Hepatitis C core antigen: Diagnosis and monitoring of patients infected with hepatitis C virus

Int J Infect Dis. 2019 Dec:89:131-136. doi: 10.1016/j.ijid.2019.09.022. Epub 2019 Sep 30.

Abstract

Introduction: New efficient strategies are needed for the assessment of active hepatitis C virus (HCV) infection. The aim of this study was to evaluate the ability of HCV core antigen (HCV-cAg) as a marker of active HCV infection in newly diagnosed patients, for treatment monitoring, and for the detection of therapeutic failure.

Materials and methods: A prospective study was conducted at a regional reference hospital in Spain. HCV-cAg and viral load (RNA-HCV) were tested in plasma or serum samples from three patient groups: new diagnosis, treatment monitoring, and treatment failure. The treatment monitoring group was tested at the beginning of treatment, at 4 weeks post-initiation, at the end of treatment, and at 12 weeks post-treatment completion. The Architect HCV core antigen assay was performed for HCV-cAg testing, and viral load was quantified with the Cobas 6800 system.

Results: A total of 303 samples from 124 patients were analyzed. Excellent correlation was seen between HCV-cAg and HCV-RNA (R2=0.932). The optimal cut-off value was 3fmol/l in the receiver operating characteristics curve analysis, and the area under the curve was 0.987 (95% confidence interval 0.972-1.000). HCV-cAg sensitivity and specificity were 97% and 95%, respectively. Most diverging results were observed in the treatment follow-up group.

Conclusions: HCV-cAg demonstrated good sensitivity and specificity as a marker for active HCV infection, new diagnosis, detection of antiviral therapeutic failure, and treatment monitoring.

Keywords: Alternative and new tools; HCV core antigen; Hepatitis C; Hepatitis C virus; Monitoring treatment.

MeSH terms

  • Adult
  • Antiviral Agents / therapeutic use
  • Female
  • Hepacivirus / classification
  • Hepacivirus / genetics
  • Hepacivirus / isolation & purification*
  • Hepatitis C / diagnosis*
  • Hepatitis C / drug therapy
  • Hepatitis C / epidemiology
  • Hepatitis C / virology
  • Hepatitis C Antigens / genetics*
  • Hepatitis C Antigens / metabolism
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • RNA, Viral / genetics
  • ROC Curve
  • Sensitivity and Specificity
  • Spain / epidemiology
  • Viral Load

Substances

  • Antiviral Agents
  • Hepatitis C Antigens
  • RNA, Viral