The Korean journal of hepatology最新文献

{"title":"MR imaging of hepatic lymphangioma.","authors":"Woo Jung Choi, Woo Kyoung Jeong, Yongsoo Kim, Jinoo Kim, Ju Yeon Pyo, Young Ha Oh","doi":"10.3350/kjhep.2012.18.1.101","DOIUrl":"https://doi.org/10.3350/kjhep.2012.18.1.101","url":null,"abstract":"A case of primary hepatic lymphangioma with a microcystic component was incidentally found in a 75-year-old woman. Although ultrasonography (US) and computed tomography (CT) showed a mixed lesion including cystic and solid components, magnetic resonance imaging (MRI) demonstrated the morphologic characteristics of the lesion better than other modalities.","PeriodicalId":87153,"journal":{"name":"The Korean journal of hepatology","volume":"18 1","pages":"101-4"},"PeriodicalIF":0.0,"publicationDate":"2012-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/84/53/kjhep-18-101.PMC3326998.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30580491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of prognostic factors and 5-year survival rate in patients with hepatocellular carcinoma: a single-center experience.","authors":"Sang Seok Lee,&nbsp;Hyun Sung Shin,&nbsp;Hyung Joon Kim,&nbsp;Su Jin Lee,&nbsp;Hyun Suk Lee,&nbsp;Kyung Hee Hyun,&nbsp;Yong Hyun Kim,&nbsp;Byoung Woon Kwon,&nbsp;Jin Hyung Han,&nbsp;Hoon Choi,&nbsp;Bae Hwan Kim,&nbsp;Joon Hyuk Lee,&nbsp;Ha Yan Kang,&nbsp;Hyun Deok Shin,&nbsp;Il Han Song","doi":"10.3350/kjhep.2012.18.1.48","DOIUrl":"https://doi.org/10.3350/kjhep.2012.18.1.48","url":null,"abstract":"<p><strong>Background/aims: </strong>Hepatocellular carcinoma (HCC), which is the third most common cancer in Korea, has a very poor prognosis. However, only a few studies have performed a comprehensive survival-related analysis in all patients who were consecutively diagnosed and treated over a given period of time. The aim of this study was to determine the 5-year survival rate and its prognostic factors among HCC patients.</p><p><strong>Methods: </strong>In total, 257 patients who were consecutively diagnosed with HCC between January 2000 and December 2003 were followed until death or until December 2008. We analyzed their survival outcomes according to their clinical characteristics, tumor staging, and treatment modalities, and determined the independent prognostic factors affecting survival.</p><p><strong>Results: </strong>The patients were aged 59±10 years (mean±SD). During the follow-up period, 223 patients (86.8%) died and the overall median survival was 10.8 months; the 1-, 3-, and 5-year survival rates were 44.4%, 21.0%, and 12.1%, respectively. The outcomes in patients with tumor node metastasis (TNM) stage I or II and Child-Pugh class A or B were significantly better with surgical resection than with other treatment modalities (P<0.01). Patients who underwent supplementary transcatheter arterial chemoembolization as a second-line treatment after surgical resection had better outcomes than those who underwent surgical resection alone (P=0.02). Initial symptoms, Child-Pugh class, serum alpha-fetoprotein, tumor size, portal vein thrombosis, and TNM stage were found to be independent prognostic factors for survival among HCC patients.</p><p><strong>Conclusions: </strong>This retrospective cohort study elucidated survival outcomes and prognostic factors affecting survival in HCC patients at a single center.</p>","PeriodicalId":87153,"journal":{"name":"The Korean journal of hepatology","volume":"18 1","pages":"48-55"},"PeriodicalIF":0.0,"publicationDate":"2012-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/50/b7/kjhep-18-48.PMC3326996.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30582183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimal time for repeating the IgM anti-hepatitis A virus antibody test in acute hepatitis A patients with a negative initial test.","authors":"Jong Jin Hyun,&nbsp;Yeon Seok Seo,&nbsp;Hyonggin An,&nbsp;Sun Young Yim,&nbsp;Min Ho Seo,&nbsp;Hye Sook Kim,&nbsp;Chang Ha Kim,&nbsp;Ji Hoon Kim,&nbsp;Bora Keum,&nbsp;Yong Sik Kim,&nbsp;Hyung Joon Yim,&nbsp;Hong Sik Lee,&nbsp;Soon Ho Um,&nbsp;Chang Duck Kim,&nbsp;Ho Sang Ryu","doi":"10.3350/kjhep.2012.18.1.56","DOIUrl":"https://doi.org/10.3350/kjhep.2012.18.1.56","url":null,"abstract":"<p><strong>Background/aims: </strong>The nonspecific clinical presentation of acute hepatitis A (AHA) mandates the detection of anti-hepatitis A virus IgM antibodies (IgM anti-HAV) in the serum for obtaining a definitive diagnosis. However, IgM anti-HAV might not be present during the early phase of the disease. The aim of this study was to determine the optimal time for repeating the IgM anti-HAV test (HAV test) in AHA patients with a negative initial test.