The Relationship between Alphafetoprotein and Aetiological Factors in Patients with Hepatocellular Carcinoma in Nnewi

Background : Hepatitis B virus(HBV) is unarguably the major cause of hepatocellular carcinoma (HCC) in Nigeria. Other aetiologies including Hepatitis C virus(HCV) and aflatoxin have been reported to be of less significance. This study was aimed at determining the relationship between alpha-fetoprotein (AFP) and viral/aflatoxin aetiologies in HCC. Methods: Sixty consecutive patients with HCC seen at the Nnamdi Azikiwe University Teaching Hospital, Nnewi and 60 patients with non-hepatic diseases who were age and sex matched to the index patients and used as controls were investigated for the presence of AFP, HBsAg, anti-HCV, and aflatoxin(AFB). Results: Of the 60 cases of HCC analyzed, there were 38 males and 22 females. The AFP concentration in patients with HCC ranged from 4-934ng/ml with a mean of 451.57±265.1ng/ml and that in the controls was 3-477ng/ml with a mean of 83.43±129.33ng/ml. The difference was statistically significant (p=0.000). Diagnostic AFP concentration e”400ng/ml was seen in 38 (63%) of the patients with HCC and in 3(5%) of controls (P=0.000). Amongst those with HCC, AFP concentration e”400ng/ml was found in100% of patients who were positive for both HBsAg and anti- HCV, 86% of patients who were HBsAg positive, 80% of those who were anti-HCV positive and 89% of those who had significant aflatoxin levels. However, only HBsAg showed a statistically significant correlation with diagnostic serum AFP levels (p=0.005). Conclusion: We conclude that in patients with HCC in Nnewi, high values of AFP correlate positively with viral aetiology especially HBV.