A decrease in AFP level related to administration of interferon in patients with chronic hepatitis C and a high level of AFP

• Published in: Digestive diseases and sciences 2006-04, Vol.51 (4), p.808-812
• Main Authors: MURASHIMA, Shiro, TANAKA, Masatoshi, HARAMAKI, Makoto, YUTANI, Shigeru, NAKASHIMA, Yutaka, HARADA, Kazunori, IDE, Tatsuya, KUMASHIRO, Ryukichi, SATA, Michio
• Format: Article
• Language: English
• Subjects: Aged; alpha-Fetoproteins - drug effects; alpha-Fetoproteins - metabolism; Biological and medical sciences; Biomarkers - analysis; Carcinoma, Hepatocellular - pathology; Carcinoma, Hepatocellular - prevention & control; Dose-Response Relationship, Drug; Drug Administration Schedule; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; Gastroenterology. Liver. Pancreas. Abdomen; Hepatitis C, Chronic - diagnosis; Hepatitis C, Chronic - drug therapy; Human viral diseases; Humans; Infectious diseases; Interferon-alpha - therapeutic use; Liver Function Tests; Liver Neoplasms - pathology; Liver Neoplasms - prevention & control; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Male; Medical sciences; Middle Aged; Predictive Value of Tests; Probability; Prognosis; Recombinant Proteins; Retrospective Studies; Risk Assessment; Sensitivity and Specificity; Severity of Illness Index; Tumors; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Viral diseases; Viral hepatitis
• ISSN: 0163-2116; 1573-2568
• DOI: 10.1007/s10620-006-3211-2

It is known that there is a very high incidence of hepatocellular carcinoma (HCC) among patients with type C chronic hepatitis and cirrhosis, and alpha -fetoprotein (AFP) has been widely used as a diagnostic marker for HCC. However, there are some patients showing continuous high AFP values but no evidence of HCC, and some studies have defined such patients as a high-risk group for HCC. In vitro study has shown that interferon (IFN) inhibits cell proliferation and enhances apoptosis as well as specific cytotoxic T lymphocytes against HCC, resulting in direct anticancer actions. In this study, we investigated the effect of IFN on AFP changes in chronic hepatitis C patients. Of 40 patients with chronic hepatitis C in whom diagnostic imaging confirmed the absence of HCC, 24 patients showed high pretreatment AFP values (high AFP group: AFP level > 10 ng/dl; mean +/- SD, 46.3 +/- 41.5 ng/dl) and 16 showed low pretreatment AFP values (low AFP group: pretreatment AFP level < or = 10 ng/dl; mean +/- SD, 5.3 +/- 2.2 ng/dl). Pretreatment clinical parameters were statistically evaluated in relation to the AFP value. In the high AFP group, the platelet count, albumin level, and prothrombin (%) were significantly lower (P = 0.047, P = 0.0002, and P = 0.044, respectively), suggesting that AFP value increases with advancing liver disease. Subsequently 27 patients were administered IFN (IFN group), and the remaining 13 patients were administered Stronger Neo-minophagen C (SNMC), a glycyrrhizin preparation (SNMC group), as a control group receiving liver-protective therapy. Alanine aminotransferase was reduced in both the IFN and the SNMC group (mean, 132.56 to 60.07 mg/ml [P < 0001] and 147.85 to 56.23 mg/ml [P = 0.0240], respectively). AFP was significantly reduced in the IFN group (mean, 30.03 to 12.65 ng/ml; P = 0.0034), but there was no significant change in AFP in the SNMC group (mean, 29.70 to 39.17 ng/ml). AFP is useful for diagnosing HCC; however, some patients show a persistently high AFP level in the absence of HCC, and these patients have been described as a high-risk group for HCC. In this study, we found that IFN therapy but not SNMC universally reduced the AFP baseline. Since AFP is a significant predictor for HCC, therapeutic strategies for hepatitis C, e.g., long-term low-dose IFN treatment, may reduce hepatocarcinogenesis.