title: Clinical significance of elevated alpha-foetoprotein (AFP) in patients with chronic hepatitis C without hepatocellular carcinoma in upper EGYPT.
abstract: OBJECTIVE
  Egypt has the highest prevalence of hepatitis C in the world. Alpha-foetoprotein (AFP) is important in the diagnosis of hepatocellular carcinoma (HCC), but elevated AFP levels have also been observed in chronic hepatitis C (CHC) without HCC. We evaluated the clinical correlation between elevated AFP levels and CHC. We analysed data from a population-based cohort of patients with hepatitis C virus (HCV) infection to assess the prevalence of elevated serum AFP, to determine its association with clinical and virologic parameters and with clinical outcomes.
  
  
  METHODS
  From December 2009 to April 2011, 121 patients with no evidence of HCC with regular abdominal ultrasound or other imaging studies (multislice computed tomography (MSCT) or magnetic resonance imaging (MRI)) were controlled by a chart review.
  
  
  RESULTS
  The prevalence of elevated AFP ≥10ngml(-1) was 11.6%. Univariate analysis revealed that fibrosis stage III/IV, alanine aminotransferase (ALT) more than 45IUl(-1) and platelet count less than 150×10(9) l(-1) were significantly associated with elevated AFP. Multivariate analysis revealed that the independent variable associated with elevated serum AFP was fibrosis stage III/IV, p=0.015. Multivariate analysis also revealed that AST>45IUl(-1) and AFP ≥10 ngml(-1) were associated with advanced fibrosis using a cut-off AFP value >10 ngml(-1). The sensitivity and specificity of diagnosing fibrosis score III/IV were 26.1% and 97.3%, respectively.
  
  
  CONCLUSIONS
  Elevated AFP levels were observed in 11.65% of patients with CHC. Elevated AFP levels correlated positively with fibrosis stage III/IV; ALT elevation, thrombocytopenia and AFP ≥10 ngml(-1) were associated with advanced fibrosis.
authors.affiliation: Department of Internal Medicine, Assiut University Hospital, Assiut, Egypt. yamany1@yahoo.com
authors.forename: Mohammad A
authors.initials: MA
authors.lastname: Kobeisy
authors.forename: Khairy H
authors.initials: KH
authors.lastname: Morsy
authors.forename: Mohammad
authors.initials: M
authors.lastname: Galal
authors.forename: Sohair K
authors.initials: SK
authors.lastname: Sayed
authors.forename: Mohammad M
authors.initials: MM
authors.lastname: Ashmawy
authors.forename: Fattahallah M
authors.initials: FM
authors.lastname: Mohammad
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D000704:Analysis of Variance; D001219:Aspartate Aminotransferases / Q000097:blood; D004534:Egypt; D005260:Female; D016174:Hepacivirus; D019698:Hepatitis C, Chronic / Q000097:blood* / Q000150:complications; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood* / Q000473:pathology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010976:Platelet Count; D012372:ROC Curve; D012680:Sensitivity and Specificity; D013921:Thrombocytopenia / Q000097:blood / Q000150:complications; D019562:Viral Load; D055815:Young Adult; D000509:alpha-Fetoproteins / Q000378:metabolism*
chemical_list: D000509:alpha-Fetoproteins; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase