In chronic viral hepatitis without malignancy, abnormal serum carbohydrate 19-9 antigen levels are associated with liver disease severity and are related to different viral aetiology 2010 Jun;42(6):458-9

Increased CA19-9 serum levels are frequent inchronic viral hepatitis. This does not indicate concurrent neoplasia, but correlates with the grade of liver fibrosis. Moreover, the increase in CA19-9 is significantly higher in patients with HCV infection compared with HBV, thus related to the viral aetiology. Based on the most recent literature, we propose that this may be explained by the more fibrogenic properties of HCV than HBV, but further research is needed to assess the specific role of HCV in CA19-9 synthesis. An interaction between HCV proteins and hepatic stellate cells may contribute to HCV-induced liver fibrosis.Further investigationsmay clarify if CA19-9 assumes the role of an indirect marker of hepatic fibrosis, in addition to being a neoplastic marker.We propose that CA19-9 can be used in combination with the other markers already in use, in order to increase the diagnostic accuracy of the available tests, and increasing the positive andnegative predictive values.