Beom Kyung Kim

Wonju Severance Christian Hospital, Genshū, Gangwon-do, South Korea

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Publications (78)294.86 Total impact

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    ABSTRACT: To determine factors predictive of discordance in staging liver fibrosis using liver biopsy (LB) and acoustic radiation force impulse (ARFI) elastography in patients with chronic hepatitis B (CHB). Consecutive patients with CHB who underwent LB and ARFI elastography on the same day from November 2010 to March 2013 were prospectively recruited from three tertiary hospitals. We analyzed 105 patients (median age of 47 years). The F0-1, F2, F3, and F4 fibrosis stages were identified in 27 (25.7%), 27 (25.7%), 21 (20.0%), and 30 (28.6%) patients, respectively. The areas under the receiver operating characteristics curves for ARFI elastography in assessing ≥F2, ≥F3, and F4 was 0.814, 0.848, and 0.752, respectively. The discordance of at least one stage between LB and ARFI was observed in 68 patients (64.8%) and of at least two stages in 16 patients (15.2%). In a multivariate analysis, advanced fibrosis stage (F3-4) was the only factor that was negatively correlated with one-stage discordance (p=0.042). Moreover, advanced fibrosis stage was negatively (p=0.016) correlated and body mass index (BMI) was positively (p=0.006) correlated with two-stage discordance. Advanced fibrosis stage (F3-4) was a predictor of nondiscordance between LB and ARFI elastography; BMI also influenced the accuracy of ARFI elastography.
    Gut and Liver 06/2015; DOI:10.5009/gnl14391 · 1.49 Impact Factor
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    ABSTRACT: Nonalcoholic fatty liver disease (NAFLD) has a close relationship with coronary atherosclerosis. We investigated the association between coronary atherosclerosis and liver fibrosis, represented as coronary artery calcification (CAC) score and live stiffness (LS) value assessed using transient elastography (TE), respectively, in patients with NAFLD. Between January 2013 and March 2014, a total of 285 asymptomatic subjects without chronic liver and ischemic heart diseases who underwent comprehensive medical health check-up were recruited. NAFLD was defined as controlled attenuation parameter (CAP) ≥ 250 dB/m on TE. The median age of the study population (men 161 and women 124) was 56 (interquartile [IQR], 50-63) years. Of these, 142 (49.8%) subjects had NAFLD. Among subjects with NAFLD, CAC score was independently correlated with male gender (β=0.230; P=0.005), elevated erythrocyte sedimentation rate (ESR) (β=0.220; P=0.019), reduced estimated glomerular filtration rate (β=-0.220; P=0.004), increased left ventricular mass index (β=0.226; P=0.027), and higher LS values (β=0.274; P<0.001). In addition, alanine aminotransferase level (β=0.214, P=0.012) and CAC score (β=0.311; P=0.001) are the only independent factors associated with LS values in subjects with NAFLD. Higher CAC score was independently correlated with LS values in subjects with NAFLD. However, it should be further investigated whether TE can be incorporated into a screening tool to identify the high risk population for coronary artery disease. This article is protected by copyright. All rights reserved.
    Journal of Gastroenterology and Hepatology 05/2015; DOI:10.1111/jgh.12992 · 3.63 Impact Factor
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    ABSTRACT: The aim of this study was to evaluate the estimated glomerular filtration rate (eGFR) during telbivudine (LdT) versus entecavir (ETV) treatment in chronic hepatitis B (CHB) patients with underlying comorbidities such as diabetes mellitus (DM), hypertension, and cirrhosis. From 2010 to 2012, 116 CHB patients treated with LdT and 578 treated with ETV were compared in this real-practice cohort. The mean changes in eGFR (Modification of Diet in Renal Disease [MDRD] formula) from baseline to months 6, 12, and 18 were analyzed using a linear mixed model. In LdT-treated patients, the mean eGFR increased by 7.6% at month 18 compared with the eGFR at baseline (MDRD formula in mL/min/1.73 m2). However, in ETV-treated patients, the mean eGFR decreased by 4.1% at month 18 compared with the eGFR at baseline. In the LdT-treated patients with DM, hypertension, cirrhosis or low eGFR. The eGFR gradually increased over time during LdT treatment, especially in patients with mild abnormal eGFR at baseline, and in those with DM, hypertension, and cirrhosis, whereas a reduction in eGFR was seen with ETV treatment.
