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Background: Serum hyaluronic acid has an important role in the pathogenesis of liver fibrosis and is one of the most studied extracellular liver matrices. The purpose of this study was to examine the relationship between serum hyaluronic acid level and liver stiffness in hepatitis B chronic patients. Methods: This was an observational cross-sectional analytic study consisting of 43 samples of chronic hepatitis B patients. Serum hyaluronic acid was measured by the ELISA method. Liver stiffness describing fibrosis was examined using Fibro scan. Results: Among forty-three subject was predominantly by females (65.1%). The average age of the study subjects was 44.023 years old. The median serum hyaluronic acid level of the study subjects was 40.318 ng/mL. The median liver stiffness in the study subjects was 5.8 kPa. There was a significant positive correlation between serum hyaluronic acid levels and liver stiffness in the study subjects with a moderate strength of r = 0.448 (P = 0.003). Conclusion: Serum hyaluronic acid levels associated with liver stiffness. [ABSTRACT FROM AUTHOR]

Introduction: Examination using Outer Membrane Protein as a marker of active Helicobacter pylori Current Infection Marker (CIM) infection has now been developed. However, the accuracy of CIM is still unknown. This study aimed to analyze the diagnostic value of serum serology using CIM compared to histopathological examination as the gold standard for diagnosing the presence of H. pylori infection in dyspepsia patients. Methods: This study involved fifty-two subjects with dyspepsia. Endoscopic, biopsy, and histopathological examination with modified-giemsa staining as gold standard and serological examination using immunochromatography method with CIM (AssureR, Singapore) had been done to all subjects of this study. Results: Pre-test probability of H. pylori infection was 17.3%. Most of subjects infected with H. pylori were male with average age of 53.89±7.75 years old. Most of endoscopic features of subjects infected with H. pylori were erosive gastritis. The sensitivity, specificity, positive predictive value, negative predictive value of CIM were 22.2%, 95.3%, 50%, and 85.4%, respectively. The positive likelihood ratio, negative likelihood ratio, and accuracy of CIM were 4.8, 0.8, and 82.7%, respectively. Conclusion: Serum serology using immunochromatography with CIM cannot replace histopathology for diagnosis of Helicobacter pylori current infection in dyspeptic patients. [ABSTRACT FROM AUTHOR]

Until now liver biopsy is still gold standard to asses liver fibrosis. Fibroscan within superiority and little limitation can be an alternative as non-invasive procedure to asses liver fibrosis. In this pioneer study among "various chronic liver disease patients at Dr Soetomo hospital resulted higher Fibroscan score of liver stiffness, whereas the highest score of liver stiffness revealed among respectively hepatoma, liver cirrhosis, chronic hepatitis C, chronic hepatitis B, and NAFLD. For future, It is important to enrollment similar study that involved bigger sample size to determine liver fibrosis among any various liver diseases and conjuncted to detect its clinical complication earlier. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 (COVID-19) is characterized by an acute respiratory infection with multisystem involvement and the association of its severity to liver function abnormalities is not well characterized. The aim of this study was to assess the association between the severity of COVID-19 patients and liver function abnormalities. This retrospective study included adult patients with confirmed COVID-19, which were classified as non-severe or severe according to World Health Organization guidelines. Liver function test results were compared between the severity groups. A total of 339 patients were included of which 150 (44.25%) were severe cases. The male-to-female ratio was 0.9:1 and 3:2 in the non-severe and severe groups, respectively ( p =0.031). Aspartate aminotransferase (AST), alanine transaminase (ALT), and total bilirubin levels and acute liver injury (ALI) incidence were significantly higher in the severe group compared to non-severe group ( p <0.001, p <0.001, p =0.025, p =0.014, respectively). In contrast, albumin levels were significantly lower ( p =0.001). Multivariate analysis showed that ALI was significantly associated with human immunodeficiency virus (HIV) infection (odds ratio (OR): 5.275; 95% confidence interval (CI): 1.165-23.890, p =0.031), hemoglobin level (OR: 1.214; 95%CI: 1.083-1.361, p =0.001), and hypoalbuminemia (OR: 2.627; 95%CI: 1.283-5.379, p =0.008). Pre-existing liver diseases were present in 6.5% of patients. No significant differences were observed between the groups based on COVID-19 severity and ALI presence. Liver function test abnormalities, including ALI, are more prevalent in patients with severe COVID-19 infection. HIV infection, high hemoglobin levels, and hypoalbuminemia may be potential risk factors for ALI., Competing Interests: All the authors declare that there are no conflicts of interest., (© 2024 The Author(s).)

Hepatitis B virus (HBV) infection is a major global health problem. It can cause chronic infection and put people at high risk of death from cirrhosis and liver cancer. This study aims to present a case of chronic hepatitis B flare in a very young adult patient. An 18-year-old previously healthy female presented with jaundice developing in one week, following the previous complaints of nausea, vomiting, abdominal pain, loss of appetite, and tiredness for about three months. The patient had no risk factors for getting HBV infection, but her HBsAg-positive mother was probably an inactive HBV carrier. The hepatitis B serological testing revealed HBsAg positivity, anti-HBs seronegativity, HBeAg positivity, anti-HBe seronegativity, anti-HBc IgM seronegativity, and high levels of HBV DNA detected > 1.70 × 108 IU/mL. There was a sharp increase in serum ALT to ≥ 5-fold ULN. The abdominal ultrasonography revealed a hepatitis feature, unremarkable portal venous flow, and an extrahepatic biliary system. The liver transient elastography revealed 15.6 kPa of liver stiffness, which was in accordance with the F3-F4 fibrosis stage. These features were typical of a hepatitis B flare, the HBeAg-positive chronic hepatitis B, previously known as the immune reactive phase. A long-term nucleos(t)ide analog therapy was programmed with Tenofovir alafenamide 25 mg daily.

Purpose: Histopathology method is often used as a gold standard diagnostic for Helicobacter pylori infection in Indonesia. However, it requires an endoscopic procedure which is limited in Indonesia. A non-invasive method, such as 14 C Urea Breath Test (UBT), is more favorable; however, this particular method has not been validated yet., Patients and Methods: A total of 55 dyspeptic patients underwent gastroscopy and 14 C-UBT test. We used Heliprobe ® UBT for UBT test. As for the histology, May-Giemsa staining of two gastric biopsies (from the antrum and corpus) were evaluated following the Updated Sydney System., Results: The Receiver Operating Characteristics analysis showed that the optimum cut-off value was 57 with excellence Area under Curve = 0.955 (95% CI = 0.861-1.000). By applying the optimum cut-off value, Heliprobe ® UBT showed 92.31% for sensitivity, 97.62% for specificity, 92.31% for positive predictive value, 97.62% for negative predictive value, 38.77 for positive likelihood ratio, 0.0788 for negative likelihood ratio, and 96.36% for the accuracy., Conclusion: The 14 C-UBT is an accurate test for H. pylori diagnosis with excellent sensitivity, specificity, and accuracy. The different optimum cut-off points suggested that a validation is absolutely necessary for new test prior application to the new population., Competing Interests: The authors report no conflicts of interest in this work., (© 2021 Miftahussurur et al.)