</p><p><strong>Methods: </strong>In total, 261 patients hospitalized with AHA were enrolled for this retrospective study. AHA was diagnosed when the test for IgM anti-HAV was positive and the serum alanine aminotransferase (ALT) level was ≥400 IU/L. Repeat HAV test was conducted after 1-2 weeks if the initial HAV test was negative but AHA was still clinically suspected.</p><p><strong>Results: </strong>The results of the initial HAV test were negative in 28 (10.7%) patients. The intervals from symptom onset to the initial-HAV-test day and from the peak-ALT day to the initial-HAV-test day were significantly shorter in the negative-initial-HAV-test group, but on multivariate analysis only the latter was significantly associated with negative results for the initial HAV test (β=-0.978; odds ratio [95% confidence interval]=0.376 [0.189-0.747]; P=0.005). The HAV test was positive in all patients when it was performed at least 2 days after the peak-ALT day.</p><p><strong>Conclusions: </strong>The results of HAV tests were significantly associated with the interval from the peak-ALT day to the HAV-test day. The optimal time for repeating the HAV test in clinically suspicious AHA patients with a negative initial HAV test appears to be at least 2 days after the peak-ALT day.</p>","PeriodicalId":87153,"journal":{"name":"The Korean journal of hepatology","volume":"18 1","pages":"56-62"},"PeriodicalIF":0.0,"publicationDate":"2012-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/42/56/kjhep-18-56.PMC3326997.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30582184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of metronomic chemotherapy for patients with advanced primary hepatocellular carcinoma with major portal vein tumor thrombosis.","authors":"Hyun Young Woo,&nbsp;Jun Mo Youn,&nbsp;Si Hyun Bae,&nbsp;Jeong Won Jang,&nbsp;Jung Hoon Cha,&nbsp;Hye Lim Kim,&nbsp;Ho Jong Chun,&nbsp;Byung Gil Choi,&nbsp;Jong Young Choi,&nbsp;Seoung Kew Yoon","doi":"10.3350/kjhep.2012.18.1.32","DOIUrl":"https://doi.org/10.3350/kjhep.2012.18.1.32","url":null,"abstract":"<p><strong>Background/aims: </strong>Low-dose metronomic chemotherapy involves the frequent administration of comparatively low doses of cytotoxic agents with no extended breaks, and it may be as efficient as and less toxic than the conventional maximum tolerated dose therapy. This study evaluated the feasibility and therapeutic efficacy of metronomic chemotherapy in patients with advanced hepatocellular carcinoma (HCC) with major portal vein thrombosis (PVT).</p><p><strong>Methods: </strong>Thirty consecutive HCC patients with major PVT with or without extrahepatic metastasis were prospectively allocated to metronomic chemotherapy consisting of epirubicin being infused through the correct hepatic artery at a dose of 30 mg/body surface area (BSA) every 4 weeks, and cisplatin (15 mg/BSA) and 5-fluorouracil (50 mg/BSA) every week for 3 weeks, with intervening 1 week breaks. The treatment response was assessed using response evaluation criteria in solid tumors (RECIST).</p><p><strong>Results: </strong>In total, 116 cycles of metronomic chemotherapy were administered to the 30 patients, with a median of 3 cycles given to individual patients (range, 1-15 cycles). Six patients (20.0%) achieved a partial response and six patients (20.0%) had stable disease. The median time to disease progression and overall survival were 63 days (range, 26-631 days) and 162 days (95% confidence interval; range, 62-262 days), respectively. Overall survival was significantly associated with baseline alpha-fetoprotein level (P=0.001) and tumor response (P=0.005). The baseline alpha-fetoprotein level was significantly associated with the disease control rate (P=0.007). Adverse events were tolerable and managed successfully with conservative treatment.</p><p><strong>Conclusions: </strong>Metronomic chemotherapy may be a safe and useful palliative treatment in HCC patients with major PVT.</p>","PeriodicalId":87153,"journal":{"name":"The Korean journal of hepatology","volume":"18 1","pages":"32-40"},"PeriodicalIF":0.0,"publicationDate":"2012-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/db/ac/kjhep-18-32.PMC3327001.