    Gut and Liver 05/2015; DOI:10.5009/gnl14297 · 1.49 Impact Factor
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    ABSTRACT: Precise assessment of liver fibrosis is necessary in patients with chronic liver disease. We investigated the performance of red cell volume distribution width (RDW)-to-platelet ratio (RPR) for the assessment of liver fibrosis in patients with chronic hepatitis B (CHB). A total of 482 consecutive patients with CHB who underwent liver biopsy between October 2005 and May 2014 were recruited. Liver stiffness (LS) was measured using transient elastography (TE). FIB-4 score, RPR, and the aspartate aminotransferase-to-platelet ratio index (APRI) were also assessed. A total of 271 (56.2%) patients were males. The median age was 44 years. F1, F2, F3, and F4 fibrosis stages were identified in 68 (14.1%), 137 (28.4%), 64 (13.3%), and 213 (44.2%) of the patients, respectively. The mean RPR increased with liver fibrosis severity: F1, 0.065; F2, 0.077; F3, 0.097; and F4, 0.121 (P<0.01). The area under the receiver operating characteristic curve (AUROC) of the RPR for predicting significant fibrosis (≥ F2) was 0.747. This result was inferior to TE (0.866, P=0.004), but comparable to FIB-4 (0.782, P=0.427) and APRI (0.716, P=0.507). The AUROC of RPR for predicting cirrhosis (F4) was 0.811, which was inferior to LS (0.915, P<0.001), but comparable to FIB-4 (0.804, P=0.805) and superior to APRI (0.680, P<0.001). The accuracy of RPR was acceptable for the assessment of liver fibrosis in patients with CHB. When TE is not available, RPR assessment is a simple method that can be used to reduce the need for liver biopsy. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Liver international: official journal of the International Association for the Study of the Liver 05/2015; DOI:10.1111/liv.12868 · 4.41 Impact Factor
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    ABSTRACT: We aimed to generate and validate a novel risk prediction model for patients with hepatocellular carcinoma (HCC) undergoing trans-arterial chemoembolization (TACE). Patients receiving TACE as the first-line therapy between 2006 and 2009 were selected from the databases of two major tertiary hospitals in Korea. The study population was randomly assigned into training (n=340) and validation (n=145) sets. From a multivariate Cox-regression model for overall survival (OS), tumor Size, tumor Number, baseline Alpha-fetoprotein level, Child-Pugh class, and Objective radiological Response after the first TACE session were selected and then scored to generate a 10-point risk prediction model (named as "SNACOR" model) in the training set. Thereafter, the prognostic performance was assessed in the validation set. In the training set, the time-dependent areas under receiver-operating characteristic curves (AUROCs) for OS at 1-, 3-, and 6-years were 0.783, 0.754, and 0.742, respectively. According to the score of the SNACOR model, patients were stratified into three groups; Low- (score 0-2), Intermediate- (score 3-6), and High-risk group (score 7-10), respectively. The Low-risk group had the longest median OS (49.8 months), followed by Intermediate- (30.7 months) and High-risk group (12.4 months) (log-rank, p<0.001). Compared to the Low-risk group, the Intermediate-risk (hazard ratio [HR] 2.13, p<0.001) and High-risk group (HR 6.17, p<0.001) retained significant risks of death. Similar results were obtained in the validation set. A simple-to-use SNACOR model for patients with HCC treated with TACE might be helpful in appropriate prognostification and guidance for decision of further treatment strategies. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Liver international: official journal of the International Association for the Study of the Liver 05/2015; DOI:10.1111/liv.12865 · 4.41 Impact Factor
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    ABSTRACT: Background&aimsThe hepatoma arterial-embolization prognostic (HAP) score predicts survival outcome in patients with hepatocellular carcinoma (HCC) treated with trans-arterial chemoembolization (TACE). We validated the HAP score in Korean subjects with HCC and investigated whether its prognostic performance is improved with additional parameters.MethodsA total of 280 patients with HCC treated with TACE between 2003 and 2009 were included. Validation and modification of HAP score were performed based on multivariate Cox regression models.ResultsThe median age of the study population (211 men, 69 women) was 60 years. Viral etiology of HCC accounted for 80.4% (n=181 for hepatitis B, 44 for hepatitis C). The median overall survival (OS) was 40.5 months. On multivariate analysis, together with the original components of the HAP score (serum albumin<3.6g/dL, total bilirubin>0.9mg/dL, alpha-fetoprotein>400ng/mL, and tumor size>7cm), tumor number≥2 was selected as an independent unfavorable prognostic factor for OS (hazard ratio 2.3; P<0.001). Accordingly, a modified HAP-II (mHAP-II) score was established by adding tumor number≥2. Although both HAP and mHAP-II scores discriminated the four different risk groups (log-rank test, all P<0.001), the mHAP-II score performed significantly better than the HAP score, as per the areas under receiver operating curves predicting OS at three years (0.717 vs. 0.658) and five years (0.728 vs. 0.645), respectively (all P<0.05).Conclusions Although the HAP score predicted OS for Korean subjects with HCC undergoing TACE, the addition of tumor number significantly improved the prognostic performance. The mHAP-II score can be used for accurate prognostication and selection of optimal candidates for TACE.This article is protected by copyright. All rights reserved.
