Evaluation of the Role of Alpha-Fetoprotein (AFP) Levels in Chronic Viral Hepatitis C Patients, Without Hepatocellular Carcinoma (HCC)

Abstract

The World Health Organization (WHO) estimates that >185 million people worldwide or 2.8% of the human population have been infected with HCV; of these 130–170 million are chronically infected and 350,000 deaths occur each year as a result of HCV-related cirrhosis and liver cancer. The prevalence of HCV varies from 1.2% to 3.8% in different regions of the world (Cornberg et al., 2011). Alpha-fetoprotein (AFP) is a foetal glycoprotein which has been widely used as a serum marker for diagnosing hepatocellular carcinoma (HCC); however, elevated serum AFP levels have also been documented in non-HCC patients with chronic liver disease (Chen et al., 2007). To fulfill the aim of the work, this study was ddeessiiggnneedd ttoo evaluate the clinical significance of Alpha-Fetoprotein (AFP) levels in chronic hepatitis C patients without hepatocellular carcinoma (HCC) in Egypt. This study was conducted through collaboration between Tropical Medicine Department, Ain Shams University and Sohag Cardiology and Hepato-Gastroenterology Center, Ministry of Health, in the period from January 2010 to January 2013. The patients enrolled in our study were selected from Tropical Medicine Clinic of Ain-Shams University Hospital "EL-Demerdash" and from the Interferon Unit - before Summary 129 treatment - of Sohag Cardiology and Hepato- Gastroenterology Center, Ministry of Health. We operated our study on selected 70 patients of chronic liver disease with proven chronic hepatitis C virus infection by history taking, clinical manifestations and positive laboratory investigations for chronic HCV infection to fulfill the predesigned inclusion criteria. All patients were subjected to the following; careful history, thorough clinical examination and laboratory investigations [liver enzymes (AST and ALT), serum albumin, INR, total and direct bilirubin, complete blood picture and viral markers (HCV-Ab, HBs-Ag and quantitative PCR for HCVRNA). Abdominal ultrasound and histopathological examination of ultrasound guided liver biopsy were done for all cases. Our study included 90 subjects, divided into two groups: Control Group: includes (20) healthy individuals, and study Group: includes (70) patients with chronic hepatitis C (CHC) without evidence of hepatocellular carcinoma (HCC). The two groups were well-matched regarding age, gender and BMI. The gender distribution of the studied group; males were 58 patients (82.9 %) while females were 12 patients (17.1%). The current study reveals that AFP levels were very much higher in HCV cases compared to controls. Summary 130