Additional Benefit of ?-Fetoprotein in Patients with Chronic Hepatitis B and C without Evidence of Hepatoma

Alpha fetoprotein is a substance produced by a fetus' liver that can be found in the amniotic fluid and in the mother's blood. But sometimes appear in abnormally increased level in certain diseases of adults, such as liver cancer, and its level in amniotic fluid can be used to detect certain fetal abnormalities, including Down syndrome and spina bifida. The importance of ?-fetoprotein level elevation in patients with chronic viral hepatitis B and C and its clinical significance in steatosis associated with HBV and HCV infection remain to be clarified. In this study assessed the clinical significance of ?-fetoprotein in patients with chronic hepatitis B and C with and without steatosis. Methods. Alpha fetoprotein was measures in fifty patients with chronic viral hepatitis which were divided into 25 patients with chronic hepatitis B (CHB) and 25 patients with chronic hepatitis C (CHC). Both groups further subdivided based on liver biopsy into chronic hepatitis B with, without steatosis and chronic hepatitis C with, without steatosis. Results. There was statistically significant increment (p less than 0.05) of the number and percentage of patients with steatosis in CHC (14, 56%) in comparison to CHB patients (9, 36%). ?-fetoprotein was significantly increased in chronic hepatitis B and C patients with steatosis (12.82 ? 5.3, 13.01 ? 7.2) than patients without steatosis (6.29?4.9, 5.94?5.9) respectively (P less than 0.001). Significant positive correlation was found between serum ?-fetoprotein and the severity of fibrosis in patients with CHC with steatosis (r 0.49, p less than0.05). While no significant correlation in CHB patients with steatosis. In all patients with steatosis whatever CHC or CHB, there was significant positive correlation between AFP and grade of steatosis (p less than0.05, r =0.52). Conclusion. Alpha fetoprotein levels significantly increased in patients with chronic hepatitis B and C with steatosis than patients without steatosis. The percentage of patients with steatosis was significantly higher in CHC than CHB. AFP levels had significant positive correlation with the severity of steatosis in patients with chronic hepatitis C and B and severity of fibrosis in chronic hepatitis C only. So in the absence of traditional causes of elevated serum AFP, steatosis should be among the differential diagnoses of elevated serum AFP levels. In other hand elevated AFP level could be considered as a marker of steatosis in chronic hepatitis B patients and marker of steatosis and fibrosis in chronic hepatitis C patients.