Relation of Alpha-Fetoprotein in Acute Hepatitis to Severity and Prognosis

Serums of 104 patients with acute hepatitis of variable severity were tested for alpha-fetoprotein by counterelectrophoresis. Among 51 patients with fulminant hepatitis and coma, alpha-fetoprotein was detected in 17 (85%) of 20 who survived and in only 12 (38.7%) of 31 fatal cases (P = 0.002, Fisher's exact test). Among 53 patients without coma, alpha-fetoprotein was detected in 16. Alpha-fetoprotein positivity was found to be related to the severity of the disease, and its appearance was followed by recovery in these patients. The high levels of alpha-fetoprotein observed in severe forms of hepatitis may represent active hepatocyte regeneration after extensive hepatic necrosis. Moreover, the presence of alpha-fetoprotein seems to be a favorable prognostic sign.