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30582181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High efficacy of adefovir and entecavir combination therapy in patients with nucleoside-refractory hepatitis B.","authors":"Hee Bok Chae,&nbsp;Mee Jin Kim,&nbsp;Eui Geun Seo,&nbsp;Yong Hyeok Choi,&nbsp;Hee Seung Lee,&nbsp;Joung Ho Han,&nbsp;Soon Man Yoon,&nbsp;Seon Mee Park,&nbsp;Sei Jin Youn","doi":"10.3350/kjhep.2012.18.1.75","DOIUrl":"https://doi.org/10.3350/kjhep.2012.18.1.75","url":null,"abstract":"<p><strong>Background/aims: </strong>Newly developed and potent antiviral agents suffer from the problem of drug resistance. Multidrug resistance is a major impediment in the treatment of patients with chronic hepatitis B (CHB). In line with American Association for the Study of Liver Diseases guidelines, adefovir dipivoxil (ADV) add-on therapy is recommended in the case of lamivudine resistance, while tenofovir disoproxil fumarate (TDF) is recommended for ADV or entecavir (ETV) resistance. TDF is currently not available in Korea. ADV+ETV combination therapy may be a viable alternative to TDF in patients with either ADV or ETV resistance. However, the efficacy of ADV+ETV combination therapy in patients with CHB and multidrug resistance is unclear. This study investigated the efficacy of ADV+ETV combination therapy in patients with multidrug resistance.</p><p><strong>Methods: </strong>Twenty-five patients were enrolled and were administered ADV+ETV combination therapy for at least 6 months. Blood was drawn at baseline and at 3, 6, 9, and 12 months after commencing treatment, and the following blood parameters were analyzed: alanine transaminase, hepatitis B e-antigen (HBeAg), anti-hepatitis B e-antigen, and hepatitis B virus (HBV) DNA levels. The initial virological response (IVR) was defined as an HBV DNA level of <4 log(10) copies/mL after 6 months of combination therapy.</p><p><strong>Results: </strong>The IVR rate was 76%. The proportion of patients with a high viral load (≥5.0 log) dropped from 76% at baseline to only 5% after 6 months of treatment. The biochemical response rate during the first 6 months was 71%. HBeAg was lost in 2 patients (10%).</p><p><strong>Conclusions: </strong>ADV+ETV combination therapy induced a good IVR in CHB patients who were refractory to more than 2 antiviral agents. This regimen may be a good alternative to TDF in Korea, where that drug is not available.</p>","PeriodicalId":87153,"journal":{"name":"The Korean journal of hepatology","volume":"18 1","pages":"75-83"},"PeriodicalIF":0.0,"publicationDate":"2012-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3350/kjhep.2012.18.1.75","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30582186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical features of acute viral hepatitis B in Korea: a multi-center study.","authors":"Hye Jin Choi,&nbsp;Soon Young Ko,&nbsp;Won Hyeok Choe,&nbsp;Yeon Seok Seo,&nbsp;Ji Hoon Kim,&nbsp;Kwan Soo Byun,&nbsp;Young Seok Kim,&nbsp;Seung Up Kim,&nbsp;Soon Koo Baik,&nbsp;Jae Youn Cheong,&nbsp;Tae Yeob Kim,&nbsp;Oh Sang Kwon,&nbsp;Jeong Han Kim,&nbsp;Chang Hong Lee,&nbsp;So Young Kwon","doi":"10.3350/kjhep.2011.17.4.307","DOIUrl":"https://doi.org/10.3350/kjhep.2011.17.4.307","url":null,"abstract":"<p><strong>Background/aims: </strong>The incidence of Hepatitis B has significantly declined since the introduction of an HBV vaccination program. The aim of this study was to investigate recent clinical features of acute viral hepatitis B (AVH-B) in Korea.</p><p><strong>Methods: </strong>A total of 2241 patients with acute viral hepatitis were enrolled and their data were collected from nine medical-centers between January 2006 and December 2009.</p><p><strong>Results: </strong>One hundred nineteen (5.3%) of the 2241 were diagnosed as AVH-B. Among 78 patients with AVH-B whose data were analyzed, 50 were male, and the mean age was 38.6 years. In an initial test, mean AST, ALT and total-bilirubin levels were 1296.2 IU/L, 2109.6 IU/L and 9.3 mg/dl, respectively. Positivity frequencies for HBeAg and anti-HBe were 55.1% and 67.9%, respectively, and the mean HBV DNA level was 5.2 log10 copies/ml. The mean length of hospitalization was 11.6 days. During follow-up, AST, ALT and total bilirubin levels were normalized or near-normalized in all patients without serious complications. Sixty-three of 66 (95.4%) patients showed HBsAg loss and 37 (56.1%) patients showed HBsAg seroconversion. Only 3 patients (4.5%) showed persistent hepatitis B viremia. There was no case of death or liver transplantation. Nine patients (11.3%) had received anti-viral agents and their clinical outcomes were not significantly different from those of patients treated without antiviral agents.