Introduction: Hepatocellular carcinoma (HCC) remains a molecularly heterogeneous malignancy with limited therapeutic biomarkers. While transcriptomic studies have identified dysregulated genes, their prognostic relevance, proteomic concordance, and interactions with hepatitis B virus (HBV) mutations remain underexplored. Methods: We integrated multi-omics analyses of two independent HCC cohorts (GEO datasets), proteomic profiling, survival data, HBV mutation associations, immune cell infiltration, drug sensitivity (GDSC), and genomic alteration patterns to define drivers of HCC progression. Results: We identified 23 genes, including AURKA, CDK1, MKI67, linked to poor survival and genomic instability, and three protective genes (PLVAP, GSTA4, GREB1). HBV mutations (PreS, A1762T/G1764A) correlated with elevated expression of proliferative (TOP2A, RRM2) and metabolic (SQLE) genes, particularly in genotype C HCC. Despite minimal pathological stage variation, tumors exhibited robust cell cycle/EMT pathway activation (ASPM, CCNB1), highlighting molecular heterogeneity. Proliferative genes paradoxically associated with regulatory immune subsets (B cells, nTregs) and immunosuppression. Drug sensitivity analysis revealed ASPM and STMN1 as therapeutic vulnerabilities, while SPP1 and PRKAA2 marked resistance. Genomic profiling confirmed frequent mutations/CNAs in poor-prognosis genes (MKI67, CDKN2A) and stability in protective genes. Conclusion: This study establishes a multi-omics framework linking HBV-driven oncogenesis, genomic instability, and immune evasion to HCC progression. Prognostic signatures and pathway activation patterns advocate for molecular subtyping to complement clinical staging. The dual association of proliferative genes with immune suppression and drug sensitivity highlights opportunities for combinatorial therapies targeting oncogenic drivers (CDK1, ASPM) and immune checkpoints. These findings advance precision oncology strategies in HBV-associated HCC.
Introduction: Examining erythrocyte, leukocyte, and platelet indices is critical for diagnosis, disease management, therapy selection, and monitoring. It is imperative to evaluate the hematology analyzer used for a complete blood examination, as each device possesses distinct specifications, methods, and technologies. This study aimed to compare complete blood count parameters, specifically the erythrocyte, leukocyte, and platelet indices, using Sysmex XN-3000 and Yumizen H2500. Methods: This cross-sectional study used blood samples from adult outpatients aged >18 years at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. Samples were collected using purposive sampling, resulting in 100 blood specimens for complete blood count analysis. The examined variables included erythrocyte, leukocyte, and platelet indices, which were compared across two different instruments, i.e., Sysmex XN-3000 and Yumizen H2500. The data were analyzed using either the Spearman or Pearson correlation test (p<0.05). The Bland-Altman plotting was employed to assess the differences between variables, with a minimum of five agreed-upon outliers. Results: Significant correlations were observed across all parameters, except for the mean corpuscular hemoglobin concentration (MCHC), which showed limited agreement in the Bland-Altman analysis. The Pearson and Spearman analyses revealed a significant correlation in the parameters of erythrocytes (0.00), leukocytes (0.00), and platelets (0.00). The Bland-Altman plot indicated seven outliers in the average MCHC values from the two analyzers, demonstrating insufficient agreement. Conclusion: There is significant agreement and correlation in the erythrocyte, leukocyte, and platelet indices from both analyzers. This finding affirms the compatibility of both instruments for clinical use, with caution advised when interpreting MCHC values. Highlights: This study evaluated the validity of different hematology analyzers for complete blood count examinations in medical laboratories, a topic that has rarely been discussed in detail. The results of this study are expected to contribute to the quality improvement of medical laboratory technologies in Indonesia.
Soil-transmitted helminths (STHs) are significant pathogens affecting approximately 1.5 billion people globally, with the highest prevalence in sub-Saharan Africa, South America, and Asia. This study examined the effectiveness of albendazole, a widely used anthelminthic drug, in treating STH infections, particularly focusing on its potential resistance. Despite its effectiveness in many cases, recent studies have indicated a concerning trend of reduced efficacy, particularly against species such as Trichuris trichiura. This study reviewed literature from the past decade, identifying key studies that demonstrate a decline in albendazole’s effectiveness across various populations, including school-aged children in multiple regions. The findings proposed that while albendazole remains the primary treatment option, its effectiveness varies significantly based on geographic and demographic factors, raising concerns about the emergence of drug resistance. This study emphasizes the need for ongoing monitoring and potential pharmacological combinations to enhance treatment efficacy and address the threat of resistance. Ultimately, the research highlights the complexity of managing STH infections and the necessity for tailored intervention strategies. Highlights: 1. Although albendazole is a commonly used medication for soil-transmitted helminths (STHs), its efficacy seems to be waning, thereby requiring additional research to analyze potential resistance. 2. Many studies have pointed out a decreased efficacy of albendazole, despite none having verified resistance, indicating that the medication remains efficacious in specific groups, geographical areas, and dosage regimens where STH infections are prevalent.
