Correlation of serum alpha-fetoprotein (AFP) level with liver function parameters in hepatitis B virus (HBV) infected patients in Bangladeshi population

Paper Details

Research Paper 01/09/2012
Views (428) Download (3)

Correlation of serum alpha-fetoprotein (AFP) level with liver function parameters in hepatitis B virus (HBV) infected patients in Bangladeshi population

Nuruzzaman Masum, Hasib Uddin Ahmed Chowdhury, Md. Raihan Chowdhury, Sharif Neaz, Kazi Saiful Islam, Ishtiaq Mahmud
Int. J. Biosci.2( 9), 13-19, September 2012.
Certificate: IJB 2012 [Generate Certificate]


Hepatitis B attacks the liver and can cause both acute and chronic disease. Elevated ALT, AST and ALP are the parameter of liver function test. Along with this high alpha fetoprotein serum levels have also been found in 60– 70% of patients with hepatocellular carcinoma; nevertheless, there are other causes that increase this particular protein. A prospective study was performed among 32 healthy control (HBsAg-) and 96 patients (HbsAg+) with their first attack of HBV-related acute hepatitis. In these study AFP, AST, ALT and ALP levels were measured. Among the 29 patients, 9 of them exhibited AFP level in between 10-20(IU/ml), 8 of them exhibited AFP level in between 21-70(IU/ml) and 12 of them exhibited AFP level in between 71-300(IU/ml) with a highest level of 297.90(IU/ml). Beside those 29 patients, other 67 patients of our 96 patient groups have also showed normal AFP level lower than 10(IU/ml). The AFP level of the control group was found normal and it was less than 10(IU/ml).The mean AFP level of patient group is significantly higher ( P< 0.001) compared to the control group and this value is higher than the reference range. The mean AFP level of patient group above 40 years old was significantly higher (P< 0.001) compared to the patient group of less than 40 years old. The Serum AFP level has shown positive correlation with the serum ALT (p=0.01;r=0.9330),AST(p=0.01,r=0.927) and ALP(p=0.01,0.829).


Abelev GI. 1971. Alpha-fetoprotein in ontogenesis and its association with malignant tumours. Advanc. Cancer Res. 14, 295-358.

Akeyama  T,  Koyama  T,  Kamada  T.  1972. Alpha-fetoprotein in acute viral hepatitis. New Engl. J. Med. 287, 989.

Anzola M. 2004. Hepatocellular carcinoma: role of hepatitis B and hepatitis C viruses proteins in hepatocarcinogenesis. J Viral Hepat. 11(5), 383-393.

Bae JS, Park SJ, Park KB. 2005. Acute exacerbation of hepatitis in liver cirrhosis with very high levels of alpha-fetoprotein but no occurrence of hepatocellular carcinoma. Korean J. Intern. Med. 20, 80-5.

Bellet DH, Wands JR, Isselbacher KJ, Bohuon C. 1985.Serum alphafetoprotein levels in human disease: Perspective from a highly specific monoclonal radioimmunoassay. Proc Null Acad Sci USA. 8 (1), 3869- 3873.

Chisari FV, Ferrari C. 1995. Hepatitis B virus immunopathogenesis. Annu Rev Immunol. 13, 29-60.

Crandall BF. 1981. Alpha-fetoprotein: A review. CRC Crit Rev Cfin LabSci. 15, 127-158.

Di Bisceglie AM, Hoofnagle JH. 1989. Elevations in serum alpha-fetoprotein levels in patients with chronic hepatitis B. Cancer. 64, 2117-20.

Ganem D, Prince AM. 2004. Hepatitis B virus infection–natural history and clinical consequences. N Engl J Med. 350(11), 1118-1129.

Hoofnagle JH, Shafntz DA, Popper H. 1987. Chronic type B hepatitis and the “healthy” hepatitis B surface antigen carrier state. Hepafology.7, 758-763.

Iannacone M, Sitia G, Ruggeri ZM, Guidotti LG. 2007. HBV pathogenesis in animal models: recent advances on the role of platelets. J Hepatol. 46(4), 719-726.

Ishii, M. 1973. Radioimmunoassay of alpha-fetoprotein. Gann Monogr. Cancer Res. 14, 89-98.

Tsai JF, Chang WY, Jeng JE, Ho MS, Lin ZY, Tsai JH. 1994. Frequency of raised alpha-fetoprotein level among Chinese patients with hepatocellular carcinoma related to hepatitis B and C. Br J Cancer. 69(6), 1157–1159.

Kew MC. 1983. Hepatocellular carcinoma. Postgrad Med J. (Suppl 4) 59, 78-87.

Lok AS, Lai CL. 1989. Alpha-Fetoprotein monitoring in Chinese patients with chronic hepatitis B virus infection: role in the early detection of hepatocellular carcinoma. Hepatology. 9,110-15.

Lok, A.; Mcmahon, B. 2007. “Chronic hepatitis B”. Hepatology (Baltimore, Md.) 45 (2), 507–539.

McMahon BJ, Heyward WL, Ritter D et al. 1987. A comprehensive programme to reduce the incidence of hepatitis B virus infection and its sequelae in Alaskan natives. Lancet. 2(1), 134-1 136.

Kew MC, Purves LR, Bersohn. 1973. Serum alpha-fetoprotein Levels in Acute Viral Hepatitis.GUT. 14(12), 939-942.

Purves LR, Branch WR, Geddes EW, Manso C, Portugal M. 1973. Serum alpha-fetoprotein. VII. The range of apparent serum values in normal people, pregnant women, and primary liver cancer high risk populations. Cancer (Philad.) 31, 578-587.

Purves LR, Purves M. 1972. Serum alpha-feto-protein. VI.The radio-immunoassay: evidence for the presence of AFP in the serum of normal people and during pregnancy. S. Afr. med. J. 46, 1290-1297.

Ruoslahti E, Seppail AM. 1972b. Normal and increased alphafetoprotein in neoplastic and non-neoplastic liver disease. Lancet, 2, 278-279.

Seeff LB, Beebe GW, Hoofnagle JH. 1987. Serologic follow-up of the 1942 epidemic of post-vaccination hepatitis in the United States Army. N Engl J Med 3(I6), 965-970.

Smith JB. 1971. Occurrence of alpha-fetoprotein in acute viral hepatitis. Int. J. Cancer 8, 421-424.

Werner M. 1969. Serum protein changes during the acute phase reaction. Clin. chim. Acta, 25, 299-305.

Wei-Chen T, Tsung-Hui H, Jing-Houng W, Chao-Hung H, Sheng-Nan L, Chi-Shin C, Chuan-Mo L. 2009. Clinical Implications of Alpha-fetoprotein in Chronic Hepatitis C. J. Form. Med Association 108, 210-218.

Xu B, Hu D-C, Rosenberg DM. 2003. Chronic hepatitis B: a long-term retrospective cohort study of disease progression in Shanghai, China. J. Gastroenterol. Hepatol. 18, 1345-52.

Yao FY. 2003. Dramatic reduction of the alpha-fetoprotein level after lamivudine treatment of patients with chronic hepatitis B virus infection and cirrhosis. J. Clin. Gastroenterol. 36, 440-2.

Yongnian H, Qun T, Wei Z, Xiaoqing Z, Longying Y. 2008. Clinical, biochemical, immunological and virological profiles of, and differential diagnosis between, patients with acute hepatitis B and chronic hepatitis B with acute flare. JGHF 23(11), 1178-1733.