Hepatitis C virus core antigen: A potential alternative to HCV RNA testing among persons with substance use disorders

Abstract

BackgroundThe hepatitis C virus (HCV) core antigen (HCVcAg) may be an alternative diagnostic method to HCV RNA especially in populations such as substance users, the homeless or in resource-limited settings. AimsTo evaluate performance of HCVcAg test in patients with opioid use disorder (OUD) on methadone in order to document its performance characteristics in the target population and to ensure that its specificity remains consistent across different populations. MethodsHCVcAg levels from 109 methadone-maintained patients were compared to HCV RNA levels. ResultsMean age was 53.8±7.8years, 59.6% were male, 68.8% African American, and 44% HCV-infected. HCVcAg was detectable in 47 of 48 HCV-infected, and undetectable in all HCV RNA negative patients. The HCVcAg assay had sensitivity of 97.9% and specificity of 100%. Correlation with HCV RNA levels was excellent (r=0.88, 95% CI 0.76; 0.95, p<0.01). ConclusionHCVcAg has excellent performance for the diagnosis of HCV infection in patients with OUD on methadone.