ASSOCIATION OF ALPHA PROTEIN LEVELS WITH THE SEVERITY OF VIRAL DISEASE IN PATIENTS WITH HBV AND HCV INFECTION
Objective: To determine association of alpha-fetoprotein (AFP) levels with presence and severity of disease in patients with CLD due to HBV and HCV viral infection.
Material and Methods: This observational study was carried out in the Chemical and molecular Pathology Department, Sheikh Zayed Hospital and Medical College, Rahim Yar Khan from between 2016-2018. The study was conducted by collecting the clinical and laboratory data of patients with chronic liver disease as a part of routine management attending our hospital. We collected the data of 230 study subjects including eighty-five females and one hundred and forty-five males. All of them were having chronic liver disease which was diagnosed by ultrasonography and referred to pathology laboratory for their routine Liver Function Tests, serology for hepatitis B and C, follow up investigation along with Alpha-feto protein (AFP) levels and viral load. Twenty-five females and same number of males as disease free controls were also included.
Results: Serum levels of AST, ALT and alkaline phosphatase (ALP) were found to be significantly higher in hepatitis patients with Chronic Liver Disease (CLD) as compared to control subjects. Similarly, total and direct bilirubin were also observed to be elevated in study subjects as compared to controls. Total proteins and globulins were higher while serum albumin was lower in study group as compared to control subjects (p<0.05). All the laboratory parameters showed significant difference statistically (p<0.005) except for globulin.
Mean viral load in patients with HCV (n=130) was found to be 2.2x106 IU/mL while in patients with HBV (n=100) it was 4.1x105 IU/mL. A significant positive correlation (r=0.82) was found between viral load (estimated by quantitative PCR) and AFP in HBV positive subjects. No significant correlation was found between viral load and AFP in hepatitis C positive patients.
Conclusion: Serum AFP levels were high in CLD patients with HBsAg positive along with the high viral load. Serum AFP could be helpful in detecting progression in patients with HBV.
Key Words: Alpha-feto protein, HBV, Hepatocellular carcinoma, Viral load, Chronic liver disease.