标题: Effect of antiviral treatment on AFP levels in HBV-related cirrhotic patients: [打印本页] 作者: liver411 时间: 2010-6-18 06:38 标题: Effect of antiviral treatment on AFP levels in HBV-related cirrhotic patients:
ABSTRACT
Summary. Alpha-fetoprotein (AFP) is a marker of the presence of hepatocellular
carcinoma (HCC), but is also elevated in advanced chronic hepatitis B. The
detection and usage of AFP tests need to be improved. A cohort of 101 patients
with advanced chronic hepatitis B and elevated AFP values was treated with
entecavir (ETV) or peginterferon-α2a. ETV was more effective in reducing AFP
levels; mean time to AFP normalization was 11.9 weeks after ETV treatment
initiation vs 22.3 weeks in peginterferon treated patients (P = 0.000). An
additional cohort of 93 hepatitis B virus (HBV) cirrhotic patients with
elevated AFP were treated with ETV prospectively and maintained under
intensive surveillance. HCC developed in 16 (17.2%) patients in whom the
strongest independent predictor was a continued AFP rise in spite of ongoing
treatment. In this context, nodules of sizes 10-14 mm and 15-20 mm were
detected in 40% of patients each. In conclusion, HBV cirrhotic patients with
rising AFP levels were at very high risk of HCC development. Early detection
of minute lesions may be possible by monitoring AFP levels, whilst patients
are on treatment in conjunction with enhanced computed tomography examination.
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Received April 2009; accepted for publication July 2009
DIGITAL OBJECT IDENTIFIER (DOI)
10.1111/j.1365-2893.2009.01208
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