Evaluation of Serum Alpha-Fetoprotein Level in Chronic Hepatitis C Patients

Hepatitis C virus (HCV) infection represents an important risk factor for hepatocellular carcinoma (HCC). Alpha-fetoprotein (AFP) is a widely used biomarker for HCC. However, elevated serum AFP levels in different statuses of chronic hepatitis C (CHC) is not well defined. This study aimed to evaluate the relationship between AFP levels and HCV viral load in CHC patients. We also analyzed the correlation between three liver func-tion enzyme levels (AST, ALT, GGT) and HCV RNA viral load in CHC patients.

A total of 279 patients infected with HCV were included in this study. Patients were divided into two groups: HCV RNA positive and HCV RNA negative group. Serum HCV RNA load was measured by Quantitative Real-time PCR. Electrochemiluminescence assay (ECLA) was used to determine the serum AFP levels. The differences between two groups in AFP levels and biochemical profile (AST, ALT, GGT) was evaluated.

The HCV RNA-positive group had significantly higher serum AFP levels than the negative groups (12.61 vs. 4.72 ng/mL, p < 0.0001). There was no correlation between AFP levels and HCV RNA viral load in HCV infection patients (p = 0.92). A significant correlation was observed between serum ALT (r = 0.243, p = 0.005), GGT (r = 0.212, p = 0.016) levels and HCV RNA viral load. Poor correlation (r = 0.148, p = 0.093) was found between AST levels and HCV RNA viral load. Interestingly, there was a positive correlation (r = 0.337, p < 0.001) between ALT and AFP levels in the whole study population.

We concluded that serum HCV RNA positive patients were candidates for therapeutic prevention of HCC and liver inflammation regardless of the HCV RNA viral load. Furthermore, higher burden of HCV viral load was associated with more severe liver damage.