Comparison of an Immunochromatographic Rapid Strip Test, ELISA and PCR in the Diagnosis of Hepatitis C in HIV Patients in Hospital Settings in Cameroon

Abstract

Cameroon belongs to the group of countries highly endemic for hepatitis C viruses. Coinfection of hepatitis C and HIV are also common due to the shared route of transmission of both viruses. In hospital settings in Cameroon, diagnosis prior to treatment of hepatitis C is based solely on the results obtained with an immunochromatographic rapid strip test (97%). This study was aimed at determining the validity of the results that is obtained when an immunochromatographic rapid strip test is used to diagnose hepatitis C virus infection in HIV-positive patients in comparison with more sensitive and specific methods like ELISA and PCR. In a cross-sectional study in two parts, 700 participants were enrolled, 350 were HIV-positive patients and a control group of 350 individuals not infected with HIV. All participants were screened for anti-HCV antibodies using ACON HCV strip test, an assay commonly used in 57·1% of Cameroon hospitals. While using the rapid strip test, of the 350 HIV-positive patients, 25 (7·1%) were found to be positive with the rapid strip test of whom 3(12%) were positive with an ELISA and all 3(100%) positive with the ELISA were also positive with PCR. Evaluation of the rate of false positives with the rapid strip test using ELISA as the gold standard gave a rate of 6·3%. Meanwhile in the control group, after screening with the rapid strip test, 39 (11·1%) were positive of whom 6 (15·4%) were positive with the ELISA and 3 (50%) of the 6 positive with the ELISA were positive with the PCR. Evaluation of the rate of false positives with the rapid strip test in the control group using ELISA as the gold gave a rate of 9·6%. False positive results with this immunochromatographic rapid strip test for the diagnosis of hepatitis C virus infection is therefore common and therefore reinforce the need for a confirmatory test prior to treatment in hospital settings in Cameroon.

Diagnostic accuracy of blood centers in the screening of blood donors for viral markers

“…The various facilities analysed in the study showed a mean false positivity of 2.2%, 2.8% and 11.1% for HBV, HCV and HIV testing respectively when compared with ELISA ( Table 1 ). These rates are in the range of what was obtained in other studies [ 25 , 27 , 28 ]. The mean false negative was 3.0%, 75.0% and 0.0% for HBV, HCV and HIV respectively.…”

“…In blood bank settings, false positive results most often than not has negative consequences on blood donors as this will drive way a lot of potential donors thereby decreasing the blood stock of a facility. However, several studies have suggested that false positives especially in the case of HCV testing can never be completely ruled out especially in Africa where Africans have be shown to produce antibodies that react non-specifically with most rapid tests and lower generations of ELISA a phenomenon that has necessitated the development of newer generations of ELISA [ 27 , 29 ]. The residual risk of transmission of HBV, HCV and HIV as a result of the use of RIA was estimated using the Modified Wald method [ 21 ].…”

Prevalence of Coinfection with Malaria and HIV among Children in Yaoundé, Cameroon: A Cross-Sectional Survey Performed in Three Communities in Yaoundé

“…The prevalence observed was lower than the malaria prevalence of 35% reported in the general population of Yaoundé [22]. This decrease in malaria prevalence in the current study could be attributed to the relentless effort by Cameroon's government to reduce transmission through the distribution of insecticide-treated bed nets (ITNs) to every household in the country as well as the intense sensitization campaign through media [16] [26]. The malaria prevalence in the current study was also lower compared to the national prevalence of 29% [27].…”

Hospital-visiting pregnant women signal an increased spread of hepatitis C infection in Khyber Pakhtunkhwa region of Pakistan

“…Both ELISA and ICT are Anti-HCV antibody assays and are designed to detect HCV presence in serologic samples, however, ICT in the present study gave negative results for nearly half of the samples identified as HCV positive in ELISA tests. ICT has been found to produce both false negatives and false positives in serological HCV studies [ 23 ]. The main attraction of the ICT strip test is its low cost and technical ease.…”