John Carl Hoefs

picture of John Carl Hoefs

Professor Emeritus - Gastroenterology, Medicine
School of Medicine

M.D., George Washington University

Phone: (949) 9873051
Fax: (714) 4567753

University of California, Irvine
University of California Irvine Medical Center
City Tower 400 Rm 810
333 Manchester
Mail Code: 4092
Orange, CA 92668
Research Interests
Hepatitis B, Hepatitis C, Ascites, Chronic liver disease, Liver-spleen scan, Hepatic function
Research Abstract
Dr. Hoefs is an expert in the evaluation of chronic liver disease (CLD), any problem related to ascites, and the treatment of hepatitis B and C. The recent focus of Dr. Hoefs' clinical investigations is to find the best, noninvasive way to assess hepatic structure and function. He is conducting an evaluation of the characteristics of the liver in pathologic states (most recently using quantitative morphometric analysis of fibrosis on liver biopsy) and an evaluation of the quantitative liver-spleen scan (QLSS) using single photon emission computerized tomography (SPECT) analysis as a means of measuring hepatic function. The QLSS appears to be the best non-invasive method of evaluating liver disease and this has been confirmed in a prospective NIH study. The full value of this test is still under investigation. Dr. Hoefs is also devising models of portal metabolism in patients with chronic liver disease and is exploring noninvasive ways of assessing this hemodynamic condition. Dr. Hoefs' additional studies concern ascites, both related and unrelated to chronic liver disease. He proposed the presently used method of evaluating patients with ascites using the serum to ascites albumin gradient (SAAG). First proposed in 1983, this has become the standard throughout the world. He continues to study the mechanisms of ascites formation to improve the life of patients with difficult to treat ascites. He is interested in ascites infections such as spontaneous bacterial peritonitis. Dr. Hoefs basic research describing oncotic-hydrostatic balance between serum and extra-cellular compartments led to the development of the SAAG. Finally, Dr. Hoefs has extensive on-going experience in the treatment of hepatitis B and C, being involved in many of the key research studies in this area over the last 16 years. He was awarded the NIH sponsored HALT-C trial for UCI in 1999 for the maintenance treatment of non-responders with hepatitis C and continues to analyze data and publish the results.
Lok AS, Sterling RK, Everhart JE, Wright EC, Hoefs JC, Di Bisceglie AM, Morgan TR, Kim H, Lee WM, Bonkovsky HL, Dienstag JL, and the HALT-C Trial Group Des-gamma-carboxy Prothrombin and Alpha fetoprotein as Biomarkers for the Early Detection of Hepatocellular Carcinoma Gastroenterology 2010 Feb; 138: 493-502.
Everhart JE, Wright EC, Goodman ZD, Dienstag JL, Hoefs JC, Kleiner DE, Ghany MG, Prognostic Value of Ishak Fibrosis Stage: Findings from the HALT-C Trial Hepatology. 2010 Dec;51(2):585-94
Everson GT, Shiffman ML, Morgan TR, Hoefs JC, Sterling RK, Wagner DA, Kugelmas M, Doherty MC, Wright EC, and the HALT-C Trial Group The Spectrum of Hepatic Functional Impairment in Patients with Fibrosis and Compensated Cirrhosis Due to Chronic Hepatitis C: Results from the HALT-C Trial. Alimentary Pharmacology & Therapeutics 2008; 27(9):798-809.
Hoefs JC, Wang F, Kanel G: Functional Measurement of the Non-Fibrotic Hepatic Mass in Cirrhotic Patients. Am J of Gastroenterol 1997;92:2054-2058.
Freedman ND, Everhart JE, Lindsay KL, Ghany MG, Curto TM, Shiffman ML, Lee WM, Lok AS, Di Bisceglie AM, Bonkovsky HL, Hoefs JC, Dienstag JL, Morishima C, Abnet CC, Sinha R, HALT-C Trial Group. Coffee Intake is Associated with Lower Rates of Liver Disease Progression in Chronic Hepatitis C. Hepatology. 2009 Nov;50(5):1360-9. Comment in Hepatology. 2009 Nov;50(5):1673, author reply 1673.
Hoefs JC, Morgan TR. 72 weeks of treatment for patients with partial EVR? (editorial). Hepatology 2007; 46:1671-4.
Hoefs JC, Sheikh M, Guererro HJ Milne N: Factors affecting the quantitative liver spleen scan in normal individuals. Digestive Diseases and Sciences 2005; 50:283-9
Hoefs J, Aulakh VS. Treatment of chronic HCV infection in special populations. Int J Med Sci. 2006;3 (2):69-74.
Hoefs JC, Wang FW, Walker B, Kanel G. A novel, simple method of functional spleen volume calculation by liver-spleen scan. J Nuc Med. 1999;40:1745-55.