    Liver international: official journal of the International Association for the Study of the Liver 05/2015; DOI:10.1111/liv.12878 · 4.41 Impact Factor
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    Beom Kyung Kim, Seung Up Kim
    Journal of Hepatology 04/2015; DOI:10.1016/j.jhep.2015.04.007 · 10.40 Impact Factor
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    ABSTRACT: Data comparing EASL and mRECIST criteria for response evaluation in treatment of hepatocellular carcinoma are rare. We evaluated inter-observer variability by these two response evaluation criteria in treatment-naïve patients undergoing chemoembolization. For 133 patients undergoing chemoembolization, two radiologists independently measured sum of bi-dimensional and uni-dimensional diameters at baseline using both EASL criteria and mRECIST, and their changes on first follow-up for up to 5 target lesions. Concordance correlation coefficients for sum of bi-dimensional and uni-dimensional diameters at baseline between two observers were 0.992 and 0.988, respectively. However, those for their changes on follow-up were 0.865 and 0.877, respectively. Similarly, mean differences in sum of bi-dimensional and uni-dimensional diameters at baseline between two observers were small; -0.455 and 0.079cm, respectively. However, mean differences in changes (%) in sum of bi-dimensional and uni-dimensional diameters on first follow-up between observers increased by -9.715% and -9.320%, respectively. Regarding tumour numbers, kappa-value between observers was 0.942. For treatment response (complete or partial response, stable disease and progression), kappa-value was 0.941 by both criteria. When only up to two target lesions were assessed, kappa-value was 1.000 by both criteria. Inter-observer agreements using both response evaluation criteria were excellent, especially when up to two targets were assessed. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
    Digestive and Liver Disease 04/2015; DOI:10.1016/j.dld.2015.04.004 · 2.89 Impact Factor
  • PLoS ONE 03/2015; 10(3):e0121009. DOI:10.1371/journal.pone.0121009 · 3.53 Impact Factor
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    ABSTRACT: Adequate visibility is an important factor for achieving successful endoscopic hemostasis for the treatment of upper GI bleeding (UGIB). The independent factors that affect visibility during endoscopic procedures have yet to be determined. To determine the factors that affect endoscopic visibility and to create a model that can predict in which patients unacceptable visibility is suspected before emergent endoscopic procedures for UGIB. Prospective, observational study. University-affiliated tertiary care hospital in South Korea. A total of 121 patients admitted because of UGIB. Analysis of the visibility score of the emergency endoscopies for UGIB. Factors affecting the visibility score of endoscopy and a classification and regression tree (CART) model for predicting of visibility. The EGD time and the appearance of the nasogastric (NG) tube aspirate were independent factors that were significantly associated with visibility (EGD time, P < .001; red blood appearance in NG tube aspirate, P < .001; coffee grounds appearance of NG tube aspirate, P = .006). Based on these results, a CART model was developed by using 70 patients who had been allocated to the training set. The CART generated algorithms that proposed the use of the appearance of the NG tube aspirate and the EGD time (8.5 hours) to predict visibility. The sensitivity and specificity for predicting poor visibility were 71.4% and 86.4%, respectively. The use of the CART model enables the prediction of which patients will have poor visibility during emergent endoscopy. Copyright © 2015 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.
