Education raises Awareness

Raising awareness about hepatitis C means know something about it. Here are a few powerful facts:

    More people in the U.S. die every year from hepatitis C than die from HIV.
    The hepatitis C death rate is increasing annually.
    More than half of those who die from hepatitis C, are 55 to 64 years old.
    The number of new hepatitis C infections is increasing at alarming rates, particularly among teens and young adults.
    Despite the increase in new hepatitis C virus (HCV) infections, there has been a decrease in the prevalence of HCV in the U.S. because so many are dying.
    The CDC recommends testing all persons born from 1945 through 1965 for hepatitis C

    Blood Tests

 What is alpha-fetoprotein (AFP) blood test?
    In which situations are high blood levels of AFP seen in adults?
    What tests are available for measuring AFP?
    What is the sensitivity of AFP for diagnosing liver cancer?
  
  Alpha-fetoprotein Blood Test Index

What tests are available for measuring AFP?

Several assays (tests) for measuring AFP are available. Generally, normal levels of AFP are below 10 ng/ml. Patients with various types of acute and chronic liver diseases without documentable liver cancer can have mild or even moderate elevations of AFP, though usually less than 500 ng/ml.

The use of the AFP assay in prenatal, perinatal, and pediatric care is beyond the scope of this discussion. We will confine the discussion to its use as a tumor screening test and as a tumor marker.

What is the sensitivity of AFP for diagnosing liver cancer?

Primary liver cancer, or hepatocellular carcinoma or hepatoma, is more common in some forms of chronic liver disease. As a screening test in patients with chronic hepatitis B and C, or hemochromatosis, AFP has a sensitivity for liver cancer of about 60%. In other words, an elevated AFP blood test is seen in about 60% of liver cancer patients. That leaves 40% of patients in these high-risk groups who can have liver cancer but have normal AFP levels. Consequently, the test is not diagnostic but is an indicator of a potential situation. Therefore, a normal AFP does not exclude liver cancer. For example; AFP levels are normal in a fibrolamellar carcinoma, a variant of hepatocellular carcinoma. Also, as noted above, an abnormal AFP does not mean that a patient has liver cancer. It is important to note, however, that patients with cirrhosis and an abnormal AFP, despite having no documentable liver cancer, still are at very high risk of developing liver cancer. Thus, any patient with cirrhosis and an elevated AFP, particularly with steadily rising blood levels, will either most likely develop liver cancer or actually already have an undiscovered liver cancer.

An AFP greater than 500 ng/ml is very suggestive of liver cancer. In fact, the blood level of AFP loosely relates to (correlates with) the size of the liver cancer.

Medical Author:
Tse-Ling Fong, MD
Medical Editor:
Charles Patrick Davis, MD, PhD