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Elevated alpha fetoprotein, no hepatocellular carcinoma.

Mallikarjun Patil1, Keyur A Sheth2, Channagiri K Adarsh2

  • 1Department of Gastroenterology, St. John's Medical College, Bengaluru 560034, Karnataka, India.

Journal of Clinical and Experimental Hepatology
|March 11, 2015
PubMed
Summary

High alpha fetoprotein levels in chronic hepatitis B patients can indicate hepatic inflammation, not necessarily cancer. Antiviral therapy can reduce these elevated levels, suggesting a link to viral replication.

Keywords:
AFP, alpha fetoproteinALP, alkaline phosphataseALT, alanine aminotransferaseANA, antinuclear antibodyASMA, anti-smooth muscle antibodyAST, aspartate aminotransferaseGGT, gamma glutamyl transferaseHBeAg, hepatitis B virus e antigenHCC, hepatocellular carcinomaLCA, lens culinaris agglutininalpha fetoprotein (AFP)anti-LKM-1, anti-liver kidney microsomal antibodyhepatitis B infectionhepatocellular carcinoma (HCC)

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Area of Science:

  • Hepatology
  • Biochemistry

Background:

  • Alpha fetoprotein (AFP) is a glycoprotein typically found at high levels in fetuses, decreasing rapidly after birth.
  • Elevated AFP levels are often associated with hepatocellular carcinoma (HCC), but can also be seen in chronic liver diseases like viral hepatitis.
  • Chronic hepatitis B infection is a significant risk factor for liver disease progression.

Purpose of the Study:

  • To investigate the cause of significantly elevated alpha fetoprotein levels in a patient with chronic hepatitis B.
  • To determine if elevated AFP levels in this context are indicative of hepatocellular carcinoma or other hepatic conditions.
  • To assess the impact of antiviral therapy on alpha fetoprotein levels in chronic hepatitis B.

Main Methods:

  • Case presentation of a 35-year-old male with jaundice and known chronic hepatitis B.
  • Monitoring of alpha fetoprotein levels.
  • Assessment for evidence of hepatocellular carcinoma.
  • Initiation and monitoring of antiviral therapy.

Main Results:

  • The patient presented with jaundice and a high AFP level (740.9 ng/ml).
  • Despite elevated AFP, there was no evidence of hepatocellular carcinoma.
  • AFP levels decreased following the initiation of antiviral therapy.

Conclusions:

  • Significantly elevated alpha fetoprotein levels in chronic hepatitis B can be attributed to hepatic inflammation and viral replication, rather than solely indicating hepatocellular carcinoma.
  • Antiviral therapy may lead to a reduction in AFP levels in such cases.
  • This case highlights the importance of considering inflammatory and viral factors in AFP elevation in chronic hepatitis B patients.