Improving Diagnosis of Hepatitis C Virus Infection Using Hepatitis C Core Antigen Testing in a Resource-Poor Setting

Sociedade Brasileira de Medicina Tropical. Revista

article

Ayswarya Kannan¹  Lalitha Biswas²  Anil Kumar¹  Jessy Kurian³  Anjaly S.Nair⁴  Parasmal Suresh²  Shine Sadasivan⁵  Raja Biswas² 

[1] Amrita Institute of Medical Sciences, Department of Microbiology;Center for Nanoscience and Molecular Medicine;Amrita Institute of Medical Sciences, Molecular biology laboratory;Amrita Institute of Medical Sciences, Department of Biostatistics;Amrita Institute of Medical Sciences, Department of Gastroenterology

关键词: Hepatitis C Virus core antigen;    Hepatitis C Virus;    RNA;    HCV antibodies;    Sustained viral response;   

DOI  :  10.1590/0037-8682-0253-2020

学科分类：农业科学（综合）

来源: Sociedade Brasileira de Medicina Tropical

【 摘 要 】

Introduction: We compared the hepatitis C virus (HCV) core antigen test with the HCV RNA assay to confirm anti-HCV results to determine whether the HCV core antigen test could be used as an alternative confirmatory test to the HCV RNA test. Methods: Sera from 156 patients were analyzed for anti-HCV and HCV core antigen using a chemiluminescent microparticle immunoassay (Architect i2000SR) and for HCV RNA using the artus HCV RG RT-PCR Kit (QIAGEN) in a Rotor-Gene Q instrument. Results: The diagnostic sensitivity, specificity, and positive and negative predictive values of the HCV core antigen assay compared to the HCV RNA test were 77.35%, 100%, 100%, and 89.38%, respectively. HCV core antigen levels showed a good correlation with those from HCV RNA quantification (r = 0.872). However, 13 samples with a viral load of less than 4000 IU/mL were negative in the HCV core antigen assay. All gray-zone reactive samples were also RNA positive and were positive on repeat testing. Conclusions: The Architect HCV core antigen assay is highly specific and has an excellent positive predictive value. At the present level of sensitivity (77%), the study is still relevant in a low-income setting in which most of the HCV-positive patients would go undiagnosed, since HCV RNA testing is not available and/or not affordable. HCV core antigen testing can also help determine the true burden of infection in a population, considering the fact that almost 50% of the anti-HCV positive cases are negative for HCV RNA.

【 授权许可】

CC BY