Comparative Analysis of Alpha-Fetoprotein (AFP) Levels and Their Clinical Correlates in Hepatitis B and Hepatitis C Patients

Abstract

Alpha-fetoprotein (AFP) is a widely used but non-specific biomarker in chronic liver disease, often elevated due to inflammation or hepatocellular carcinoma (HCC). Whether its clinical correlates differ between chronic hepatitis B (CHB) and C (CHC) remains inadequately characterized. This study aimed to compare serum AFP levels and their associations with key clinical variables in CHB and CHC patients, to elucidate etiology-specific biomarker patterns. A retrospective cross-sectional study was conducted on 110 patients (62 CHB, 48 CHC) at Saidu Teaching Hospital, Swat. Serum AFP, viral load, liver enzymes, and other biochemical parameters were analyzed. Statistical comparisons, Spearman's correlation, and multivariate linear regression were performed to identify independent predictors of AFP. Median AFP was significantly higher in CHC patients (9.4 ng/mL) than in CHB patients (6.8 ng/mL, p=0.027). In CHB, AFP showed weak positive correlation with HBV DNA (ρ=0.28, p=0.028) and strong correlation with ALT (ρ=0.51) and AST (ρ=0.49). In CHC, AFP correlated strongly with ALT (ρ=0.63) and AST (ρ=0.58), but not with HCV RNA (ρ=0.12, p=0.418). Multivariate analysis identified ALT and HBV DNA as independent predictors of AFP in CHB, while only ALT was predictive in CHC. In CHB, AFP correlated with both viral load (HBV DNA) and liver inflammation (ALT, AST), whereas in CHC, AFP correlated strongly with inflammation markers but not with viral load (HCV RNA).