Hepatitis C core antigen testing to diagnose active hepatitis C infection among haemodialysis patients

Wong, Xue Zheng and Gan, Chye Chung and Mohamed, Rosmawati and Yahya, Rosnawati and Ganapathy, Shubash and Tan, Soek Siam and Lim, Soo Kun (2020) Hepatitis C core antigen testing to diagnose active hepatitis C infection among haemodialysis patients. BMC Nephrology, 21 (1). ISSN 1471-2369, DOI https://doi.org/10.1186/s12882-020-02154-4.

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BackgroundHepatitis C virus (HCV) infects more than 71 million people worldwide and chronic HCV infection increases the risk of liver cirrhosis and failure. Haemodialysis (HD) is one of the renal replacement therapies with risk of HCV transmission. Anti-HCV antibodies are the serological screening test for HCV infection that does not detect active phase of infection. Majority HCV infected HD patients in Malaysia do not have further HCV RNA performed due to high cost and thus HCV treatment is less frequently offered. HCV Core Antigen (HCV Ag) can potentially be used to diagnose active HCV infection in HD population in comparison to HCV RNA, at lower cost.MethodsWe conducted a cross-sectional study to assess the correlation between HCV Ag and HCV RNA and to identify the prevalence of active HCV infection among HCV seropositive HD patients from dialysis centres across West Malaysia from July 2019 to May 2020. Pre-dialysis blood was taken and tested for both HCV Ag and HCV RNA tests. HCV Ag was tested with Abbott ARCHITECT HCV Ag test.ResultsWe recruited 112 seropositive HD patients from 17 centres with mean age of 54.0411.62years, HD vintage of 14.1 +/- 9.7years, and male constitute 59.8% (67) of the study population. HCV Ag correlates well with HCV RNA (Spearman test coefficient 0.833, p<0.001). The sensitivity was 90.7%, specificity 100%, positive predictive value (PPV) 100%, negative predictive value (NPV) 76.5%, and accuracy 92.9%. For HCV RNA level>3000IU/mL, HCV Ag had a higher sensitivity of 95.1% and greater correlation (Spearman test coefficient 0.897, p<0.001). The prevalence of active HCV infection was 76.8% among HCV seropositive HD patients.Conclusions Although HCV Ag is less sensitive, it shows an excellent correlation with HCV RNA and has 100% PPV. HCV Ag can be considered as an alternative diagnostic tool for chronic active HCV infection among HD cohort, who can then be considered for HCV treatment. For seropositive HD patient with negative HCV Ag, we recommend to follow-up with HCV RNA test.

Item Type: Article
Funders: National Kidney Foundation, Malaysia Society of Nephrology
Uncontrolled Keywords: Abbott ARCHITECT HCV Ag; HCV Core antigen; Hepatitis C virus; HCV RNA; Haemodialysis
Subjects: R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Divisions: Faculty of Medicine
Depositing User: Mrs. Siti Mawarni Salim
Date Deposited: 28 Sep 2022 06:51
Last Modified: 28 Sep 2022 06:51
URI: http://eprints.um.edu.my/id/eprint/31691

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