Introduction: The human immunodeficiency virus (HIV) compromises the immune system, making the monitoring of cluster of differentiation (CD4) counts and viral loads critical for assessing disease progression and opportunistic infection risks. Eye-related manifestations, such as uveitis, are common among HIV patients. The purpose of this study was to investigate the differences in CD4 count and viral load between HIV patients with infectious posterior uveitis and those without at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. Methods: A retrospective study with an analytical observational design was conducted using the medical records of 75 HIV patients. The examined variables included CD4 count and viral load as independent variables, alongside the incidence and absence of infectious posterior uveitis as dependent variables. The inclusion criteria were HIV patients with regular follow-ups, thereby excluding those with irregular follow-ups. The analysis used the Mann-Whitney test, with p<0.05 indicating a statistically significant difference. Results: All 75 samples met the inclusion criteria for analysis. The majority of the patients were male (64%) and within the age range of 31 to 40 years (44%). Patients with infectious posterior uveitis had significantly lower CD4 counts (p<0.05) compared to those without the disease. However, no significant differences in viral loads (p>0.05) were observed between patients with posterior uveitis and those without. Conclusion: CD4 counts differ significantly between patients with infectious posterior uveitis and those without, while viral loads show no considerable differences. Highlights: This study highlights the differences in cluster of differentiation (CD4) lymphocyte count and viral load between HIV patients with infectious posterior uveitis and those without. The findings may provide new insights into the immunological mechanisms underlying infectious posterior uveitis in persons living with HIV. This work contributes to determining the factors that affect the development of infectious posterior uveitis and explores the potential use of CD4 lymphocyte count and viral load as biomarkers for the diagnosis and management of the disease.
Tuberculosis remains a major global health concern, with a sharp increase in new cases in 2022, exceeding the prevalence before the coronavirus disease 2019 (COVID-19) pandemic. Conventional antituberculosis therapy, comprising a combination of first-line medications, is essential for controlling tuberculosis. However, more than 7% of patients undergoing treatment may develop drug-induced liver injury (DILI), mainly from isoniazid and rifampicin. This literature review aimed to evaluate DILI in tuberculosis, focusing on its causes, diagnosis, and management. Several factors, including age, sex, genetic predisposition, and pre-existing liver conditions, affect the occurrence of antituberculosis DILI. Advanced age and being female are significant risk factors for severe liver injury. Diagnosing DILI requires careful differentiation from other hepatic disorders, as its clinical presentation may include symptoms such as jaundice, abdominal pain, and elevated liver enzyme levels. Early detection relies heavily on liver function tests and clinical assessments. Managing DILI involves promptly discontinuing the offending drug, closely monitoring the patient, and gradually reintroducing medications, prioritizing less hepatotoxic options, such as rifampicin. Hepatoprotective agents and alternative drug regimens, particularly those excluding pyrazinamide, may be used to mitigate the risk of liver injury. The rise in tuberculosis cases in 2022 underscores the ongoing global burden of this disease and the critical need for effective treatment strategies. Tailored therapeutic approaches, comprehensive liver function monitoring, and early identification of DILI are vital for minimizing hepatotoxicity while ensuring successful tuberculosis management. Although hepatoprotective drugs and alternative regimens show promise, further research is necessary to optimize their application across diverse patient populations. Highlights: 1. This article presents a thorough evaluation of antituberculosis drug-induced liver injury, particularly concerning its causes, diagnosis, and management, highlighting the importance of a meticulous differentiation from other liver disorders through a comprehensive assessment of clinical indicators. 2. The literature review included studies utilizing advanced diagnostic tools for precise causality determination as well as innovative approaches, such as the selective omission of pyrazinamide or the integration of non-standard treatment protocols, which offer promising avenues to mitigate hepatotoxicity risk. 3. This literature review suggests that hepatoprotective agents, such as N-acetylcysteine, may have advantages due to their notable efficacy in preserving liver function, offering a proactive strategy for patient safety.
