title: Serum alpha-foetoprotein level predicts treatment outcome in chronic hepatitis C.
abstract: OBJECTIVE
  To analyse the association between serum alpha-foetoprotein (AFP) levels and sustained virological response (SVR) in treated patients.
  
  
  METHODS
  One-hundred patients with chronic hepatitis C were treated with pegylated interferon alpha-2a plus ribavirin for 48 weeks. The primary endpoint was SVR. Linear regression analysis was performed to identify clinical, biological, and histological factors affecting baseline AFP levels. The association between pretreatment serum AFP and SVR was assessed by multivariate logistic regression analysis.
  
  
  RESULTS
  Of 100 patients, 95 were infected with genotype 4, one with genotype 1, and four with undetermined genotype. The median serum AFP level was 4.5 ng/ml and AFP values ranged from 1.2 to 49.8 ng/ml. In multivariate analysis, higher fibrosis stage and higher steatosis score were independently associated with higher serum AFP levels. SVR rate was 61.0% (61/100), and was lower for patients with AFP levels above rather than below the median value (40.8% versus 80.4%, respectively, P < 0.001). In multivariate analysis, including adjustment for age, gender, body mass index, steatosis score, fibrosis stage, ALT level, haemoglobin level, clotting time, HCV RNA viral load, and treatment dose received, a baseline serum AFP level above the median value was associated with a lower SVR rate (OR [95% CI]=0.10 [0.03-0.42], P < 0.001). None of the seven patients with increased (above 15 ng/ml) pretreatment AFP achieved SVR.
  
  
  CONCLUSIONS
  In this study, higher baseline serum AFP levels independently predicted a lower SVR rate among patients with chronic hepatitis C. If confirmed with genotypes other than 4, these findings would suggest adding serum AFP to the list of factors predictive of treatment response.
authors: Unité d'Epidémiologie des Maladies Emergentes, Institut Pasteur, Paris, France.
authors: Sylvia
authors: S
authors: Males
authors: Rita Raafat
authors: RR
authors: Gad
authors: Gamal
authors: G
authors: Esmat
authors: Hasan
authors: H
authors: Abobakr
authors: Mohamed
authors: M
authors: Anwar
authors: Claire
authors: C
authors: Rekacewicz
authors: Mostafa
authors: M
authors: El Hoseiny
authors: Khaled
authors: K
authors: Zalata
authors: Mohamed
authors: M
authors: Abdel-Hamid
authors: Pierre
authors: P
authors: Bedossa
authors: Stanislas
authors: S
authors: Pol
authors: Mostafa K
authors: MK
authors: Mohamed
authors: Arnaud
authors: A
authors: Fontanet
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D004534:Egypt; D005260:Female; D019698:Hepatitis C, Chronic / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007279:Injections, Subcutaneous; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage / Q000627:therapeutic use*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D018579:Patient Selection; D011092:Polyethylene Glycols / Q000008:administration & dosage / Q000627:therapeutic use*; D011506:Proteins / Q000378:metabolism*; D011994:Recombinant Proteins; D012254:Ribavirin / Q000008:administration & dosage / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome; D019562:Viral Load; D014779:Virus Replication / Q000187:drug effects; D000509:alpha-Fetoproteins
chemical_list: C097353:AFP protein, human; D000998:Antiviral Agents; D015415:Biomarkers; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011506:Proteins; D011994:Recombinant Proteins; D000509:alpha-Fetoproteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a