Alpha-Fetoprotein and Hepatitis B Antigen in Acute Hepatitis and Primary Cancer of the Liver

Ruoslahti, E., Seppälä, M., Räsänen, J. A., Vuopio, P. & Helske, T. 1973. Alpha-Fetoprotein and Hepatitis B Antigen in Acute Hepatitis and Primary Cancer of the Liver. Scand. J. Gastroent. 8, 197-202.A relationship between alpha-fetoprotein (AFP) and the hepatitis B (HB Ag, H.A.A., SH, Australia) antigen was recently suggested by an increased incidence of HB Ag with a concomitant elevated serum AFP level in primary liver cancer, and an increase of serum AFP in HB Ag positive hepatitis. We determined circulating AFP levels by a highly sensitive radioimmunoassay and found increased levels in 3 out of 19 patients with acute hepatitis. These 3 were HB Ag negative. Sequential serum samples revealed an increase of AFP within the normal range in 4 patients, of whom 2 were HB Ag positive and 2 negative. AFP levels in 100 apparently healthy carriers of HB Ag were similar to those found in the normal Finnish population. Of 23 patients with a histologically verified primary liver cancer, 3 showed evidence of previous contact with the hepatitis B antigen. While hepatitis may play a role in the aetiology of primary cancer of the liver even in Scandinavia, our results do not indicate a straightforward relationship between the presence of HB Ag and increased serum levels of AFP.