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  1. Article: Noninvasive tests for liver fibrosis in 2024: are there different scales for different diseases?

    Lai, Jimmy Che-To / Liang, Lilian Yan / Wong, Grace Lai-Hung

    Gastroenterology report

    2024  Volume 12, Page(s) goae024

    Abstract: Liver fibrosis is the common pathway from various chronic liver diseases and its progression leads to cirrhosis which carries a significant risk for the development of portal hypertension-related complications and hepatocellular carcinoma. It is crucial ... ...

    Abstract Liver fibrosis is the common pathway from various chronic liver diseases and its progression leads to cirrhosis which carries a significant risk for the development of portal hypertension-related complications and hepatocellular carcinoma. It is crucial to identify and halt the worsening of liver fibrosis given its important prognostic implication. Liver biopsy is the gold standard for assessing the degree of liver fibrosis but is limited due to its invasiveness and impracticality for serial monitoring. Many noninvasive tests have been developed over the years trying to assess liver fibrosis in a practical and accurate way. The tests are mainly laboratory- or imaging-based, or in combination. Laboratory-based tests can be derived from simply routine blood tests to patented laboratory parameters. Imaging modalities include ultrasound and magnetic resonance elastography, in which vibration-controlled transient elastography is the most widely validated and adopted whereas magnetic resonance elastography has been proven the most accurate liver fibrosis assessment tool. Nonetheless, noninvasive tests do not always apply to all liver diseases, nor does a common cut-off value of a test mean the same degree of liver fibrosis in different scenarios. In this review, we discuss the diagnostic and prognostic performance, as well as the confounders and limitations, of different noninvasive tests on liver fibrosis assessment in various liver diseases.
    Language English
    Publishing date 2024-04-11
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2710871-5
    ISSN 2052-0034
    ISSN 2052-0034
    DOI 10.1093/gastro/goae024
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  2. Article ; Online: Using NIS2+™ to identify at-risk MASH in clinical trials.

    Lai, Jimmy Che-To / Wong, Vincent Wai-Sun

    Journal of hepatology

    2023  Volume 80, Issue 2, Page(s) 181–183

    Language English
    Publishing date 2023-11-25
    Publishing country Netherlands
    Document type Editorial
    ZDB-ID 605953-3
    ISSN 1600-0641 ; 0168-8278
    ISSN (online) 1600-0641
    ISSN 0168-8278
    DOI 10.1016/j.jhep.2023.11.009
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  3. Article ; Online: Reply to: "For long-term outcomes, is the impact of cirrhosis more important than HBsAg seroclearance?"

    Lai, Jimmy Che-To / Wong, Grace Lai-Hung / Yip, Terry Cheuk-Fung

    Journal of hepatology

    2023  Volume 80, Issue 1, Page(s) e32–e34

    MeSH term(s) Humans ; Hepatitis B Surface Antigens ; Liver Cirrhosis ; Carcinoma, Hepatocellular ; Liver Neoplasms ; DNA, Viral ; Hepatitis B virus
    Chemical Substances Hepatitis B Surface Antigens ; DNA, Viral
    Language English
    Publishing date 2023-10-10
    Publishing country Netherlands
    Document type Letter ; Comment
    ZDB-ID 605953-3
    ISSN 1600-0641 ; 0168-8278
    ISSN (online) 1600-0641
    ISSN 0168-8278
    DOI 10.1016/j.jhep.2023.10.003
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  4. Article ; Online: Unmet need in screening for hepatitis D virus: Time to take action.

    Lai, Jimmy Che-To / Wong, Grace Lai-Hung / Wong, Vincent Wai-Sun / Yip, Terry Cheuk-Fung

    Journal of hepatology

    2023  

    Language English
    Publishing date 2023-12-16
    Publishing country Netherlands
    Document type Letter
    ZDB-ID 605953-3
    ISSN 1600-0641 ; 0168-8278
    ISSN (online) 1600-0641
    ISSN 0168-8278
    DOI 10.1016/j.jhep.2023.12.006
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  5. Article ; Online: Can we use old NAFLD data under the new MASLD definition?

