Clinical significance of elevated alpha-fetoprotein (AFP) in patients with chronic hepatitis C, but not hepatocellular carcinoma

Am J Gastroenterol. 2004 May;99(5):860-5. doi: 10.1111/j.1572-0241.2004.04152.x.

Abstract

Background: Although elevated serum alpha-fetoprotein (AFP) is often seen in patients with chronic hepatitis C (CHC), its prevalence, risk factors, and clinical significance remain to be determined.

Aims: The present study assessed the frequency of, the risk factors for, and the clinical significance of elevated AFP in patients with CHC, but not hepatocellular carcinoma.

Methods: This retrospective study utilized systematic chart review and statistical analyses to investigate 357 U.S. patients with CHC from a university medical center and a regional veteran administration medical center.

Results: The prevalence of elevated serum AFP (i.e., >/=10.0 microg/L) was 23.0%, including 15.3% (28/183), 24.5% (25/102), and 42.0% (29/69) in patients with chronic hepatitis C and stage 0-II, III, and IV hepatic fibrosis, respectively. After adjusting for age, HCV load, and hepatic steatosis, stage III/IV fibrosis, elevated aspartate aminotransferase (AST), and prolonged prothrombin time as measured by international normalized ratio (INR) remained independently associated with elevated serum AFP in these patients. A serum AFP level of 15.0 microg/L was 22.8% sensitive and 94.5% specific for stage III/IV fibrosis.

Conclusions: In patients with chronic hepatitis C, 23.0% had elevated serum AFP that is independently associated with stage III/IV hepatic fibrosis, elevated level of AST, and prolonged INR.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Analysis of Variance
  • Biomarkers / blood
  • Carcinoma, Hepatocellular / blood*
  • Carcinoma, Hepatocellular / diagnosis
  • Carcinoma, Hepatocellular / epidemiology
  • Cohort Studies
  • Female
  • Hepatitis C, Chronic / blood*
  • Hepatitis C, Chronic / diagnosis
  • Hepatitis C, Chronic / epidemiology
  • Humans
  • Liver Neoplasms / blood*
  • Liver Neoplasms / diagnosis
  • Liver Neoplasms / epidemiology
  • Male
  • Middle Aged
  • Prevalence
  • Probability
  • Prognosis
  • ROC Curve
  • Retrospective Studies
  • Risk Assessment
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Statistics, Nonparametric
  • alpha-Fetoproteins / analysis
  • alpha-Fetoproteins / metabolism*

Substances

  • Biomarkers
  • alpha-Fetoproteins