Impact of Serum Alpha-fetoprotein Levels on the Response to Antiviral Therapy in Egyptian Patients with Chronic Hepatitis C

Abstract

AIM: The changes in alpha-fetoprotein (AFP) levels and the response to anti-viral therapy among chronic HCV patients have become of great interest. This study was intended to investigate the potential use of AFP level as a predictor for end of treatment response (ETR) in chronic HCV patients and detect its changes with therapy. METHODS: Retrospective data of 2378 biopsy-proven chronic HCV Egyptian patients who received anti-viral therapy at the National Hepatology and Tropical Medicine Research Institute, Egypt were analyzed. Detailed baseline and follow up data with special emphasis on the serial AFP levels were evaluated. RESULTS: Early virological (EVR) and ETR were 58%, 42% respectively on an intention to-treat basis. Median baseline AFP at 3.5 ng/mL; was significantly correlated with amino-transferase levels, stages of fibrosis and grades of necro-inflammation. AFP levels decreased with IFN therapy regardless of virologic response with a significant decrease in patients with ETR. ETR was more evident among patients AFP<3.5ng/mL compared to those with higher values ( 91.3% vs 87.2 respectively; p-value, 0.03).There was a significant decrease between baseline AFP and levels at either 24 or 48 weeks of therapy; 2.1ng/mL and 2.8ng/mL respectively. ETR was significantly related to the difference at week 24; p-value 0.034 but not to the latter; p-value 0.11. CONCLUSIONS: In chronic HCV patients; low baseline AFP level could be a potential predictor for ETR while the decrease in serial AFP levels was related to anti-viral therapy irrespective of treatment outcome.