    Song, Sherlot Juan / Lai, Jimmy Che-To / Wong, Grace Lai-Hung / Wong, Vincent Wai-Sun / Yip, Terry Cheuk-Fung

    Journal of hepatology

    2023  Volume 80, Issue 2, Page(s) e54–e56

    MeSH term(s) Humans ; Non-alcoholic Fatty Liver Disease/diagnosis ; Non-alcoholic Fatty Liver Disease/epidemiology
    Language English
    Publishing date 2023-08-02
    Publishing country Netherlands
    Document type Letter
    ZDB-ID 605953-3
    ISSN 1600-0641 ; 0168-8278
    ISSN (online) 1600-0641
    ISSN 0168-8278
    DOI 10.1016/j.jhep.2023.07.021
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  6. Article ; Online: Secondary prevention for hepatocellular carcinoma in patients with chronic hepatitis B: are all the nucleos(t)ide analogues the same?

    Yip, Terry Cheuk-Fung / Lai, Jimmy Che-To / Wong, Grace Lai-Hung

    Journal of gastroenterology

    2020  Volume 55, Issue 11, Page(s) 1023–1036

    Abstract: Reducing the incidence of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB) is the key ultimate goal set in essentially all treatment guidelines. There has been solid evidence supporting the relationship between serum hepatitis B ... ...

    Abstract Reducing the incidence of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB) is the key ultimate goal set in essentially all treatment guidelines. There has been solid evidence supporting the relationship between serum hepatitis B virus (HBV) DNA level and risk of HCC. Antiviral treatment with oral nucleos(t)ide analogues (NAs) leads to sustained viral suppression and hence is often adopted as the secondary prevention for HCC in CHB patients. The first-generation NA, lamivudine, reduced the risk of HCC at 3 years compared to placebo; yet, its high emergence of antiviral resistance has made it no longer recommended in the international guidelines. Recent heated debate is about the two current first-line NAs-entecavir and tenofovir disoproxil fumarate (TDF)-Are they just as good to reduce HCC risk in CHB patients? A handful of cohort studies show two different kinds of observations-TDF is better than entecavir in lowering HCC risk, or these two NAs have led to similarly low risk of HCC. Tenofovir alafenamide (TAF), a modified version of TDF higher rate of ALT normalization, would be another potent nucleotide analogue is the treatment of choice for secondary prevention for HCC.
    MeSH term(s) Antiviral Agents/administration & dosage ; Antiviral Agents/pharmacology ; Carcinoma, Hepatocellular/prevention & control ; Carcinoma, Hepatocellular/virology ; DNA, Viral/blood ; Drug Resistance, Viral ; Hepatitis B, Chronic/complications ; Hepatitis B, Chronic/drug therapy ; Humans ; Liver Neoplasms/prevention & control ; Liver Neoplasms/virology ; Risk ; Secondary Prevention/methods ; Sustained Virologic Response
    Chemical Substances Antiviral Agents ; DNA, Viral
    Language English
    Publishing date 2020-09-24
    Publishing country Japan
    Document type Comparative Study ; Journal Article ; Review
    ZDB-ID 1186495-3
    ISSN 1435-5922 ; 0944-1174
    ISSN (online) 1435-5922
    ISSN 0944-1174
    DOI 10.1007/s00535-020-01726-3
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    Zs.A 620: Show issues Location:
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  7. Article ; Online: HCV elimination in Hong Kong - Non-government organisation (NGO) activities.

    Lai, Jimmy Che-To / Ho, Agnes Hiu-Yan / Wu, Claudia Wing-Kwan / Wong, Grace Lai-Hung

    Global health & medicine

    2021  Volume 3, Issue 5, Page(s) 283–287

    Abstract: World Health Organization (WHO) calls for global hepatitis strategy to eliminate viral hepatitis by 2030. Yet many high-income countries were unable to achieve HCV elimination by 2030. Apart from the tremendous efforts and resources from the governments, ...