</p><p><strong>Conclusions: </strong>The prevalence of AVH-B among acute hepatitis patients is relatively low in Korea. AVH-B infection can be cured without complications in almost all patients, regardless of antiviral treatment.</p>","PeriodicalId":87153,"journal":{"name":"The Korean journal of hepatology","volume":"17 4","pages":"307-12"},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c6/0e/kjhep-17-307.PMC3304668.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30440636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metastatic hepatocellular carcinoma presenting as facial nerve palsy and facial pain.","authors":"Jong In Yang,&nbsp;Jung Mook Kang,&nbsp;Hee Jin Byun,&nbsp;Go Eun Chung,&nbsp;Jeong Yoon Yim,&nbsp;Min Jung Park,&nbsp;Jeong Hoon Lee,&nbsp;Jung Hwan Yoon,&nbsp;Hyo Suk Lee","doi":"10.3350/kjhep.2011.17.4.319","DOIUrl":"https://doi.org/10.3350/kjhep.2011.17.4.319","url":null,"abstract":"<p><p>Facial nerve palsy due to temporal bone metastasis of hepatocellular carcinoma (HCC) has rarely been reported. We experienced a rare case of temporal bone metastasis of HCC that initially presented as facial nerve palsy and was diagnosed by surgical biopsy. This patient also discovered for the first time that he had chronic hepatitis B and C infections due to this facial nerve palsy. Radiation therapy greatly relieved the facial pain and facial nerve palsy. This report suggests that hepatologists should consider metastatic HCC as a rare but possible cause of new-onset cranial neuropathy in patients with chronic viral hepatitis.</p>","PeriodicalId":87153,"journal":{"name":"The Korean journal of hepatology","volume":"17 4","pages":"319-22"},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e4/8a/kjhep-17-319.PMC3304660.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30440638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osler-Weber-Rendu disease presenting with hepatocellular carcinoma: radiologic and genetic findings.","authors":"Joo Ho Lee,&nbsp;Yung Sang Lee,&nbsp;Pyo Nyun Kim,&nbsp;Beom Hee Lee,&nbsp;Gu Whan Kim,&nbsp;Han Wook Yoo,&nbsp;Nae Yun Heo,&nbsp;Young Suk Lim,&nbsp;Han Chu Lee,&nbsp;Young Hwa Chung,&nbsp;Dong Jin Suh","doi":"10.3350/kjhep.2011.17.4.313","DOIUrl":"https://doi.org/10.3350/kjhep.2011.17.4.313","url":null,"abstract":"<p><p>This is a case report of a 68-year-old man with hepatocellular carcinoma (HCC) accompanied by hereditary hemorrhagic telangiectasia (HHT), also known as Osler-Weber-Rendu disease, and hepatic vascular malformation. HHT is an autosomal dominant disorder of the fibrovascular tissue that is characterized by recurrent epistaxis, mucocutaneous telangiectasias, and visceral arteriovenous malformations. HHT is caused by mutation of the genes involved in the signaling pathway of transforming growth factor-β, which plays an important role in the formation of vascular endothelia. Hepatic involvement has been reported as occurring in 30-73% of patients with HHT. However, symptomatic liver involvement is quite rare, and the representative clinical presentations of HHT in hepatic involvement are high-output heart failure, portal hypertension, nodular regenerative hyperplasia, and symptoms of biliary ischemia. Some cases of HCC in association with HHT have been reported, but are very rare. We present herein the characteristic radiologic and genetic findings of HHT that was diagnosed during the evaluation and treatment of HCC.</p>","PeriodicalId":87153,"journal":{"name":"The Korean journal of hepatology","volume":"17 4","pages":"313-8"},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/86/ed/kjhep-17-313.PMC3304659.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30440637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioeconomic costs of liver disease in Korea.","authors":"Sunmi Lee,&nbsp;Woojin Chung,&nbsp;Kyung Rae Hyun","doi":"10.3350/kjhep.2011.17.4.274","DOIUrl":"https://doi.org/10.3350/kjhep.2011.17.4.274","url":null,"abstract":"<p><strong>Background/aims: </strong>This study analyzed the scale and trends of the social and economic costs of liver disease in Korea for the past 5 years.