Abstract
ObjectiveThe prevalence of hepatitis C virus (HCV) infection is typically evaluated based on the current rate of positivity of anti-HCV antibody; however, HCV RNA positivity is considered the main criterion for antiviral treatment of HCV infection in the clinical setting. In this study, we evaluated the prevalence of HCV infection based on anti-HCV and HCV RNA detection in the population of Liaoning Province, and investigated the correlation between serum HCV RNA positivity and anti-HCV levels.MethodsA total of 192,202 patients who underwent serum anti-HCV examination at Shengjing Hospital in 2018 were enrolled in the study. Anti-HCV production was tested using a chemiluminescence assay, and serum HCV RNA detection was performed with Roche COBAS TaqMan (CTM) Analyzer.ResultsThe prevalence of anti-HCV was 1.21 and 0.93% among male and female patients in Liaoning Province, respectively. The positive rates of anti-HCV and serum anti-HCV levels were both age-related, in which patients over 40 years of age had a significantly higher anti-HCV positive rate than those younger than 40 years. Among the anti-HCV-positive patients, the average HCV RNA positive rate was 51.66 and 35.93% in males and females, respectively. Spearman rank analysis showed a significantly positive correlation between serum HCV RNA positivity and the level of anti-HCV. The best cut-off value using serum anti-HCV levels to predict the positivity of HCV RNA was determined to be 9.19 signal-to-cut-off ratio (s/co) in males and 10.18 s/co in females.ConclusionThe prevalence of anti-HCV in the general population of Liaoning Province was around 1.04%, which was higher than that previously reported from a national survey of HCV infection in China. Approximately 42.9% of the anti-HCV-positive patients also tested positive for HCV RNA. However, the positive correlation between the serum anti-HCV and HCV RNA levels suggests that the positivity of serum HCV RNA can be predicted according to the anti-HCV level in anti-HCV-positive patients, which can improve screening and facilitate timely intervention to prevent the spread of infection.
Highlights
Chronic hepatitis C virus (HCV) infection is a high risk factor for the development of chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma [1]
There was no difference in anti-HCV positive rates between males and females in patients younger than 20 years (P = 0.144, χ2 = 2.134), whereas among patients older than 20 years, males had a higher positive rate than females (P < 0.001,χ2 = 130.228), especially in those older than 40 years (P < 0.001,χ2 = 36.495) (Table 1)
We found an anti-HCV-positive rate of 1.04%, which is higher than the rate of 0.53% reported previously in northern China in 2006 [4, 5]
Summary
Chronic hepatitis C virus (HCV) infection is a high risk factor for the development of chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma [1]. In 2006, the China Center for Disease Control and Prevention reported that the prevalence of anti-HCV in central China (0.67%) was slightly higher than that in eastern and western China (0.37 and 0.31%, respectively), whereas the prevalence in northern China (0.53%) was significantly higher than that in southern China (0.29%) These data suggested that only 5.6 million people are infected with HCV in China with a prevalence of about 1% [5]. It is essential to identify patients in need of antiviral treatment in a timely and effective manner to provide proper therapy Such effective screening and intervention can help to eliminate the active replication of HCV and prevent disease progression, but could reduce the overall rate of infection and prevalence of HCV in the population by minimizing the chance of transmission [9, 10]
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