Alpha-fetoprotein before and after pegylated interferon therapy for predicting hepatocellular carcinoma development

Table 1 Characteristics of patients enrolled in the present study

Patient characteristics	n = 1255
Age (yr)	59 (18-79)1
Gender (male/female)	674/581
HCV genotype (1/2/3)	846/406/3
White blood cell (/μL)	5076 ± 15062
Hemoglobin (g/dL)	14.0 ± 1.52
Platelet count (10000/μL)	16.7 ± 5.52
Alanine aminotransferase (IU/L)	56 ± 372
Alpha-fetoprotein (ng/mL)	4.6 (0.9-223)1
Therapeutic outcome (SVR/relapse/NVR)	665/335/255

¹Median (range);

²Mean ± SD. SVR: Sustained virological response; NVR: Partial or null virological response.

Table 2 Logistic regression analysis of factors associated with alpha-fetoprotein ≥ 5 ng/mL before therapy

	Univariate analysis		Multivariate analysis
Factors	OR (range1)	P	OR (range1)	P
Age (1: ≥ 60 yr)	1.2 (0.96-1.5)	0.10
Gender (1: male)	1.2 (0.93-1.5)	0.19
HCV genotype (1: type 1)	0.72 (0.57-0.92)	0.007
White blood cell (1: ≥ 4000/μL)	0.78 (0.60-1.0)	0.061
Hemoglobin (1: ≥ 12.5 g/dL)	0.97 (0.74-1.3)	0.80
Platelet count (1: ≥ 130000/μL)	0.31 (0.24-0.41)	< 0.0001	0.35 (0.27-0.46)	< 0.0001
ALT (1: ≥ 40 IU/L)	3.0 (2.3-3.8)	< 0.0001	2.7 (2.1-3.4)	< 0.0001

¹95%CI. HCV: Hepatitis C virus; ALT: Alanine aminotransferase.

Table 3 Logistic regression analysis of factors associated with decreased alpha-fetoprotein < 5 ng/mL 1 year after therapy among the patients showing alpha-fetoprotein ≥ 5 ng/mL before therapy

	Univariate analysis		Multivariate analysis
Factors	OR (range1)	P	OR (range1)	P
SVR patients
Age (1: ≥ 60 yr)	0.84 (0.50-1.4)	0.50
Gender (1: male)	1.3 (0.77-2.2)	0.32
HCV genotype	0.89 (0.54-1.5)	0.64
White blood cell (1: ≥ 4000/μL)	0.79 (0.43-1.5)	0.45
Hemoglobin (1: ≥ 12.5 g/dL)	0.55 (0.26-1.2)	0.12
Platelet count (1: ≥ 130000/μL)	1.2 (0.66-2.0)	0.60
ALT (1: ≥ 40 IU/L)	1.5 (0.82-2.8)	0.19
ALT at end of therapy (1: ≥ 40 IU/L)	0.86 (0.43-1.7)	0.68
ALT 1 yr after therapy (1: ≥ 40 IU/L)	0.27 (0.087-0.86)	0.027	0.27 (0.087-0.86)	0.027
Non-SVR patients
Age (1: ≥ 60 yr)	0.89 (0.55-1.4)	0.64
Gender (1: male)	1.2 (0.73-1.9)	0.53
HCV genotype	1.1 (0.59-2.2)	0.70
White blood cell (1: ≥ 4000/μL)	1.5 (0.86-2.7)	0.15
Hemoglobin (1: ≥ 12.5 g/dL)	1.6 (0.91-2.8)	0.10
Platelet count (1: ≥ 130000/μL)	1.8 (1.1-2.9)	0.019	1.5 (0.88-2.4)	0.14
ALT (1: ≥ 40 IU/L)	1.2 (0.69-2.1)	0.53
ALT at end of therapy (1: ≥ 40 IU/L)	0.31 (0.18-0.54)	< 0.0001	0.41 (0.22-0.75)	0.0040
ALT 1 yr after therapy (1: ≥ 40 IU/L)	0.35 (0.21-0.59)	< 0.0001	0.53 (0.30-0.93)	0.028

¹95%CI. SVR: Sustained virological response; HCV: Hepatitis C virus; ALT: Alanine aminotransferase.

Table 4 Risk factors of hepatocellular carcinoma development after interferon therapy for chronic hepatitis C patients in Cox proportional hazard models

	Univariate analysis		Multivariate analysis
Factors	HR (range1)	P	HR (range1)	P
SVR patients
Age (1: ≥ 60 yr)	4.7 (1.7-13)	0.0028	3.8 (1.4-11)	0.0092
Gender (1: male)	1.3 (0.53-3.3)	0.55
HCV genotype	0.84 (0.35-2.0)	0.71
White blood cell (1: ≥ 4000/μL)	1.4 (0.41-4.8)	0.58
Hemoglobin (1: ≥ 12.5 g/dL)	1.2 (0.35-4.0)	0.79
Platelet count (1: ≥ 130000/μL)	0.20 (0.081-0.47)	0.0003	0.35 (0.14-0.88)	0.022
ALT (1: ≥ 40 IU/L)	3.0 (0.87-10)	0.083
ALT at end of therapy (1: ≥ 40 IU/L)	2.4 (0.81-7.2)	0.12
ALT 1 yr after therapy (1: ≥ 40 IU/L)	0.99 (0.13-7.4)	0.99
AFP (1: ≥ 5 ng/mL)	28 (3.7-208)	0.0012	13 (1.6-109)	0.017
AFP at end of therapy (1: ≥ 5 ng/mL)	8.0 (3.2-20)	< 0.0001	1.9 (0.61-5.9)	0.27
AFP 1 yr after therapy (1: ≥ 5 ng/mL)	5.5 (2.3-13)	< 0.0001	1.5 (0.50-4.2)	0.49
Non-SVR patients
Age (1: ≥ 60 yr)	1.4 (0.87-2.3)	0.16
Gender (1: male)	2.3 (1.4-3.9)	0.001	2.1 (1.3-3.6)	0.0035
HCV genotype	0.15 (0.037-0.61)	0.0083	0.19 (0.046-0.78)	0.021
White blood cell (1: ≥ 4000/μL)	0.64 (0.39-1.0)	0.076
Hemoglobin (1: ≥ 12.5 g/dL)	0.90 (0.54-1.5)	0.69
Platelet count (1: ≥ 130000/μL)	0.26 (0.15-0.42)	0.0025	0.47 (0.28-0.81)	0.0063
ALT (1: ≥ 40 IU/L)	2.7 (1.5-4.9)	0.0014	1.0 (0.53-2.0)	0.92
ALT at end of therapy (1: ≥ 40 IU/L)	2.8 (1.8-4.5)	< 0.0001	1.2 (0.69-2.0)	0.54
ALT 1 yr after therapy (1: ≥ 40 IU/L)	2.4 (1.5-3.9)	0.0003	1.2 (0.69-2.0)	0.56
AFP (1: ≥ 5 ng/mL)	13 (4.9-37)	< 0.0001	4.6 (1.4 - 15)	0.011
AFP at end of therapy (1: ≥ 5 ng/mL)	6.5 (3.6-12)	< 0.0001	0.97 (0.40-2.3)	0.94
AFP 1 yr after therapy (1: ≥ 5 ng/mL)	7.8 (4.1-15)	< 0.0001	3.0 (1.2-7.1)	0.014

¹95%CI. SVR: Sustained virological response; ALT: Alanine aminotransferase; AFP: Alpha fetoprotein.