    Abstract World Health Organization (WHO) calls for global hepatitis strategy to eliminate viral hepatitis by 2030. Yet many high-income countries were unable to achieve HCV elimination by 2030. Apart from the tremendous efforts and resources from the governments, many non-government organizations (NGOs) have been working very hard to contribute to HCV elimination. In Hong Kong, the Center for Liver Health of The Chinese University of Hong Kong (CUHK) has been working very closely with various NGOs to educate and screen subjects who previously use intravenous drugs. In this review article, we discussed in details the New Life New Liver Program, and the barriers to HCV elimination, with special highlight the role of NGOs in overcoming the barriers.
    Language English
    Publishing date 2021-10-26
    Publishing country Japan
    Document type Journal Article ; Review
    ISSN 2434-9194
    ISSN (online) 2434-9194
    DOI 10.35772/ghm.2021.01049
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  8. Article ; Online: Reply to Sun et al.

    Lai, Jimmy Che-To / Wong, Vincent Wai-Sun / Wong, Grace Lai-Hung

    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

    2019  Volume 70, Issue 12, Page(s) 2748–2749

    MeSH term(s) Cohort Studies ; Hepatitis B, Chronic ; Hepatitis E ; Humans
    Language English
    Publishing date 2019-07-31
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 1099781-7
    ISSN 1537-6591 ; 1058-4838
    ISSN (online) 1537-6591
    ISSN 1058-4838
    DOI 10.1093/cid/ciz725
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  9. Article ; Online: Baveno VII criteria for recompensation predict transplant-free survival in patients with hepatitis B-related decompensated cirrhosis.

    Hui, Vicki Wing-Ki / Wong, Grace Lai-Hung / Wong, Vincent Wai-Sun / Chan, Henry Lik-Yuen / Lai, Jimmy Che-To / Tse, Yee-Kit / Lai, Mandy Sze-Man / Yam, Tsz-Fai / Li, Dongrong / Fan, XiaoDan / Yip, Terry Cheuk-Fung

    JHEP reports : innovation in hepatology

    2023  Volume 5, Issue 9, Page(s) 100814

    Abstract: Background & aims: The latest Baveno VII consensus has provided guidance for identifying patients who have truly recompensated from those with hepatic decompensation. This study aimed to evaluate patients' transplant-free survival in three different ... ...

    Abstract Background & aims: The latest Baveno VII consensus has provided guidance for identifying patients who have truly recompensated from those with hepatic decompensation. This study aimed to evaluate patients' transplant-free survival in three different stages of cirrhosis.
    Methods: All patients with chronic HBV infection and liver cirrhosis treated with oral nucleos(t)ide analogues from March 2006 to December 2022 were identified from a territory-wide database in Hong Kong. Patients with follow-up duration of <1 year were excluded. Participants were classified into three mutually exclusive groups: (1) no decompensated events (
    Results: A total of 4,701 patients with cirrhosis and HBV who were treated with entecavir, tenofovir disoproxil fumarate (TDF), and tenofovir alafenamide fumarate (TAF) were identified. During a median follow-up of 5 years (interquartile range 3.7, 5 years), 3,327 (70.8%), 1,347 (29.2%), and 265 (5.6%) patients had compensated, decompensated, and recompensated cirrhosis, respectively, at least once before the end of the study. In the time-dependent multivariable model, the recompensated group had similar transplant-free survival compared with the compensated group (adjusted hazard ratio 1.16; 95% CI 0.72-1.86;
    Conclusions: The clinical significance of recompensation of cirrhosis in improving patient outcomes for individuals with CHB infection was highlighted in this study. Early identification and treatment with nucleos(t)ide analogues might promote hepatic recompensation and thus reduce mortality in patients with CHB.
    Impact and implications: The latest Baveno VII consensus introduces the new concept of hepatic recompensation, which refers to the reversal of the structural and functional changes of cirrhosis after removal, cure, or suppression of the aetiology of cirrhosis. It is essential to investigate the transplant-free survival rates of patients who are able to achieve hepatic recompensation, as this has significant implications for the medical resources required to manage liver failure and transplantation. This study features the clinical significance of hepatic recompensation by comparing patient outcomes of those who achieve it to those who do not. The early identification and use of antiviral treatment with nucleos(t)ide analogues is a pivotal strategy to promote hepatic recompensation, which has the potential to significantly reduce mortality rates in patients with chronic HBV infection and ultimately aid in the elimination of hepatitis.
    Language English
    Publishing date 2023-06-14
    Publishing country Netherlands
    Document type Journal Article
    ISSN 2589-5559
    ISSN (online) 2589-5559
    DOI 10.1016/j.jhepr.2023.100814
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  10. Article ; Online: Diabetes Mellitus Impacts on the Performance of Hepatocellular Carcinoma Risk Scores in Chronic Hepatitis B Patients.

