AFP AND THE DIAGNOSIS OF HCC

A case-control study also evaluated the diagnostic characteristics of the serum AFP in screening for HCC in patients with different types of chronic liver disease. The following sensitivities and specificities were observed [33]:

• AFP cutoff 16 µg/L (sensitivity 62, specificity 89 percent)
• AFP cutoff 20 µg/L (sensitivity 60, specificity 91 percent)
• AFP cutoff 100 µg/L (sensitivity 31, specificity 99 percent)
• AFP cutoff 200 µg/L (sensitivity 22, specificity 99 percent)

HEPATITIS AND HIV

At present, almost half of all HIV patients are coinfected with either hepatitis B virus (HBV) or hepatitis C virus (HCV), and the liver has become one of the most important organs affecting survival, quality of life, and health care costs. In fact, a recent European study showed that chronic liver disease, especially that due to hepatotropic viruses, was the fifth leading cause of death among HIV patients admitted to the hospital over a 4.5-year period.

Hepatocellular necrosis (hepatitis) in HIV-infected patients is usually due either to use of hepatotoxic drugs or infection by hepatitis viruses. Given the shared epidemiologic risks of sexual contact (homosexual or heterosexual), intravenous drug use, and in the past, use of blood products, it is not surprising that up to 95% of patients infected with HIV have serologic markers of past HBV infection (anti-HBs or anti-HBc positive) and 10% to 15% are chronic carriers (HBsAg positive).