HCV core antigen: toward elimination of nucleic acid testing?

Abstract

Following the advent of highly effective direct-acting antivirals (DAAs), now available at generic prices in most countries, elimination of hepatitis C virus (HCV) has become a global health priority. 1 WHOGlobal health sector strategy on viral hepatitis 2016–2021: towards ending viral hepatitis. http://apps.who.int/iris/bitstream/10665/246177/1/WHO-HIV-2016.06-eng.pdfDate: June, 2016 Date accessed: September 10, 2018 Google Scholar However, the very small proportion of patients with HCV being tested and treated for hepatitis C globally overshadows the ambitious 2030 WHO elimination targets. Approximately 20% of patients with HCV are aware of their diagnosis, and less than 10% were treated for their infection in 2015; therefore, achieving the 80% treatment coverage goal recommended by WHO is still a long way off. 1 WHOGlobal health sector strategy on viral hepatitis 2016–2021: towards ending viral hepatitis. http://apps.who.int/iris/bitstream/10665/246177/1/WHO-HIV-2016.06-eng.pdfDate: June, 2016 Date accessed: September 10, 2018 Google Scholar HCV core antigen as an alternative to HCV RNA testing in the era of direct-acting antivirals: retrospective screening and diagnostic cohort studiesThese data support the use of HCV core antigen testing to document HCV viraemia in a cost-saving diagnostic algorithm. In a treatment setting, HCV core antigen testing can be used instead of HCV RNA testing for diagnosis and documentation of treatment adherence, but it might not be adequate to determine SVR. This approach might improve access to care, particularly in low-income and middle-income countries. Full-Text PDF