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

Pérez‐García, A.; Aguinaga, Aitziber; Navascués, Ana; Castilla, Jesús; Ezpeleta, Carmen

doi:10.1016/j.ijid.2019.09.022

Cited by 17 publications

(22 citation statements)

References 26 publications

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“…In the era of effective DAAs in the treatment of hepatitis C, screening for anti-HCV is insufficient. Recently, some solutions have been published, such as the point-of-care HCV RNA test [22,23], anti-HCV reflex HCV RNA test [14], anti-HCV reflex HCV Ag test [15], and single HCV Ag test [14,24,25]. These tests can decrease unnecessary referrals and visits, which can reduce the burden on rural areas.…”

Section: Discussionmentioning

confidence: 99%

Community-Based Screening for Hepatitis B and C Infectivity Using Two Quantitative Antigens to Identify Endemic Townships

Huang

Lin

Chen

et al. 2022

Viruses

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Screening and linkage to care are essential to achieve viral hepatitis elimination before 2030. The accurate identification of endemic areas is important for controlling diseases with geographic aggregation. Viral activity drives prognosis of chronic hepatitis B and hepatitis C virus infection. This screening was conducted in Chiayi County from 2018–2019. All residents aged 30 years or older were invited to participate in quantitative HBsAg (qHBsAg) and HCV Ag screening. Among the 4010 participants (male: female = 1630: 2380), the prevalence of qHBsAg and HCV Ag was 9.9% (396/4010) and 4.1% (163/4010), respectively. High-prevalence townships were identified, three for qHBsAg >15% and two for HCV Ag >10%. The age-specific prevalence of qHBsAg was distributed in an inverse U-shape with a peak (16.0%, 68/424) for subjects in their 40 s; for HCV, prevalence increased with age. Concentrations of qHBsAg <200 IU/mL were found in 54% (214/396) of carriers. The rate of oral antiviral treatment for HCV was 75.5% (114/151), with subjects younger than 75 years tending to undergo treatment (85.6% vs. 57.4%, p < 0.001). QHBsAg and HCV Ag core antigens can reflect the concentration of the viral load, which serves as a feasible screening tool. Using quantitative antigen screening for hepatitis B and C in community-based screening, two hyperendemic townships were identified from an endemic county.

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Section: Discussionmentioning

confidence: 99%

Community-Based Screening for Hepatitis B and C Infectivity Using Two Quantitative Antigens to Identify Endemic Townships

Huang

Lin

Chen

et al. 2022

Viruses

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“…In addition, HCVcAg assays, which are easier to perform than reverse transcription-PCR, also save time and are less expensive. HCVcAg is used currently to monitor patients undergoing antiviral therapy and to determine the clinical efficacy of such treatment [22][23][24].…”

Section: Discussionmentioning

confidence: 99%

Hepatitis C core antigen: a simple predictive marker for treatment response to the new direct-acting antiviral drugs in chronic HCV Egyptian patients

Elbrolosy

El-Hamouly

Eed

et al. 2021

Egypt Liver Journal

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Background Successful eradication of hepatitis C virus (HCV) has great impact on the prognosis of HCV-related complications and the associated mortality. The development of the new direct-acting antiviral drugs (DAAs) has revolutionized the treatment of HCV infection. HCV core antigen (HCVcAg) is a recently developed marker that displayed a good correlation with HCV RNA assays. Our main objectives were to correlate between serum levels of HCVcAg and HCV RNA loads in chronic HCV patients as well as to explore the potential value of HCVcAg assay in predicting treatment response to the new DAAs. The study enrolled a total of 280 chronic HCV-infected patients scheduled to start the new regimen for treatment of chronic HCV by all-oral, interferon-free DAAs. According to the viral load, the studied individuals were arranged into three groups corresponding to mild, moderate, and sever viremia. Serum level of HCVcAg was determined by ELISA technique and HCV RNA viral loads were quantified using the real-time PCR system. The assays were performed three times for all participants: prior to initiation of treatment, at the end of treatment (week 12), and 3 months post-treatment cessation (week 24). Results A statistically significant difference between HCV RNA and HCVcAg baseline levels among different viremia groups was detected (P < 0.001). There was a significant positive correlation between HCV RNA and HCVcAg baseline values among all the studied cases (P < 0.05) with a correlation coefficient of 0.752, 0.976, and 1.00 respectively for mild, moderate, and severe viremia groups. 92.9% (260/280) of the studied patients achieved sustained virologic response, 3.6% (10/280) were non-responders, and 3.6% (10/280) had recurrent viremia/relapse as regards RT-PCR results. Conclusion HCVcAg is a promising alternative to HCV RNA assay. The ELISAs for HCVcAg proved excellent correlations with HCV RNA levels. Moreover, HCVcAg can be introduced as a simple and highly specific tool for monitoring the new DAA regimens particularly in low-resource settings.