    Gastrointestinal Endoscopy 03/2015; 81(6). DOI:10.1016/j.gie.2014.12.024 · 4.90 Impact Factor
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    ABSTRACT: Background /A ims: Early detection of liver cirrhosis in its subclinical stage is of paramount importance to identify high-risk individuals of developing hepatocellular carcinoma (HCC). This study investigated whether transient elastography (TE) can identify patients with subclinical cirrhosis (SCC) who are at increased risk of developing HCC among chronic hepatitis B (CHB) patients without clinical evidence of cirrhosis.Methods: A total of 2,876 CHB patients without clinical cirrhosis who received TE examinations between April 2006 and December 2012 were enrolled in this prospective study. SCC was defined as a non-clinical cirrhosis, but with a liver stiffness (LS) value ≥13 kPa.Results: The mean age of the study population was 46.1 years, and male gender was predominant (n=1,775, 61.7%). The mean LS value was 7.9 kPa and SCC was identified in 285 (9.9%) patients. During the median follow-up period of 48.9 (range, 6.6-96.2) months, HCC developed in 16 patients (13.3 per 1,000 person-years) in the SCC group and 36 (3.4 per 1,000 person-years) in the non-SCC group. The cumulative incidence rate of HCC in the SCC group was significantly higher than that in the non-SCC group (P<0.001, long-rank test). On multivariate analysis, SCC was independently associated with a risk of developing HCC, regardless of antiviral therapy (without antiviral therapy: hazard ratio [HR] 4.680, 95% confidence interval [CI] 1.187-18.441, P=0.027; with antiviral therapy: HR 3.344, 95% CI 1.526-7.328, P=0.003).Conclusion: Our data suggest that TE can identify CHB patients with SCC who are at increased risk of developing HCC, even when cirrhosis is not clinically apparent. This article is protected by copyright. All rights reserved.
    Hepatology 01/2015; 61(6). DOI:10.1002/hep.27735 · 11.19 Impact Factor
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    ABSTRACT: The aim of this study is to evaluate prognostic significances of not only the initial and the best response during repeated trans-arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC), if eligible, but also time-point of achieving treatment responses.
    Journal of Hepatology 01/2015; 62(6). DOI:10.1016/j.jhep.2015.01.022 · 10.40 Impact Factor
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    ABSTRACT: To investigate the prevalence of significant liver fibrosis assessed using transient elastography (TE) and its predictors in asymptomatic general population. A total of 159 subjects without chronic viral hepatitis who underwent comprehensive medical health check-up between January 2012 and July 2012 were prospectively recruited. Significant liver fibrosis was defined as liver stiffness value > 7.0 kPa. The mean age and body mass index (BMI) of the study population (men 54.7%) was 56.0 years and 24.3 kg/m(2). Among the study subjects, 11 (6.9%) showed significant liver fibrosis. On univariate analysis, BMI, alanine aminotransferase (ALT), homeostasis model assessment of insulin resistance, carotid intimal media thickness (IMT), number of calcified plaques on carotid ultrasound, and visceral fat area on computed tomography were significantly higher in subjects with significant liver fibrosis than in those without (all P < 0.05). However, on multivariate analysis, BMI [odds ratio (OR) =1.487; P = 0.045], ALT (OR = 1.078; P = 0.014), carotid IMT (OR = 3.244; P = 0.027), and the number of calcified carotid plaques (OR = 1.787; P = 0.031) were independent predictors of significant liver fibrosis. The prevalence of significant liver fibrosis assessed using TE was 6.9% in apparently healthy subjects. High BMI, high ALT, thicker carotid IMT, and higher numbers of calcified carotid plaques were independently associated with the presence of significant liver fibrosis.
  • 01/2015; DOI:10.2147/JHC.S79353
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    ABSTRACT: Liver stiffness (LS) measurement using transient elastography can accurately assess the degree of liver fibrosis, which is associated with the risk of the development of hepatocellular carcinoma (HCC). We investigated whether LS values could predict HCC de novo recurrence after radiofrequency ablation (RFA). This retrospective, multicenter study analyzed 111 patients with HCC who underwent RFA and LS measurement using transient elastography between May 2005 and April 2011. All patients were followed until March 2013 to monitor for HCC recurrence. This study included 76 men and 35 women with a mean age of 62.4 years, and the mean LS value was 21.2 kPa. During the follow-up period (median 22.4 months), 47 (42.3%) patients experienced HCC de novo recurrence, and 18 (16.2%) died. Patients with recurrence had significantly more frequent liver cirrhosis, more frequent history of previous treatment for HCC, higher total bilirubin, larger spleen size, larger total tumor size, higher tumor number, higher LS values, and lower platelet counts than those without recurrence (all P<0.05). On multivariate analysis, together with previous anti-HCC treatment history, patients with LS values >13.0 kPa were at significantly greater risk for recurrence after RFA, with a hazard ratio (HR) of 3.115 (95% confidence interval [CI], 1.238-7.842, P<0.05). Moreover, LS values independently predicted the mortality after RFA, with a HR of 9.834 (95% CI, 1.148-84.211, P<0.05), together with total bilirubin. Our data suggest that LS measurement is a useful predictor of HCC de novo recurrence and overall survival after RFA.