</p><p><strong>Methods: </strong>The social aspects of socioeconomic costs were projected for viral hepatitis (B15-B19), liver cirrhosis, malignant neoplasm of the liver (C22) and other liver diseases (K70-K76), as representative diseases by dividing costs into direct and indirect from 2004 to 2008. Direct costs include hospitalization, outpatient, and pharmacy costs in the health-care sector, and transportation and caregiver costs. Indirect costs include the future income loss due to premature death and the loss of productivity resulting from absence from work.</p><p><strong>Results: </strong>The social and economic costs of liver disease were projected to be KRW 5,858 billion in 2004, KRW 5,572 billion in 2005, KRW 8,104 billion in 2006, KRW 6,095 billion in 2007, and KRW 5,689 billion in 2008. The future income loss resulting from premature death is thus greatest, from 73.9% to 86.1%, followed by the direct medical costs, from 9.0% to 18.1%. The productivity loss resulting from absence from work accounts for 3.3-5.5%, followed by the direct nonmedical costs such as transportation and caregiver costs, at 1.5-2.5%.</p><p><strong>Conclusions: </strong>Among the socioeconomic costs of liver disease in Korea, the future income loss resulting from premature death is showing a decreasing trend, whereas direct medical costs are increasing dramatically.</p>","PeriodicalId":87153,"journal":{"name":"The Korean journal of hepatology","volume":"17 4","pages":"274-91"},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/45/ec/kjhep-17-274.PMC3304661.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30440709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Virologic response is not durable after adefovir discontinuation in lamivudine-resistant chronic hepatitis B patients.","authors":"Young Kul Jung,&nbsp;Jong Eun Yeon,&nbsp;Kwang Gyun Lee,&nbsp;Eun Seok Jung,&nbsp;Jeong Han Kim,&nbsp;Ji Hoon Kim,&nbsp;Yeon Seok Seo,&nbsp;Hyung Joon Yim,&nbsp;Sun Ho Um,&nbsp;Ho Sang Ryu,&nbsp;Kwan Soo Byun","doi":"10.3350/kjhep.2011.17.4.261","DOIUrl":"https://doi.org/10.3350/kjhep.2011.17.4.261","url":null,"abstract":"<p><strong>Background/aims: </strong>We investigated the durability of the biochemical and virologic responses after adefovir (ADV) discontinuation in lamivudine-resistant (LMV-R) chronic hepatitis B (CHB) patients, and the outcomes of ADV discontinuation compared to that of ADV maintenance.</p><p><strong>Methods: </strong>The indication for ADV treatment cessation was an undetectable level of hepatitis B virus (HBV) DNA documented on two occasions at least 6 months apart. All patients received additional ADV for at least 12 months after the confirmation of undetectable HBV DNA (Cobas TaqMan PCR assay, <70 copies/mL). Of 36 patients who had a sufficient ADV therapeutic effect, 19 discontinued ADV treatment, while the others maintained it. A virologic rebound was arbitrarily defined as the redetection of HBV DNA at a level higher than 10(5) copies/mL.</p><p><strong>Results: </strong>In the ADV discontinuation group, ADV treatment and additional therapy were administered for medians of 33 months (range, 12-47 months) and 18 months, respectively. The patients were followed for a median of 12 months (range, 3-30 months) after ADV cessation. During that period, 18 of 19 patients (95%) experienced viral relapse. Viral rebound was observed in six patients (32%). However, 12 of 18 patients (67%) exhibited serum HBV DNA levels of less than (5) copies/mL. Biochemical relapses were observed in four of the six patients with viral rebound. In the ADV maintenance group, patients were treated for a median of 53 months (range, 31-85 months), and 9 patients (53%) experienced viral breakthrough.</p><p><strong>Conclusions: </strong>During short-term follow-up after ADV discontinuation, most patients (95%) exhibited viral relapse, whereas and viral breakthrough occurred in about half of patients (53%) maintained on ADV therapy. Therefore, the durability of virologic response after ADV discontinuation in LMV-R patients was unsatisfactory. In addition, and viral breakthrough was not infrequent in the ADV continuation group.</p>","PeriodicalId":87153,"journal":{"name":"The Korean journal of hepatology","volume":"17 4","pages":"261-7"},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/52/61/kjhep-17-261.PMC3304672.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30440707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}