Alpha-Fetoprotein as a Predictive Marker for Patients with Hepatitis B-Related Acute-on-Chronic Liver Failure

Abstract

Background and Aims The value of alpha-fetoprotein (AFP) in hepatitis B-related acute-on-chronic liver failure (HBACLF) is not fully understood. The present study aimed to evaluate the prognostic effect of AFP on the prediction of HBACLF outcomes. Methods We investigated a cohort of patients with HBACLF admitted from January 2013 to May 2017. The endpoint of followup was 180 days, death, or liver transplantation. AFP concentrations were estimated on admission. To make statistical comparisons, we used chi-squared test, receiver operating characteristic (ROC) curve analysis, survivorship curve analysis, and Cox proportional-hazards model. Results A total of 92 patients (81.5% male, median age of 46 years) were included. Overall survival rate within 180 days was 43.48%, and the value of log10AFP⁡ ≥ 2.04 indicated a better prognosis with 76.9% specificity and 62.5% sensitivity for patients with HBACLF. Age (HR 1.041), total bilirubin (HR 1.004), log10AFP⁡ (HR 2.155), and INR (HR 1.446) were found to be risk factors of survival. Conclusion AFP could be a useful marker to predict outcomes of acute-on-chronic liver failure.

Determinants of re‐compensation in patients with hepatitis B virus‐related decompensated cirrhosis starting antiviral therapy

“…A histologic study disclosed that AFP synthesis is augmented in the early regenerative phase after liver injury; in particular, proliferation of AFP (+) acinary‐arranged hepatocytes appears to be a more efficient pathway for hepatic regeneration 23 . Furthermore, some clinical studies have suggested that serum AFP level could be a good prognostic marker for better outcomes not only in patients with acute hepatic failure but also in those with acute‐on‐chronic liver failure 24,25 . Thus, elevated AFP levels in the absence of HCC may indicate active hepatocyte regeneration and presage early re‐compensation.…”

The Conquering influence of the Nano extracts of pomegranate peels and pistachio leaves in amelioration of acute liver failure

“…9). These results may really meet the fact that alteration in the redox status would stimulate the entire inflammatory cascade including the activation of a series of transcription factors [79,80,81] . AFP is regarded as a biomarker of proliferating liver stem cells under conditions of liver injury [82].…”

Brassica juncea L. (Mustard) Extract Silver NanoParticles and Knocking off Oxidative Stress, ProInflammatory Cytokine and Reverse DNA Genotoxicity

“…It can clearly be seen the expression of TNF-αandIL6 is about 70%. These findings may ensure that the entire inflammatory cascade, including the activation of transcription factors, is activated when the redox status is attached [ 46 , 47 , 48 ]. However, these parameters were remodulated and downregulated by mustard extract treatment in both normal and its nano form either pre-or post TAA intoxication.…”