Hepatitis C Core Antigen Testing to Diagnose Active Hepatitis C Infection Among Haemodialysis Patients

Abstract

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. METHODS We 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.RESULTS We recruited 112 seropositive HD patients from 17 centres with mean age of 54.04±11.62 years, HD vintage of 14.1±9.7 years, 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 >3000 IU/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.

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

“…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).…”

HCV core antigen plays an important role in the fight against HCV as an alternative to HCV‐RNA detection

“…Diagnostic value of HCV-cAg detection (comparing with HCV-RNA) HCV-cAg sensitivity was 95.1% and Spearman test coefficient 0.897 [p < 0.001]) 35. Test of 98 samples from HCV-infected patients pointed out that the HCV Ag and HCV-RNA results agreed well (Spearman test coefficient 0.9041, p < 0.0001) in all genotypes and subtypes for HD patients 37.…”

Experimental Study of Flow and Heat Transfer in Granular Media

“…As discussed earlier, simulation results need to be validated experimentally and there are several experimental techniques that have been adopted by researchers to investigate granular flows. Among these techniques are granular bed freezing [21,22], positron emission particle tracking (PEPT) [23][24][25][26], magnetic resonance imaging (MRI) [27][28][29][30], computed tomography (CT) [31][32][33][34], near-infrared spectroscopy (NIR) [35][36][37][38][39][40][41][42][43], and particle image velocimetry (PIV) [44][45][46][47][48][49].…”

“…Recently, PEPT and PIV have gained popularity and are mostly used to visualize the granular flows [23][24][25][26][44][45][46][47][48][49]. In PEPT, tracer particles are introduced in the granular bed and are tracked to visualize their 3D movement [6].…”