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

•Hepatitis C virus core antigen (HCV-cAg) levels correlate with HCV RNA levels.•HCV-cAg can be used as a surrogate marker of HCV infection.•HCV-cAg simplifies the HCV infection flowchart.•HCV-cAg is able to detect failure to direct-acting antiviral treatments. New efficient strategies are needed for...

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Bibliographic Details
Published in:International journal of infectious diseases 2019-12, Vol.89, p.131-136
Main Authors: Pérez-García, Alejandra, Aguinaga, Aitziber, Navascués, Ana, Castilla, Jesús, Ezpeleta, Carmen
Format: Article
Language:English
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Summary:•Hepatitis C virus core antigen (HCV-cAg) levels correlate with HCV RNA levels.•HCV-cAg can be used as a surrogate marker of HCV infection.•HCV-cAg simplifies the HCV infection flowchart.•HCV-cAg is able to detect failure to direct-acting antiviral treatments. 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. 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. 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. HCV-cAg demonstrated good sensitivity and specificity as a marker for active HCV infection, new diagnosis, detection of antiviral therapeutic failure, and treatment monitoring.
ISSN:1201-9712
1878-3511
DOI:10.1016/j.ijid.2019.09.022