Dynamics of serum α‑fetoprotein in viral hepatitis C without hepatocellular carcinoma

Abstract

Viral hepatitis C represents a significant liver pathology worldwide, with a detrimental impact on national health systems. The present study aimed to correlate the levels of serum α-fetoprotein (AFP) with prognostic tools such as Fibroscan ® , the presence of mixed cryoglobulinemia, and various demographic and standard biochemical markers, in patients with chronic hepatitis C, unrelated to hepatocellular carcinoma (HCC). A clinical study was designed considering three study groups: Hepatitis C virus (HCV) group including 35 patients with chronic hepatitis C and detectible viral load; sustained viral response (SVR) group including 20 HCV patients without detectable virus load 12 weeks after therapy cessation; a control group represented by 37 healthy volunteers. It was observed that serum AFP was moderately increased in the HCV and SVR groups and was positively correlated with aspartate transaminase (AST), alkaline phosphatase (AP), and γ-glutamyl transferase (GGT). The incidence of mixed cryoglobulinemia was increased in the HCV group, and the degree of fibrosis assessed by Fibroscan ® was increased in both the HCV and SVR groups. In conclusion, the data revealed that a moderate increase in AFP levels could be present in patients with HCV even in the absence of HCC, unrelated to viral load or therapy response and that there was a linear positive correlation between serum levels of AFP and the degree of hepatic cytolysis and cholestasis. Additionally, mixed cryoglobulinemia was present in HCV patients with patent viral load, decreasing in those with SVR after therapy cessation unrelated to any renal impairment, while the degree of fibrosis was increased in HCV-infected patients, with no reversibility 12 weeks after successful therapy.

Safety and Efficacy of Direct-acting Antiviral Therapies for Chronic HCV Infection in Hemodialysis Patients

“…The importance of HCV cure in hemodialysis patients has two dimensions: Avoidance of progression of liver disease and its complications on the one hand, and ensuring optimal conditions for a potential kidney transplant on the other (8). A recent study evaluated the impact of HCV on liver inflammation by demonstrating increased alpha-fetoprotein levels in HCV-infected patients in the absence of hepatocellular carcinoma (21). Regarding alpha-fetoprotein in dialysis patients, it has been shown that levels do not increase with uremia but in fact decrease after dialysis sessions, thus raising questions of interpretation regarding its value as a tumor marker in patients with end-stage kidney disease (22).…”

The Management of Postoperative Cognitive Dysfunction in Cirrhotic Patients: An Overview of the Literature

“…For clinical purposes, West Haven criteria are used to classify HE into four stages, but they are often used subjectively and fail to accurately identify minimal hepatic encephalopathy (mHE). Thus, further efforts should be made to identify novel predictive biomarkers in various subclinical cirrhosis-associated conditions that could lead to cognitive impairment [ 8 , 9 , 10 , 11 , 12 , 13 , 14 ].…”

Epigenetics in inflammatory liver diseases: A clinical perspective (Review)

“…Although the screening tests and therapeutic algorithms are well-established in various hepatic diseases, including liver transplantation as etiologic therapy in end-stage liver disease, strategies to identify reversible lesions in early stages and to develop new epigenetic therapies should be prioritized ( 18-20 ).…”