver operating characteristic curve of Liang score was 0.79 (95% confidence interval, 0.70–0.89). A cutoff value of nine provided an extremely high negative predictive value of 99.9% and high sensitivity of 90.0% at 5 years in the validation cohort. Patients with Liang score ≤9 had HCC incidence <0.2% per year in both training and validation cohorts, in whom HCC surveillance might be exempted.
Conclusion
A novel HCC risk score, Liang score, based on FIB-4 index, is applicable and accurate to identify treatment-naïve CHB patients with very low risk of HCC to be exempted from HCC surveillance.

Citations

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Suboptimal Performance of Hepatocellular Carcinoma Prediction Models in Patients with Hepatitis B Virus-Related Cirrhosis
Jae Lee, Tae Lim, Hye Lee, Seung Kim, Jun Park, Do Kim, Sang Ahn, Hyun Lee, Jung Lee, Ja Kim, In Min, Beom Kim
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Risk of hepatocellular carcinoma in untreated patients with chronic hepatitis B: Independent of HBeAg status?
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Clinical and Molecular Hepatology.2021; 27(3): 448. CrossRef

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Review

Viral hepatitis

Unmet need in chronic hepatitis B management: Lilian Yan Liang, Grace Lai-Hung Wong; Clin Mol Hepatol 2019;25(2):172-180.
Published online February 12, 2019; DOI: https://doi.org/10.3350/cmh.2018.0106

Abstract
PDF

Despite all these exciting developments, there remain some unmet needs in the management for patients with chronic hepatitis B (CHB). As majority of CHB patients are going to use oral nucleos(t)ide analogues (NAs) for decades, Safety profile of NAs is of no doubt an important issue. The newest nucleotide analogue tenofovir alafenamide is potent in terms of viral suppression, together with favourable renal and bone safety profile. Biochemical response as reflected by alanine aminotransferase (ALT) normalization is recently found to be prognostically important. Patients who achieved ALT normalization have reduced the risk of hepatic events by 49%. Functional cure as reflected by hepatitis B surface antigen seroclearance not only implies patients may stop NA treatment, it also confers to a reduced risk of hepatocellular carcinoma and other hepatic events. Hence functional cure should be the ultimate treatment goal in CHB patients. Preemptive antiviral treatment may reduce mother-to-child transmission of hepatitis B virus, especially if birth dose of vaccination cannot be given in the first two hours after delivery. Lastly, despite the currently first-line NAs have high-genetic barrier to drug resistance mutations, there are still are many patients who were previously treated with low barrier of resistance including lamivudine, telbivudine or adefovir dipivoxil which could lead to antiviral resistance and affecting the choice of NAs.

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