Background: Tumor necrosis factor alpha (TNF-α) is physiologically essential for a healthy immune response. Although TNF-α can help the immune system regulate, producing too much or inappropriate of it can be dangerous and can cause diseases. Patients and methods: this study was conducted on 90 patients with liver diseases and 25 healthy control G1, patients divided into 4 groups, (G2) 25 patients with HCV infection, (G3) 25 HCC+HCV infection, (G4) 25 patients with HBV infection, (G5) 15 patients with HCC + HBV. Results: There was a statistically significant difference between the five groups with p-value >0.001^*, Compared to the control group the four groups HCV (G2), HCV+HCC (G3), HBV (G4), and HBV+HCC (G5) have the same statistically significant difference with the same (P1) p-value >0.001^* which was significant. The serum TNF-α expression level of the HCV group (G2) was significantly elevated than HCV+HCC (G3) with a (P2) p-value of 0.010^*significant. Still, the Serum TNF-α expression level of the HBV group (G4) was higher than HBV+HCC (G5) (61.05 ± 199.1, 14.36 ± 2.18 respectively) with (P7) p-value 0.960.
Conclusion: Serum TNF-α can used as a biomarker to differentiate between healthy and infected patients with HCV or HBV and the development of HCC.