AFP and viral hepatitis: The standard cut-off of 20 ng/mL for AFP for HCC detection was derived from patients with viral hepatitis; further, the use of different AFP cutoffs according to the liver disease etiology may improve specificity - higher cut-off of 59 ng/mL in patients with cirrhosis from viral hepatitis and lower cut-off of 11 ng/mL in those with non-viral etiology of cirrhosis [24].