Hoefs JC, Chen PT, Lizotte P. Non-invasive Evaluation of Liver disease Severity. Clin of Liver Dis Dec 2006; 10: 535-562.
Wong F, Bernardi M, Balk R, Christman B, Moreau R, Garcia-Tsao G, Patch D, Soriano G, Hoefs J, Navasa M. Sepsis in Cirrhosis - Report on the 7th Meeting of the International Ascites Club. Gut 2005: 54(5):718-25.
Everson GT, Hoefs JC, Seeff LB, Bonkovsky HL, Naishadham D, Shiffman ML, Kahn JA, Lok AS, Di Bisceglie AM, Lee WM, Dienstag JL, Ghany MG, Morishima C. Impact of disease severity on outcome of antiviral therapy for chronic hepatitis C: Lessons from the HALT-C trial. Hepatology. 2006 Dec;44 (6):1675-84.
Shiffman ML, Morishima C, Dienstag JL, Lindsay KL, Hoefs JC, Lee WM, Wright EC, Naishadham D, Everson GT, Lok AS, Di Bisceglie AM, Bonkovsky HL, Ghany MG, and the HALT-C Trial Group. Effect of HCV RNA Suppression During Peginterferon Alfa-2a Maintenance Therapy on Clinical Outcomes in the HALT-C Trial. Gastroenterology 2009 Dec; 137(6):1986-94. Epub 2009 Sep 10.
Lok AS, Everhart JE, Chung RT, Kim H-Y, Everson GT, Hoefs JC, Greenson JK, Sterling, RK, Lindsay KL, Lee WM, Di Bisceglie AM, Bonkovsky HL, Ghany MG, Morishima C, and the HALT-C Trial Group. Evolution of Hepatic Steatosis in Patients with Advanced Hepatitis C: Results from the Hepatitis C Antiviral Long-Term Treatment Against Cirrhosis (HALT-C) Trial. Hepatology. 2009 Jun;49(6):1828-37.
Everson GT, Shiffman, ML, Hoefs JC, Morgan TR, Sterling RK, Wagner DA, DeSanto JL, Curto TM, Wright EC, and the HALT-C Trial Group. Quantitative Tests of Liver Function Measure Hepatic Improvement after Sustained Virologic Response: Results from the HALT-C Trial. Aliment Pharmacol Ther. 2009 Mar; 29(5): 589-601.
Bonkovsky HL, Naishadham D, Lambrecht RW, Chung RT, Hoefs JC, Nash SR, Rogers TE, Banner BF, Sterling RK, Donovan JA, Fontana RJ, Di Bisceglie AM, Ghany MG, Morishima C; HALT-C Trial Group. Roles of iron and HFE mutations on severity and response to therapy during retreatment of advanced chronic hepatitis C. Gastroenterology. 2006;131(5):1440-51.
Zell J, Hoefs J, Ou S-H, Chang J, Yoon E. Precore mutant hepatitis B reactivation after treatment with CHOP-rituximab. Anti Cancer Drugs 2005; 16:83-5
Hoefs JC: UTP-Unit #33 Ascites. Undergraduate Teaching Project in Gastroenterology and Liver Disease. American Gastroenterological Association, February 1998
Hoefs JC, Runyon B: Spontaneous Bacterial Peritonitis. Disease-A-Month 31 (9):3-48, 1985
Davis GL, Esteban-Mur R, Rustgi V, Hoefs JC, et al and the International Hepatitis Interventional Therapy Group: Recombinant Interferon alfa-2b (Intron A) alone or in combination with ribavirin (rebetol) for retreatment of interferon relapse in chronic hepatitis C. NEJM. 1998;339, 21: 1493-99.
Hoefs, J.C.: The hepatorenal syndrome. In: Haubrich, ed. Bockus Gastroenterology, 5th edition. Philadelphia: W.B. Saunders Co.
Hoefs JC: Globulin Correction of Albumin Gradient: Correlation with measured Serum to Ascites Colloid Osmotic Pressure Gradient. Hepatology,16:(2)396-403, 1992.
Hoefs, J.C.: Portal hypertension. In: Gitnick, G., ed. Principles and Practice of Gastroenterology and Hepatology. New York: Elsevier, 1993.
Chang KJ, Hoefs JC: Ascites and Encephalopathy. Current Opinion in Gastroenterology 8:398-402, 1992.
NIH Grant. RFP-NIH-NIDDK-98-4 Hepatitis C Clinical Trial (HALT-C Trial – 5th year) – Clinical Centers. Multi-institutional 8-year trial of patients non-responsive to current therapies evaluating the effect of long-term maintenance therapy on the natural history of chronic Hepatitis C observing for the appearance of decompensated liver disease, hepatocellular carcinoma and death; $1,595,530; April 1999-2010.
A Phase II, randomized, controlled trial of the safety and efficacy of S-adenosyl-L-methionine disulfate p-toluene sulfonate (SAMe) in reducing serum alpha-fetoprotein (AFP) in patients with hepatitis C cirrhosis and moderately elevated serum AFP National Cancer Institute, Division of Cancer Prevention UCI04-3-01 CO-PI Tim Morgan and John Hoefs 2007-2010 $ 1.1 million
Critical Disease Care Using Multiple Modality Mining NSF 08-548 John C. Hoefs, MD, Dipu Ghosh, MSEE, MBA. $ 99,235 Award Id : 0912926 Jul 1, 2009 - Dec 31, 2009
Professional Society
American Association for the Study of Liver Disease
Other Experience
NIH Fellow
USC Liver Unit 1978—1980

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