Abstract
Hepatitis C Virus (HCV) infection is diagnosed by the presence of antibody to HCV and/or HCV RNA. This study aimed to evaluate the accuracy of anti-HCV titer (S/CO ratio) in predicting HCV viremia in patients with or without hepatitis B virus (HBV) dual infection. Anti-HCV seropositive patients who were treatment-naïve consecutively enrolled. Anti-HCV antibodies were detected using a commercially chemiluminescent microparticle immunoassay. HCV RNA was detected by real-time PCR method. A total of 1321 including1196 mono-infected and 125 HBV dually infected patients were analyzed. The best cut-off value of anti-HCV titer in predicting HCV viremia was 9.95 (AUROC 0.99, P<0.0001). Of the entire cohort, the anti-HCV cut-off value of 10 provided the best accuracy, 96.8%, with the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 96.3%, 98.9%, 99.7% and 87.3% respectively. The best cut-off value of anti-HCV titer in predicting HCV viremia was 9.95 (AUROC 0.99, P<0.0001) and 9.36 (AUROC 1.00, P<0.0001) in patients with HCV mono-infection and HBV dual-infection respectively. Among the HBV dually infected patients, the accuracy of anti-HCV titer in predicting HCV viremia reached up to 100% with the cut-off value of 9. All the patients were HCV-viremic if their anti-HCV titer was greater than 9 (PPV 100%). On the other hand, all the patients were HCV non-viremic if their anti-HCV titer was less than 9 (NPV 100%). Anti-HCV titer strongly predicted HCV viremia. This excellent performance could be generalized to either HCV mono-infected or HBV dually infected patients.
Highlights
Among the hepatitis B virus (HBV) dually infected patients, the accuracy of anti-hepatitis C virus (HCV) titer in predicting HCV viremia reached up to 100% with the cut-off value of 9
All the patients were HCV-viremic if their anti-HCV titer was greater than 9 (PPV 100%)
It is estimated that 71 million people are infected with hepatitis C virus (HCV) globally, which is a main public threat and disease burden
Summary
It is estimated that 71 million people are infected with hepatitis C virus (HCV) globally, which is a main public threat and disease burden. From the viewpoint of natural history, 70%-80% of the subjects with HCV acquisition became chronically infected, 20% of whom progress to cirrhosis within 30 years. Among these cirrhotic patients, 25% of them would develop hepatocellular carcinoma (HCC) eventually. Patients with HBV and HCV dual infection have a more deteriorated clinical course of liver disease progression, and are at an increased risk of HCC. Both viruses may interact and suppress reciprocally, making the serological and virological diagnosis more complex [3,6]. This study aimed to determine the optimal anti-HCV titer (S/CO ratio) in predicting HCV viremia in anti-HCV seropositive subjects with or without HBV dual-infection, and sought to explore the accuracy of the anti-HCV titer with different cut-off values between patients with HCV mono-infected and dually infected patients
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