TY - JOUR
T1 - Serum alpha-fetoprotein levels in patients with advanced hepatitis C
T2 - Results from the HALT-C Trial
AU - Di Bisceglie, Adrian M.
AU - Sterling, Richard K.
AU - Chung, Raymond T.
AU - Everhart, James E.
AU - Dienstag, Jules L.
AU - Bonkovsky, Herbert L.
AU - Wright, Elizabeth C.
AU - Everson, Gregory T.
AU - Lindsay, Karen L.
AU - Lok, Anna S F
AU - Lee, William M.
AU - Morgan, Timothy R.
AU - Ghany, Marc G.
AU - Gretch, David R.
N1 - Funding Information:
This study was supported by the National Institute of Diabetes & Digestive & Kidney Diseases (contract numbers are listed below). Additional support was provided by the National Institute of Allergy and Infectious Diseases (NIAID), the National Cancer Institute, the National Center for Minority Health and Health Disparities and by General Clinical Research Center grants from the National Center for Research Resources, National Institutes of Health (grant numbers are listed below). Additional funding to conduct this study was supplied by Hoffmann-La Roche Inc., through a Cooperative Research and Development Agreement (CRADA) with the National Institutes of Health.
PY - 2005/9
Y1 - 2005/9
N2 - Background/Aims: Alpha-fetoprotein (AFP) has been useful in the diagnosis of hepatocellular carcinoma (HCC) but lacks specificity. We assessed serum AFP among patients with chronic hepatitis C and advanced fibrosis to establish predictors of AFP elevations and changes with antiviral therapy. Methods: Serum AFP was measured at baseline and on therapy in patients in the Hepatitis C Antiviral Long-Term Treatment against Cirrhosis (HALT-C). AFP levels were correlated with patient demographic and clinical features. Results: Baseline AFP was ≥20 ng/mL in 191 of 1145 patients (16.6%). Mean AFP values were significantly higher in patients with cirrhosis than in those with bridging fibrosis (22.5 vs. 11.4 ng/mL, P<0.0001). Factors independently associated with raised serum AFP in patients with cirrhosis were female gender, black race, decreased platelet count, increased serum AST/ALT ratio, serum ferritin, and Mallory bodies in liver biopsies. Serum AFP levels decreased significantly during therapy with pegylated interferon α-2a and ribavirin. HCC was identified in six subjects, only three of whom had AFP>20 ng/mL. Conclusions: Among patients with advanced chronic hepatitis C, serum AFP values are frequently elevated, even in the absence of HCC. Factors associated with raised AFP include severity of liver disease, female gender and black race. Serum AFP levels decline during antiviral therapy.
AB - Background/Aims: Alpha-fetoprotein (AFP) has been useful in the diagnosis of hepatocellular carcinoma (HCC) but lacks specificity. We assessed serum AFP among patients with chronic hepatitis C and advanced fibrosis to establish predictors of AFP elevations and changes with antiviral therapy. Methods: Serum AFP was measured at baseline and on therapy in patients in the Hepatitis C Antiviral Long-Term Treatment against Cirrhosis (HALT-C). AFP levels were correlated with patient demographic and clinical features. Results: Baseline AFP was ≥20 ng/mL in 191 of 1145 patients (16.6%). Mean AFP values were significantly higher in patients with cirrhosis than in those with bridging fibrosis (22.5 vs. 11.4 ng/mL, P<0.0001). Factors independently associated with raised serum AFP in patients with cirrhosis were female gender, black race, decreased platelet count, increased serum AST/ALT ratio, serum ferritin, and Mallory bodies in liver biopsies. Serum AFP levels decreased significantly during therapy with pegylated interferon α-2a and ribavirin. HCC was identified in six subjects, only three of whom had AFP>20 ng/mL. Conclusions: Among patients with advanced chronic hepatitis C, serum AFP values are frequently elevated, even in the absence of HCC. Factors associated with raised AFP include severity of liver disease, female gender and black race. Serum AFP levels decline during antiviral therapy.
KW - Alpha-fetoprotein
KW - Antiviral therapy
KW - Cirrhosis
KW - Hepatitis C
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U2 - 10.1016/j.jhep.2005.03.019
DO - 10.1016/j.jhep.2005.03.019
M3 - Article
C2 - 16136646
AN - SCOPUS:23444432469
SN - 0168-8278
VL - 43
SP - 434
EP - 441
JO - Journal of Hepatology
JF - Journal of Hepatology
IS - 3
ER -