The diagnostic measuring of α-fetoprotein in the blood serum in children of different ages with chronic viral hepatitis B and C
Background. The actual problem of modern medicine and essential of hepatology is the problem of non-invasive diagnosis of the liver fibrosis and cirrhosis in children with chronic liver disease. This is due to the rapid progression of fibrosis in children and the use of limited invasive method of diagnosis of this disease by liver biopsy. In addition, the need for regular monitoring of the effectiveness of the treatment requires the development of a rapid non-invasive method of monitoring of fibrotic changes in the liver, which also limits the biopsy diagnostic method because of the inability of its frequent use. There are several methods of non-invasive diagnostic of the liver fibrosis and cirrhosis, most of which involves complex determination of several biochemical parameters. For these reasons, the notion of the highly sensitive screening methods for fast diagnostics of fibrosis and cirrhosis in children with chronic liver disease and also for monitoring of the effectiveness of therapy is an actual issue today.
Objective: to establish the diagnostic value of the α-fetoprotein in the blood serum at chronic viral hepatitis B and C in children.
Material and methods. The content of the α-fetoprotein measured in the blood serum in 66 children with chronic viral hepatitis B and C, aged from 8 months till 18 years, ELISA on enzyme-linked immunosorbent analyzer Humareader 2106 (USA). Statistical analysis of the results conducted in the program "STATISTICA 5.5". Reliability of difference values between independent quantitative variables determined using the U-Mann-Whitney test.
Results. In was determined that in healthy children of the control group the α-fetoprotein not determined in the blood serum. In children with chronic viral hepatitis content of the α-fetoprotein in the blood serum ranged from 0 to 13 pg/l. It is proved that the content of the α-fetoprotein are significantly higher in the phase of viral replication and with patient at high inflammatory activity in the liver (the activity of transaminase increases in 5-10 times and more).
The appearance of the protein, which is the markers of tumour and liver fibrosis in children of all ages with chronic viral hepatitis B and C, in our opinion, is an unfavourable prognostic sign that may indicate progression of the disease course and liver fibrosis.
Concludions. It was found that the criterion of progressive course of chronic viral hepatitis B and C and the progression of liver cirrhosis in children of all ages is the increase the content of α-fetoprotein in blood serum. For the screening of non-invasive diagnosis of liver fibrosis and cirrhosis in children with chronic liver disease, as well as to monitor the effectiveness of the therapy proposed measuring of α-fetoprotein, as an important indicator of collagen.