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“…There are currently two major approaches to providing point of care testing. The rst replaces viral RNA test with core antigen tests, which can provide results in 60 minutes (23)(24)(25). Core antigen tests have been approved by the WHO as an alternative for con rmatory viral load testing (26,27), and may also provide an alternative approach for assessing SRV12 (28).…”

Section: Discussionmentioning

confidence: 99%

Time To Complete hepatitis C Cascade of Care Among Patients Identified During Mass Screening Campaigns in Rural Rwanda: A Retrospective Cohort Study

Kamali¹,

Shumbusho²,

Barnhart³

et al. 2021

Preprint

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Background Since the discovery of direct-acting antivirals, treatment for hepatitis C virus (HCV) is increasingly accessible in low-resource settings, but quality of care in these settings is not known. We described progression through the cascade of care among individuals who screened positive for HCV antibodies during a mass screening campaign in Kirehe and Kayonza, two rural Rwandan districts, in September 2019. Methods This retrospective cohort study used routine clinical data to assess proportions of participants completing each stage of the cascade of care, including: a) screening positive on rapid diagnostic test; b) return of initial viral load results; c) detectable viral load; d) treatment assessment; e) treatment initiation; f) return of sustained virological response (SVR12) results; and g) achieving SVR12. We proposed three indicators to assess timely care provision and used medians and interquartile ranges (IQR) to describe the time to complete the cascade of care. Results Overall, 666 participants screened HCV positive, among them, 452 (68.1%) were female and median age was 61 years (IQR: 47, 70). Viral load results were returned for 537 (80.6%) participants of whom 448 (83.4%) had detectable viral loads. Of these, 398 (88.8%) were assessed for treatment, 394 (99%) were initiated, but only 222 (56.3%) had results returned for SVR12. Among those with SVR12 results, 208 (93.7%) achieved SVR12. When assessing timely care provision, we found 65.9% (95% CI: 62.0, 69.7) of initial viral load results were returned ≤ 30 days of screening; 45% (95% CI: 40.1, 49.8) of people with detectable viral load completed treatment assessment ≤ 90 days of initial viral load results; and 12.5% (95% CI: 9.2,16.3) of SVR12 results were returned ≤ 210 days of treatment initiation among those who initiated treatment. The overall median time from screening to SVR12 assessment was 437 days. Conclusion Despite high rates of SVR12 among those who completed all stages of the cascade of care, we identified gaps and delays in the treatment cascade. Improving communication between viral load testing hubs and health facilities could reduce the turn-around time for viral load testing, and actively monitor timeliness of care provision could improve quality of HCV care.

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

Cited by 17 publications

References 26 publications

Community-Based Screening for Hepatitis B and C Infectivity Using Two Quantitative Antigens to Identify Endemic Townships

Community-Based Screening for Hepatitis B and C Infectivity Using Two Quantitative Antigens to Identify Endemic Townships

Hepatitis C core antigen: a simple predictive marker for treatment response to the new direct-acting antiviral drugs in chronic HCV Egyptian patients

Time To Complete hepatitis C Cascade of Care Among Patients Identified During Mass Screening Campaigns in Rural Rwanda: A Retrospective Cohort Study

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