Analysis of serum α‐fetoprotein concentration in patients with viral hepatitis

OBJECTIVE: To investigate serum α‐fetoprotein (AFP) concentrations in patients with viral hepatitis. METHODS: Serum concentrations of total bilirubin (TB), alanine aminotransferase (ALT), aspartate amino­transferase (AST), albumin, globulin, AFP and viral markers were determined in 310 patients with pathologically proven viral hepatitis. The relation between the concentration of AFP and clinical manifestation, pathology, family history of liver malignant disease and virus type was studied. RESULTS: Serum AFP concentrations were elevated in 115 of the 310 patients (37.1%). According to the pathological diagnosis, the lowest positive rate of AFP was in acute hepatitis (11.7%), the highest was in chronic severe hepatitis (66.7%), the second highest in liver cirrhosis (57.5%), and chronic hepatitis was intermediate (34.2%). If the diagnosis was based on the clinical manifestation, the highest positive rate was found in chronic severe hepatitis, the lowest in chronic hepatitis, and acute hepatitis was intermediate. The positive rate of serum AFP by virus type was 35.5% for hepatitis B (HBV), superinfected with HAV or with HEV was 62.8%, and with HCV was 27.3%. Only one in six patients with HCV infection and none with simple HAV or HEV infection were positive for AFP. In patients with a family history of liver cancer, the positive rate of AFP was higher than in those without such a history (57.9%vs38.2%;P = 0.75). CONCLUSIONS: The results indicate that AFP positivity is not uncommon in patients with viral hepatitis and if the patient has an elevated concentration, it is highly likely to be HBV infection or HBV super­infected with HAV or HEV.