title: Clinical significance of elevated serum alpha-fetoprotein (AFP) level in acute viral hepatitis A (AHA).
abstract: OBJECTIVE
  The clinical course of acute viral hepatitis A (AHA) is highly variable. Serum alphafetoprotein (AFP) level is often elevated in various types of acute liver injuries, indicating active liver regeneration. This study was aimed to investigate the clinical significance of serum AFP level in the aspect of the early recovery in AHA.
  
  
  METHODS
  A total of 238 patients with AHA, confirmed by IgM anti-hepatitis A virus, were included. The patients were classified according to serum AFP level. Multivariate analysis by Cox proportional hazards model using dichotomized clinical variables was performed to identify the independent predictors for early recovery (ALT normalization within 2 weeks).
  
  
  RESULTS
  The median age (range) was 30 (17-50) years and male dominant (62%, 147/238). Compared to low AFP group, high AFP group (>10 ng/mL) had significantly lower platelet counts (p <0.0001), lower albumin (p =0.003), lower AST (p <0.001), lower ALT (p = 0.001), higher total bilirubin level (p <0.0001) on univariate analysis. On Cox regression analysis, high AFP level (>10 ng/mL) was the only independent predictor for early recovery (Hazard ratio (HR); 2.392, 95% CI; 1.564-3.659, p = 0.0001).
  
  
  CONCLUSIONS
  High serum AFP level (>10 ng/mL) may indicate the already-started recovery through active liver regeneration or the early recovery within 2 weeks in AHA.
authors.forename: Seung In
authors.initials: SI
authors.lastname: Seo
authors.forename: Su Sun
authors.initials: SS
authors.lastname: Kim
authors.forename: Bo Youn
authors.initials: BY
authors.lastname: Choi
authors.forename: Sang Ho
authors.initials: SH
authors.lastname: Lee
authors.forename: Sung Jun
authors.initials: SJ
authors.lastname: Kim
authors.forename: Hye Won
authors.initials: HW
authors.lastname: Park
authors.forename: Hyoung Su
authors.initials: HS
authors.lastname: Kim
authors.forename: Woon Geon
authors.initials: WG
authors.lastname: Shin
authors.forename: Kyung Ho
authors.initials: KH
authors.lastname: Kim
authors.forename: Jin Heon
authors.initials: JH
authors.lastname: Lee
authors.forename: Hak Yang
authors.initials: HY
authors.lastname: Kim
authors.forename: Myoung Kuk
authors.initials: MK
authors.lastname: Jang
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D005260:Female; D006506:Hepatitis A / Q000097:blood* / Q000175:diagnosis / Q000503:physiopathology; D035922:Hepatitis A Antibodies / Q000097:blood; D006801:Humans; D053208:Kaplan-Meier Estimate; D008115:Liver Regeneration; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D013997:Time Factors; D015854:Up-Regulation; D055815:Young Adult; D000509:alpha-Fetoproteins / Q000032:analysis*
chemical_list: C097353:AFP protein, human; D035922:Hepatitis A Antibodies; D000509:alpha-Fetoproteins