Isac Teodora, Isac Sebastian, Ioanitescu Simona, Mihaly Enyedi, Tanasescu Maria-Daniela, Balan Daniela Gabriela, Tulin Adrian, Iliescu Laura
Department of Internal Medicine II, Faculty of Medicine, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Department of Physiology and Neuroscience, Faculty of Medicine, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Exp Ther Med. 2021 Jul;22(1):749. doi: 10.3892/etm.2021.10181. Epub 2021 May 12.
Viral hepatitis C represents a significant liver pathology worldwide, with a detrimental impact on national health systems. The present study aimed to correlate the levels of serum α-fetoprotein (AFP) with prognostic tools such as Fibroscan, the presence of mixed cryoglobulinemia, and various demographic and standard biochemical markers, in patients with chronic hepatitis C, unrelated to hepatocellular carcinoma (HCC). A clinical study was designed considering three study groups: Hepatitis C virus (HCV) group including 35 patients with chronic hepatitis C and detectible viral load; sustained viral response (SVR) group including 20 HCV patients without detectable virus load 12 weeks after therapy cessation; a control group represented by 37 healthy volunteers. It was observed that serum AFP was moderately increased in the HCV and SVR groups and was positively correlated with aspartate transaminase (AST), alkaline phosphatase (AP), and γ-glutamyl transferase (GGT). The incidence of mixed cryoglobulinemia was increased in the HCV group, and the degree of fibrosis assessed by Fibroscan was increased in both the HCV and SVR groups. In conclusion, the data revealed that a moderate increase in AFP levels could be present in patients with HCV even in the absence of HCC, unrelated to viral load or therapy response and that there was a linear positive correlation between serum levels of AFP and the degree of hepatic cytolysis and cholestasis. Additionally, mixed cryoglobulinemia was present in HCV patients with patent viral load, decreasing in those with SVR after therapy cessation unrelated to any renal impairment, while the degree of fibrosis was increased in HCV-infected patients, with no reversibility 12 weeks after successful therapy.
丙型病毒性肝炎是全球范围内一种严重的肝脏疾病,对各国卫生系统都有不利影响。本研究旨在探讨慢性丙型肝炎患者(与肝细胞癌无关)血清甲胎蛋白(AFP)水平与Fibroscan等预后工具、混合性冷球蛋白血症的存在以及各种人口统计学和标准生化指标之间的相关性。本临床研究设计了三个研究组:丙型肝炎病毒(HCV)组,包括35例慢性丙型肝炎且病毒载量可检测的患者;持续病毒学应答(SVR)组,包括20例治疗停止12周后病毒载量不可检测的HCV患者;对照组由37名健康志愿者组成。观察到HCV组和SVR组血清AFP中度升高,且与天冬氨酸转氨酶(AST)、碱性磷酸酶(AP)和γ-谷氨酰转移酶(GGT)呈正相关。HCV组混合性冷球蛋白血症的发生率增加,Fibroscan评估的纤维化程度在HCV组和SVR组均增加。总之,数据显示即使在无肝细胞癌的HCV患者中,AFP水平也可能中度升高,这与病毒载量或治疗反应无关,且血清AFP水平与肝细胞溶解和胆汁淤积程度呈线性正相关。此外,病毒载量阳性的HCV患者存在混合性冷球蛋白血症,治疗停止后SVR患者的混合性冷球蛋白血症减少,且与任何肾功能损害无关,而HCV感染患者的纤维化程度增加,成功治疗12周后无逆转。