Wong, Xue Z. and Amirah, Azzeri and Gan, Chye Chung and Fatiha Hana, Shabaruddin and Maznah, Dahlui and Yahya, Rosnawati and Ganapathy, Shubash and Tan, Soek S. and Mohamed, Rosmawati and Lim, Soo K. (2021) Hepatitis C virus core antigen as alternative diagnostic algorithm for active hepatitis C virus infection among haemodialysis population: Cost implications. Nephrology, 26 (5). pp. 463-470. ISSN 1320-5358, DOI https://doi.org/10.1111/nep.13862.
Full text not available from this repository.Abstract
Aims In Malaysia, majority anti-HCV positive haemodialysis patients do not undergo hepatitis C confirmation due to the high cost of HCV RNA. HCV Core Antigen might be a cost-effective diagnostic test to identify HD patients who have active HCV infection eligible for Direct Acting Anti-viral therapy. Methods A cross-sectional study was conducted to assess the correlation between HCV Ag and HCV RNA and the cost implications of different diagnostic algorithms to diagnose active HCV infection using Anti-HCV, HCV Ag, and HCV RNA. Pre-dialysis blood was tested for both HCV Ag and HCV RNA. HCV Ag was tested with Abbott ARCHITECT HCV Ag test. Results Two-hundred twenty-seven haemodialysis patients were recruited from 20 centres with mean age of 57.68 +/- 12.48 years, and male constitutes 56.8% (129) of the study population. HCV Ag correlated well with HCV RNA (Spearman test coefficient 0.943, p < .001) with sensitivity of 93.9%, specificity 99.3%, and the accuracy was 97.36%. Cost analysis indicated that a sequential test involving Anti-HCV antibody as initial screening, followed by HCV Ag on Anti-HCV positive and HCV RNA on HCV Ag negative cases translated to a modest cost-saving algorithm compared to standard diagnostic algorithm. Conclusion HCV Ag correlated well with HCV RNA and can potentially be fused in an alternative diagnostic algorithm to generate cost savings methods to diagnose active HCV infection among haemodialysis patients. This alternative algorithm is especially relevant in low to middle-income countries such as Malaysia to optimize the use of the healthcare resource and gains in clinical outcomes.
| Item Type: | Article |
|---|---|
| Funders: | Malaysia Society of Nephrology, National Kidney Foundation |
| Uncontrolled Keywords: | Cost implication;Diagnostic algorithm;Haemodialysis;HCV core antigen;Hepatitis C virus |
| Subjects: | R Medicine |
| Divisions: | Faculty of Medicine |
| Depositing User: | Ms Zaharah Ramly |
| Date Deposited: | 15 Jun 2022 04:38 |
| Last Modified: | 15 Jun 2022 04:38 |
| URI: | http://eprints.um.edu.my/id/eprint/34402 |
Actions (login required)
 |
View Item |
