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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.

Excessive release of interleukin-6 (IL-6) during the progression of coronavirus disease 2019 (COVID-19) induces cytokine storms, resulting in multi-organ damages including liver injury, similar in nature with mechanism of viral hepatitis. Systemic IL-6 has been associated with the incidence of liver injury among COVID-19 patients; however, studies on IL-6 expression in the liver tissue are completely lacking. The aim of this study was to measure the IL-6 expression in the liver tissues and to determine its correlation with the degree of liver injury in fatal COVID-19 patients. Through this first cross-sectional study, IL-6 expression was measured through immunohistochemical staining and the degree of liver injury was identified based on level of serum alanine aminotransferase (ALT). The Spearman correlation test was used to identify the correlation between IL-6 expression and the degree of liver injury. A total of 47 deceased COVID-19 patients were included and IL-6 expression was observed in all post-mortem liver specimens, ranging from mild to strong expression. Liver injury at various degrees (mild to severe) was found in more than half (59.5%) of the cases. The Spearman correlation analysis suggested a statistically insignificant correlation between liver IL-6 expression and the degree of liver injury (r=0.152; p=0.309). In conclusion, even IL-6 expression was observed in all post-mortem liver specimens, there was an insignificant correlation between IL-6 expression in the liver tissue with the degree of liver injury among fatal COVID-19 patients, suggesting that IL-6 was not the only main factor contributing to liver damage in COVID-19 patients.

Hepatocellular carcinoma (HCC) is a primary malignant tumor of the liver, where 90% of cases of primary liver tumors are caused by this tumor. About 85% of HCC tumor cases also have cirrhosis of the liver. Currently, HCC is the fifth most malignant tumor in the world. Other than that, San HCC's survival is scanty. A patient at Dr. Soetomo complained of an enlarged stomach 5 months ago. The patient was first diagnosed with Hepatitis C 3 months ago but has not been treated for hepatitis C. The patient underwent several examinations in January, March and May 2022. Supportive testing of normal AFP and anti-HCV levels was performed with a positive result for HCV RNA >11.00. When considering liver function tests to assess liver disease severity using the CTP score, the score is 7 (CTP B). X-ray examination, CT scan and tumor size 11.2 x 6.7 cm were obtained, fed from the right a. hepatica, and there was no thrombosis in v. porta/hepatica. In these patients, there was no arterial enhancement, venous phase washout, and pseudocysts. The liver tumor of the aorta to the aorta, the largest size 7.3 x 11.3 x 15.9 cm, is equal to VTh11-VL3. The link expands to ±6.8 inches. Since the AFP test was normal and the CT scan did not show these results, this patient will be followed up with a biopsy. The biopsy method was performed with FNAB considering the safety of the procedure and the patient profile. Atypical FNAB results but favorable histochemistry for HCC, where CK, glypican-3, and AFP are positive. Based on the results of the examination, it was stated that the patient had Hepatoocellular Carcinoma (HCC) accompanied by cirrhosis of the liver due to chronic hepatitis C infection.

Pegylated Interferon (Peg-INF) therapy which has various side effects and is relatively severe. The side effects that occur in each individual are different, some patients treated with Peg-INF have experienced mild to severe side effects. Evaluation The side effects of Peg-INF on chronic hepatitis B and / or C have not been widely reported. Thus, I will conduct research on the side effects of Peg-INF therapy in chronic hepatitis B and / or C patients by combining two or more research results that can be combined to obtain new quantitative data. The purpose of this study was to determine the side effects of Peg-INF treatment in chronic hepatitis B and C patients.  This research uses the Systematic Review method. With the keyword "Efek Samping Pegylated Interferon"; "Pegylated Interferon successful treatment"; Pegylated Interferon Hepatitis in Asia”. As a result total of 19 journal articles were obtained and the side effects of Peg-INF were hematological, systemic, psychiatric, autoimmune and hearing function side effects.

Muhammad Miftahussurur,1,2 Adinta Windia,1 Ari Fahrial Syam,3 Iswan Abbas Nusi,1 Ricky Indra Alfaray,2,4 Kartika Afrida Fauzia,2,4 Hartono Kahar,5 Herry Purbayu,1 Titong Sugihartono,1 Poernomo Boedi Setiawan,1 Ummi Maimunah,1 Ulfa Kholili,1 Husin Thamrin,1 Amie Vidyani,1 Dalla Doohan,2 Langgeng Agung Waskito,2 Yudith Annisa Ayu Rezkitha,2,6 Gontar Alamsyah Siregar,7 Yoshio Yamaoka1,4 1Gastroentero-Hepatology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, 60286, Indonesia; 2Institute of Tropical Disease, Universitas Airlangga, Surabaya, East Java, 60115, Indonesia; 3Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Jakarta, 10430, Indonesia; 4Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Yufu, 879-5593, Japan; 5Department of Clinical Pathology, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, 60286, Indonesia; 6Faculty of Medicine, University of Muhammadiyah Surabaya, Surabaya, East Java, 60113, Indonesia; 7Division of Gastroentero-Hepatology, Department of Internal Medicine, Faculty of Medicine, University of Sumatra Utara, Medan, 20155, IndonesiaCorrespondence: Muhammad MiftahussururGastroentero-Hepatology Division, Department of Internal Medicine, Faculty of Medicine, Dr. Soetomo Teaching Hospital, Universitas Airlangga, Jalan Mayjend Prof. Dr. Moestopo No. 6– 8, Surabaya, 60286, IndonesiaTel/Fax +6231-502-3865Email muhammad-m@fk.unair.ac.idPurpose: 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 14C 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 14C-UBT test. We used Helipr