Possible causes of high bilirubin and high alpha-fetoprotein include viral hepatitis, cirrhosis, primary liver cancer, etc. 1. Viral hepatitis: bilirubin can be seen to increase, and alpha-fetoprotein can be mildly and transiently elevated in a few patients. Clinical manifestations include fever, nausea and jaundice. 2. Cirrhosis: bilirubin can be seen to increase, and alpha-fetoprotein is transiently increased. Clinical manifestations include hepatic decompensation and portal hypertension. 3. Primary hepatocellular carcinoma: when alpha-fetoprotein is more than 400ng/ml, it suggests possible hepatocellular carcinoma. Fetoprotein is persistently increased and bilirubin is elevated. It is manifested by pain in liver area and progressive enlargement of liver. If both bilirubin and alpha-fetoprotein are found to be elevated, primary liver cancer is highly suspected, and one should go to the hospital for diagnosis in time and take treatment under doctor’s guidance.