    OncoTargets and Therapy 01/2015; 8:347-356. DOI:10.2147/OTT.S75077 · 2.31 Impact Factor
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    ABSTRACT: Backgrounds/Aims:Serum fibrosis markers such as Enhanced Liver Fibrosis (ELF) test, have been suggested as alternatives for liver biopsy (LB) in assessing liver fibrosis. We investigated the efficacy of ELF test in predicting development of liver-related events (LRE) in patients with chronic hepatitis B (CHB).Methods:A total of 170 patients (103 men, 60.6%) with CHB who underwent LB and serological tests for determining ELF were enrolled. All patients were followed-up to monitor LRE development, defined as hepatic decompensation, hepatocellular carcinoma, and/or liver-related death.Results:The mean age was 45.3 years. During follow-up period (median, 41 months), 39 (22.9%) patients experienced LRE. In patients with LRE, age, proportion of male gender, ELF test results, age–spleen–platelet ratio (ASPRI), liver stiffness (LS) value, and histological fibrosis stage were significantly higher than those in patients without LRE (all P<0.05). Areas under receiver-operating characteristic curves to predict LRE development were 0.808 for ELF test, 0.732 for LS value, 0.713 for histological fibrosis stages using Batts and Ludwig scoring system, and 0.687 for ASPRI. On multivariate analysis, along with age, ELF test was an independent predictor of LRE development (adjusted hazard ratio [HR] 1.438, P<0.001). When we applied a three-tier stratification of our study population using cut-off ELF values of 8.10 and 10.40, patients with low (P=0.002; adjusted HR 0.045, 95% confidence interval [CI] 0.006–0.330) and intermediate (P<0.001; adjusted HR 0.239, 95% CI 0.122–0.469) ELF range were found less likely to develop LRE compared to those with high ELF range.Conclusion:ELF is useful in a non-invasive prediction of LRE development. TE showed statistically similar prognostic performance for LRE as ELF, but other non-invasive tests were inferior. (Hepatology 2014;)
    Hepatology 12/2014; 60(6). DOI:10.1002/hep.27389 · 11.19 Impact Factor
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    ABSTRACT: Radiological response assessment criteria in hepatocellular carcinoma (HCC) have evolved to accurately evaluate tumor responses. The WHO criteria and the subsequent Response Evaluation Criteria in Solid Tumors (RECIST) evaluate change in tumor size; however, these criteria generally ignore tumor necrosis and therefore may underestimate treatment responses. Thus, a panel of experts of the European Association for the Study of Liver (EASL) amended the response criteria to take into account tumor necrosis. In 2010, the modified RECIST (mRECIST) was developed, which consider both the concept of tumor viability based on arterial enhancement and single linear summation, ultimately simplifying EASL criteria. Currently, the mRECIST represents the gold standard for radiologically evaluating tumor response during HCC treatment. Here, the authors review application and performance of mRECIST as well as other HCC response assessment criteria and discuss unmet and open issues regarding response evaluation for HCC treatments.
