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Abstract The World Health Organization (WHO) estimates that >185 million people worldwide or 2.8% of the human population have been infected with HCV; of these 130–170 million are chronically infected and 350,000 deaths occur each year as a result of HCV-related cirrhosis and liver cancer. The prevalence of HCV varies from 1.2% to 3.8% in different regions of the world (Cornberg et al., 2011). Alpha-fetoprotein (AFP) is a foetal glycoprotein which has been widely used as a serum marker for diagnosing hepatocellular carcinoma (HCC); however, elevated serum AFP levels have also been documented in non-HCC patients with chronic liver disease (Chen et al., 2007). To fulfill the aim of the work, this study was designed to evaluate the clinical significance of Alpha- Fetoprotein (AFP) levels in chronic hepatitis C patients without hepatocellular carcinoma (HCC) in Egypt. This study was conducted through collaboration between Tropical Medicine Department, Ain Shams University and Sohag Cardiology and Hepato- Gastroenterology Center, Ministry of Health, in the period from January 2010 to January 2013. The patients enrolled in our study were selected from Tropical Medicine Clinic of Ain-Shams University Hospital ”ELDemerdash” and from the Interferon Unit - before Summary 129 treatment - of Sohag Cardiology and Hepato- Gastroenterology Center, Ministry of Health. We operated our study on selected 70 patients of chronic liver disease with proven chronic hepatitis C virus infection by history taking, clinical manifestations and positive laboratory investigations for chronic HCV infection to fulfill the predesigned inclusion criteria. All patients were subjected to the following; careful history, thorough clinical examination and laboratory investigations [liver enzymes (AST and ALT), serum albumin, INR, total and direct bilirubin, complete blood picture and viral markers (HCV-Ab, HBs-Ag and quantitative PCR for HCVRNA). Abdominal ultrasound and histopathological examination of ultrasound guided liver biopsy were done for all cases. Our study included 90 subjects, divided into two groups: Control Group: includes (20) healthy individuals, and study Group: includes (70) patients with chronic hepatitis C (CHC) without evidence of hepatocellular carcinoma (HCC). The two groups were well-matched regarding age, gender and BMI. The gender distribution of the studied group; males were 58 patients (82.9 %) while females were 12 patients (17.1%). The current study reveals that AFP levels were very much higher in HCV cases compared to controls. Summary 130 The current study assessed the correlation between AFP and different variables in the control group and in different fibrosis stages of the cases group, we found that all correlations were non significant, with the exception of total bilirubin level, which showed significant positive correlation with AFP levels among stages F3 and F4; and platelet level, which showed negative significant correlation with AFP level among F4 stage patients. Concerning the correlation between mean AFP levels and different stages of liver fibrosis, there was a positive highly significant correlation. It was found that higher serum AFP levels were associated with more advanced stage of fibrosis especially F3 & F4. Regarding the mean AFP levels in different grades of liver pathology, there was no statistical significant relation. Also, there was no statistical significant relation between the mean AFP levels and the presence of Steatosis. The present work designed a ROC curve which revealed that the level of AFP can be used as a screening for chronic HCV infection (sensitivity=75.4%, specificity=85.7%), as well as for advanced fibrosis in chronic HCV infection (sensitivity=69.7%, specificity=83.8%). The current study proved that determination of serum AFP levels may be useful as a non invasive indicator of Summary 131 severity of liver staging, as it is associated with increased levels of matavir staging. So serum AFP levels should be routinely screened in parallel with image studies in HCV positive patients. |