Signification of Serum Alpha-Fetoprotein Levels in Cases of Compensated Cirrhosis and Hepatitis C Virus without Hepatocellular Carcinoma
Authors: Manuc Daniela ,   Public Health Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania, Preda Carmen Monica ,   Gastroenterology and Hepatology Department, Fundeni Clinical Institute, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania,   Carmen Monica Preda Gastroenterology and Hepatology Department, Fundeni Clinical Institute, 258 Sos. Fundeni Bucharest 022328 Romania Phone: 0040723719900 E-mail: carmenmonica.preda@gmail.com, Sandra Irina ,   Gastroenterology and Hepatology Department, Fundeni Clinical Institute, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania, Baicus Cristian ,   Internal Medicine Department, Colentina Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania, Cerban Razvan ,   Gastroenterology and Hepatology Department, Fundeni Clinical Institute, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania, Constantinescu Ileana ,   Immunogenetics Department, Fundeni Clinical Institute, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania, Olteanu Andrei Ovidiu ,   Gastroenterology and Hepatology Department, Fundeni Clinical Institute, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania, Ciora Cosmin Alexandru ,   Gastroenterology and Hepatology Department, Fundeni Clinical Institute, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania, Manuc Teodora ,   Gastroenterology and Hepatology Department, Fundeni Clinical Institute, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania, Chiriac Daniela Elena ,   Gastroenterology and Hepatology Department, Fundeni Clinical Institute, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania, Chifulescu Andreea Elena ,   Gastroenterology and Hepatology Department, Fundeni Clinical Institute, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania, Diculescu Mircea ,   Gastroenterology and Hepatology Department, Fundeni Clinical Institute, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania, Tieranu Cristian ,   Gastroenterology and Hepatology Department, Elias Emergency Hospital, Bucharest, Romania, Negreanu Lucian ,   Gastroenterology and Hepatology Department, Emergency University Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania, Oprea-Calin Gabriela ,   Gastroenterology and Hepatology Department, Emergency University Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania, Manuc Mircea ,   Gastroenterology and Hepatology Department, Fundeni Clinical Institute, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Published: November 2022

AFP (alpha-fetoprotein) levels are increased during the development of HCC (hepatocellular carcinoma); nonetheless, it can also be produced by non-tumoral hepatocytes in conditions of high cell turnover. Our study aims to provide additional data regarding the causes of elevated AFP in patients with liver cirrhosis due to hepatitis C virus (HCV) infection.

We conducted an observational prospective cohort study that included 2068 patients with compensated cirrhosis and chronic hepatitis C genotype 1b infection. The two main inclusion criteria were the presence of advanced liver fibrosis - Metavir stage F4 - diagnosed by FibroMax testing, Fibroscan or liver biopsy, and the presence of detectable HCV RNA in the serum. Plasmatic AFP levels were determined through the electrochemiluminescence method, with a standard value ranging from 0 to 7 ng/ml. All data were obtained from the Romanian National Health Agency.

The average AFP serum levels in patients with compensated cirrhosis without HCC were 9.4 ng/ml (range 0.5 � 406 ng/ml); 30.1% of patients had significantly increased levels of AFP (>15 ng/ml). High values of serum AFP in patients with compensated liver cirrhosis without HCC was correlated with more advanced age (p<0.001), severe necroinflammatory activity detected by FibroMax (p<0.001), severe NASH (p<0.001), severe steatosis (p<0.001), low platelets (p<0.001), increased values of AST and ALT (p<0.001).