HCV core antigen is an alternative marker to HCV RNA for evaluating active HCV infection: implications for improved diagnostic option in an era of affordable DAAs.

Rujipat Wasitthankasem,Preeyaporn Vichaiwattana,Sompong Vongpunsawad,Nipaporn Siripon,Pisit Tangkijvanich,Sirapa Klinfueng,Yong Poovorawan,Chompoonut Auphimai

doi:10.7717/peerj.4008

Abstract

The core antigen of the hepatitis C virus (HCV Ag) presents an alternative marker to HCV RNA when screening patients for HCV viremia. This study sought to evaluate the utility of HCV Ag as a marker to assess active HCV infection in individuals residing in an HCV-endemic area. From 298 HCV-seropositive individuals evaluated for the presence of anti-HCV antibody, HCV Ag and HCV RNA, anti-HCV antibody was detected in 252 individuals (signal-to-cutoff ratios ≥5), HCV RNA was detected in 222 individuals (88%), and HCV Ag was reactive (≥3 fmol/L) in 220 individuals (87%). HCV genotype 1, 3, and 6 were identified. HCV Ag significantly correlated with HCV RNA irrespective of HCV genotype and/or HBV co-infection (log HCV RNA = 2.67 + 0.95 [log HCV Ag], R2 = 0.890, p < 0.001). To predict HCV viremia (HCV Ag ≥ 3 fmol/L), the accuracy, sensitivity, specificity, positive predictive value, and negative predictive value were 99%, 99%, 100%, 100% and 97%, respectively. We concluded that HCV Ag was a good surrogate marker for HCV RNA and could be used to diagnose active HCV infection in a resource-limited setting. As a result, a cost-effective strategy for screening and identifying active HCV carriers using HCV Ag detection would enable more patients access to efficacious and increasingly affordable direct-acting antivirals (DAAs) for the treatment of HCV infection.

Highlights

Infection with hepatitis C virus (HCV) can lead to acute or chronic hepatitis, liver fibrosis, cirrhosis, end-stage liver disease, and hepatocellular carcinoma (Perz et al, 2006)
How to cite this article Wasitthankasem et al (2017), HCV core antigen is an alternative marker to HCV RNA for evaluating active HCV infection: implications for improved diagnostic option in an era of affordable direct-acting antivirals (DAAs)
We aimed to evaluate the diagnostic utility of HCV core antigen (HCV Ag) as an alternative to HCV RNA to identify active HCV infection in a relatively high endemic area

Summary

Introduction

Infection with hepatitis C virus (HCV) can lead to acute or chronic hepatitis, liver fibrosis, cirrhosis, end-stage liver disease, and hepatocellular carcinoma (Perz et al, 2006). Disease progression after HCV infection depends on factors including gender, coinfection with HIV, alcohol consumption, and duration of chronic infection (Hajarizadeh, Grebely & Dore, 2013; El-Serag, 2012). The global population seroprevalence of anti-HCV antibodies. The presence of HCV antibodies can be found in spontaneous clearance, resolved infection post-treatment or persistently active disease. Treatment for HCV infection, especially in the acute phase, can facilitate viral clearance and prevent chronic infection, thereby limiting HCV-induced liver damage and mortality (Jaeckel et al, 2001; Gerlach et al, 2003; Singal et al, 2010)

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