Evaluation of Serum α-Fetoprotein Levels During Different Infection Phases of CHB Patients.

BACKGROUND: Chronic hepatitis B patients carry a high risk of developing hepatocellular carcinoma (HCC). α-Fetoprotein (AFP) is one of the most commonly used and reliable biomarkers for HCC. However, the AFP level during different phases of CHB is not well understood. We aimed to identify the AFP levels during the different infection phases of CHB patient and explore which phase is at high risk of developing HCC.

METHODS: Three hundred and fifty-five CHB patients were divided into four groups: a. immune tolerant HBeAgpositive phase (IT); b. immune reactive HBeAg-positive phase (IR), c. inactive carrier state (IC), d. HBeAg-negative activation phase (ENA). The risk of development of HCC in different group is assessed by the serum AFP levels. An electrochemiluminescence assay was used to analyze serum AFP levels.

RESULTS: Mean AFP levels were different in each phase of CHB (p < 0.001): IT (9.6 ng/mL), IR (33.7 ng/mL), IC (3.2 ng/mL), and ENA (71.6 ng/mL). The ENA phase had the highest AFP level and IC phase has the lowest. There was no correlation between serum AFP level and HBV viral load. A significant correlation between serum ALT levels and HBV viral load was observed (r = 0.272, p < 0.01).

CONCLUSIONS: These findings suggest that high levels of AFP during HBeAg-negative activation phase (ENA) may be associated with a high risk of developing of HCC. Furthermore, higher burden of HBV viral load is associated with more severe liver damage.