    Expert Review of Gastroenterology and Hepatology 11/2014; 9(3). DOI:10.1586/17474124.2015.959929 · 2.55 Impact Factor
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    ABSTRACT: BackgroundsComputed tomography (CT) and magnetic resonance imaging (MRI) play important roles in diagnosis and staging of hepatocellular carcinoma (HCC). However, prognostic roles of radiological characteristics are not yet determined.Methods Eighty-eight patients treated with chemoembolization were analyzed. Radiological parameters at baseline were assessed in all patients using both dynamic CT and MRI. Treatment responses were assessed using modified RECIST 4 weeks after the first chemoembolization.ResultsGross vascular invasion (GVI), bile duct invasion, irregular tumor margin (ITM), peripheral ragged enhancement (PRE), and satellite nodules on CT or MRI were associated with non-response (stable disease or progression) after chemoembolization, respectively (all p≤0.05). GVI, ITM, and PRE on CT or MRI were also independently associated with poor overall survival (OS), respectively (all p≤0.05). Using these results, a prognostic scoring system for CT and MRI were developed; 0, absence of all 3 features (GVI, ITM, and PRE); 1, presence of one feature; 2, presence of two features; and 3, presence of three features. After adjusting tumor size, tumor number, and alpha-fetoprotein level, both CT and MRI scores were independently associated with OS (both p<0.001). Patients with CT or MRI score≥2 had a worse OS than those with score<2 (adjusted hazard ratios, 3.837 and 2.938, respectively). MRI-specific parameters such as signal intensity on T2- or T1-weighted images, fat signal, or hyperintensity on diffusion-weighted images did not have prognostic value (all p>0.05).Conclusions Radiologic parameters by CT and MRI may be useful in biological characterization of tumors and prognostification for HCC treated with chemoembolization.This article is protected by copyright. All rights reserved.
    Liver international: official journal of the International Association for the Study of the Liver 11/2014; 35(6). DOI:10.1111/liv.12751 · 4.41 Impact Factor
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    ABSTRACT: To elucidate the benefits of successful antiviral therapy in chronic hepatitis C (CHC) patients METHODS: A total of 463 CHC patients who underwent pegylated interferon alfa and ribavirin therapy were classified as sustained virological response (SVR) or non-SVR based on response to antiviral therapy. We investigated disease progression to cirrhosis in non-cirrhotic patients, development of cirrhosis-related complications such as ascites, variceal bleeding, and hepatic encephalopathy in patients with cirrhosis, and development of hepatocellular carcinoma (HCC).
    Digestive Diseases and Sciences 09/2014; 60(2). DOI:10.1007/s10620-014-3361-6 · 2.55 Impact Factor
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    ABSTRACT: Background/Aims This study assessed the antiviral efficacy and safety of tenofovir disoproxil fumarate (TDF) for up to 12 months in Korean treatment-naïve chronic hepatitis B (CHB) patients. Methods A total of 411 treatment-naïve CHB patients who had been treated with TDF for at least 3 months (median 5.6) were consecutively enrolled. Clinical, biochemical, virological parameters and treatment adherence were routinely assessed every 3 months. Results The median age was 51.3 years, 63.0% of the patients were male, 49.6% were HBeAg (+), and 210 patients had liver cirrhosis. The median baseline HBV DNA was 5.98 (SD 1.68) log10 IU/mL. Among the patients completing week 48, 83.3% had a complete virologic response (CVR, <12 IU/mL by HBV PCR assay), and 88.2% had normalized levels of alanine aminotransferase (ALT). The cumulative probabilities of CVR at 3, 6, 9 and 12 months were 22.8%, 53.1%, 69.3% and 85.0%. During the follow-up period, 9.8% patients achieved HBeAg loss and 7.8% patients achieved HBeAg seroconversion. There was no virological breakthrough after initiating TDF. The most common TDF-related adverse event was gastrointestinal upset, and three patients discontinued TDF therapy. However, no serious life-threatening side effect was noted. Conclusions In a clinical practice setting, TDF was safe and highly effective when administered for 12 months to Korean treatment-naïve CHB patients.
    09/2014; 20(3):261-6. DOI:10.3350/cmh.2014.20.3.261

Publication Stats

598 Citations
294.86 Total Impact Points


  • 2015
    • Wonju Severance Christian Hospital
      Genshū, Gangwon-do, South Korea
    • Catholic University of Korea
      • College of Medicine
      Sŏul, Seoul, South Korea
  • 2007–2015
    • Yonsei University Hospital
      • Department of Internal Medicine
      Sŏul, Seoul, South Korea
  • 2014
    • Konkuk University
      Sŏul, Seoul, South Korea
    • Chung-Ang University
      Sŏul, Seoul, South Korea
  • 2008–2014
    • Yonsei University
      • • Institute of Gastroenterology
      • • Department of Internal Medicine
      Sŏul, Seoul, South Korea
  • 2011
    • University of Seoul
      Sŏul, Seoul, South Korea