    Yip, Terry Cheuk-Fung / Wong, Vincent Wai-Sun / Lai, Mandy Sze-Man / Lai, Jimmy Che-To / Tse, Yee-Kit / Liang, Lilian Yan / Hui, Vicki Wing-Ki / Chan, Henry Lik-Yuen / Wong, Grace Lai-Hung

    Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association

    2023  Volume 21, Issue 11, Page(s) 2864–2875.e16

    Abstract: Background & aims: We examined whether changing clinical characteristics and presence of diabetes mellitus (DM) impact the performance of hepatocellular carcinoma (HCC) risk scores.: Methods: Adult patients with chronic hepatitis B (CHB) on ≥6 months ...

    Abstract Background & aims: We examined whether changing clinical characteristics and presence of diabetes mellitus (DM) impact the performance of hepatocellular carcinoma (HCC) risk scores.
    Methods: Adult patients with chronic hepatitis B (CHB) on ≥6 months of entecavir/tenofovir treatment between January 2005 and March 2020 were identified using a territory-wide electronic database in Hong Kong. DM was defined by antidiabetic agents, hemoglobin A1c ≥6.5%, fasting glucose ≥7 mmol/L, and/or diagnosis codes. PAGE-B, modified PAGE-B (mPAGE-B), and aMAP scores were assessed by area under the time-dependent receiver operating characteristic curves (AUROCs) and compared with CAMD and REAL-B scores with DM as a component.
    Results: Of 48,706 patients, 2792, 11,563, 15,471, and 18,880 started entecavir/tenofovir treatment between 2005-2008, 2009-2012, 2013-2016, and 2017-2020, respectively; DM prevalence rose from 15.5% in 2005-2008 to 24.3% in 2017-2020. AUROCs were comparable across the 4 periods in the 5 HCC risk scores (AUROCs ranged between 0.75 and 0.81). At a median follow-up of 4.4 years, 1512 non-diabetic (4.0%) and 645 (6.2%) diabetic patients developed HCC. AUROCs of all 5 scores were lower in diabetic patients than in non-diabetic patients (AUROCs ranged between 0.67-0.71 vs 0.78-0.82; all P < .001). REAL-B score achieved an AUROC of 0.71 in diabetic and 0.82 in non-diabetic patients. Both diabetic and non-diabetic patients in the low-risk group by REAL-B score had a low HCC incidence below the threshold of cost-effective HCC surveillance, ie, 0.2% annually.
    Conclusions: REAL-B score is accurate and preferred in entecavir/tenofovir-treated CHB patients because of the increasing prevalence of DM.
    MeSH term(s) Adult ; Humans ; Carcinoma, Hepatocellular/epidemiology ; Carcinoma, Hepatocellular/etiology ; Carcinoma, Hepatocellular/diagnosis ; Liver Neoplasms/epidemiology ; Liver Neoplasms/etiology ; Liver Neoplasms/diagnosis ; Antiviral Agents/therapeutic use ; Hepatitis B, Chronic/complications ; Hepatitis B, Chronic/drug therapy ; Hepatitis B, Chronic/diagnosis ; Tenofovir/therapeutic use ; Risk Factors ; Diabetes Mellitus/epidemiology
    Chemical Substances Antiviral Agents ; Tenofovir (99YXE507IL)
    Language English
    Publishing date 2023-02-22
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2119789-1
    ISSN 1542-7714 ; 1542-3565
    ISSN (online) 1542-7714
    ISSN 1542-3565
    DOI 10.1016/j.cgh.2023.02.004
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