Hepatitis C virus core antigen: A diagnostic and treatment monitoring marker of hepatitis C virus in Indian population.

Item request has been placed! ×
Item request cannot be made. ×
loading   Processing Request
  • Additional Information
    • Source:
      Publisher: Springer India Country of Publication: India NLM ID: 8409436 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 0975-0711 (Electronic) Linking ISSN: 02548860 NLM ISO Abbreviation: Indian J Gastroenterol Subsets: MEDLINE
    • Publication Information:
      Publication: India : Springer India
      Original Publication: Bombay : Indian Society of Gastroenterology,
    • Subject Terms:
    • Abstract:
      Background: The diagnosis and treatment monitoring of hepatitis C is quite challenging. The screening test, i.e. antibody assay, is unable to detect acute cases, while the gold standard hepatitis C virus (HCV) reverse transcriptase polymerase chain reaction (RTPCR) assay is not feasible in resource-limited countries such as India due to high cost and infrastructure requirement. European Association for the Study of the Liver and World Health Organization have approved a new marker, i.e. HCV core antigen (HCVcAg) assay, as an alternative to molecular assay. In this study, we have evaluated HCVcAg assay for diagnosis and treatment monitoring follow-up in Indian population infected with hepatitis C.
      Methods: Blood specimen of 90 clinically suspected cases of acute hepatitis C were tested simultaneously for anti-HCV antibody assay via ELISA (enzyme-linked immunoassay), HCVcAg assay by chemiluminescence immune assay (CLIA) and HCV RTPCR VL (viral load) assay. Thirty-four HCV RTPCR positive patients were further enrolled in treatment monitoring group whose blood samples were tested at the beginning of treatment, two weeks, four weeks and 12 weeks via HCV core Ag assay and HCV RTPCR Viral Load assay.
      Results: Considering HCV RTPCR as gold standard, diagnostic performance of HCV core Ag assay and anti-HCV antibody assay was evaluated. The sensitivity and specificity of HCV core Ag assay were higher than that of anti-HCV Antibody assay, i.e. 88.3% and 100% vs. 23.3% and 83.3%, respectively. The overall diagnostic accuracy of HCV core Ag assay was 92.20%. Among treatment follow-up group, HCV core Ag levels correlated well with HCV viral load levels, at the beginning of treatment (baseline) till 12 weeks showing highly significant Spearman rank correlation coefficient of > 0.9 with HCV viral load levels.
      Conclusions: HCV core Ag assay is a cost-effective, practically feasible substitute of HCV RTPCR viral load assay for diagnosis as well as long duration treatment monitoring of hepatitis C infection in resource-limited settings.
      (© 2024. Indian Society of Gastroenterology.)
    • References:
      World Health Organization. Global health sector strategy on viral hepatitis 2016–2021, towards ending viral hepatitis. Geneva: WHO; 2016.
      World Health Organization. Guidelines on hepatitis B and C testing. Geneva. Switzerland: World Health Organization; 2017. p. 2017.
      Kuo YH, Chang KC, Wang JH, et al. Is hepatitis C virus core antigen an adequate marker for community screening? J Clin Microbiol. 2012;50:1989–93. (PMID: 10.1128/JCM.05175-11224616763372126)
      Ghany MG, Strader DB, Thomas DL, Seeff LB; American Association for the Study of Liver Diseases. Diagnosis management, and treatment of hepatitis C: an update. Hepatology. 2009;49:1335–74.
      Centers for Disease Control and Prevention. Guidelines for laboratory testing and result reporting. 2013. http://www.cdc.gov/hepatitis/hcv/labtesting.htm . Accessed 20 December 2022.
      Centers for Disease Control and Prevention. Guidelines for laboratory testing and result reporting. MMWR Morb Mortal 2013;62:362–5. http://www.cdc.gov/mmwr/pdf/wk/mm62e0507a2.pdf . Accessed 20 December 2022.
      WHO. Guidelines for the screening, care and treatment of persons with chronic hepatitis C infection. Update version. 2018. https://www.who.int/publications/i/item/9789241550345 . Accessed 20 December 2022.
      Arboledas JCA, Guerrero IP, Rodríguez MJB, et al. Hepatitis C virus core antigen in the management of patients treated with new direct-acting antivirals. Diagn Microbiol Infect Dis. 2017;89:29–34. (PMID: 10.1016/j.diagmicrobio.2017.06.00628669680)
      Galli C, Julicher P, Plebani M. HCV core antigen comes of age: a new opportunity for the diagnosis of hepatitis C virus infection. Clin Chem Lab Med. 2018;56:880–8. (PMID: 10.1515/cclm-2017-075429702484)
      Benito R, Arribas J, Algarate S, Cebollada R, Gude MJ. Hepatitis C virus core antigen for screening organ donors and recipients. Diagn Microbiol Infect Dis. 2018;91:126–9. (PMID: 10.1016/j.diagmicrobio.2018.01.02129477273)
      Wang Y, Jie W, Ling J, Yuanshuai H. HCV core antigen plays an important role in the fight against HCV as an alternative to HCV-RNA detection. J Clin Lab Anal. 2021;35:e23755.
      Central Bureau of Health Intelligence (2016) Ministry of Health and Family Welfare. National Health Profile. New Delhi, India. https://cbhidghs.mohfw.gov.in/index .
      National guidelines for Diagnosis and Management of Viral Hepatitis. Ministry of Health and family welfare, Government of India. National Viral Hepatitis Control Program (NVHCP) National Health Portal Of India. 2018. Accessed  3/4/2023.
      Alonso R, Pérez-García F, López-Roa P, Alcalá L, Rodeño P, Bouza E.  HCV core-antigen assay as an alternative to HCV RNA quantification: a correlation study for the assessment of HCV viremia. Enferm Infecc Microbiol Clin (Engl Ed). 2018;36:175–8.
      Rebucci C, Cerino A, Cividini A, Timo L, Furione M, Mondelli MU. Monitoring response to antiviral therapy for patients with chronic hepatitis C virus infection by a core-antigen assay. J Clin Microbiol. 2003;41:3881–4.
      Ponnuvel S, Fletcher GJ, Anantharam R, Varughese S, David VG, Abraham P. Clinical utility of hepatitis C virus core antigen (HCVcAg) assay to identify active HCV infection in hemodialysis and renal transplant patients. PLoS One. 2021;16:e0250263.
      Solitano V, Plaz Torres MC, Pugliese N, Aghemo A. Management and treatment of hepatitis C: are there still unsolved problems and unique populations? Viruses. 2021;13:1048. https://doi.org/10.3390/v13061048 . (PMID: 10.3390/v13061048342059668228389)
      Harrison GL, Pryor J, Malani J, et al. Infection frequency of hepatitis C virus and IL28B haplotypes in Papua New Guinea, Fiji, and Kiribati. PLoS One. 2013;8:e66749.
      Mateos P. Names, ethnicity and populations; tracing identity in space. Heidelberg: Springer; 2014.
      Mateos P. A review of name-based ethnicity classification methods and their potential in population studies. Popul Space Place. 2007;13:243–63. (PMID: 10.1002/psp.457)
      Kumbhar N, Ramachandran K, Kumar G, Rao Pasupuleti SS, Sharma MK, Gupta E. Utility of hepatitis C virus core antigen testing for diagnosis and treatment monitoring in HCV infection: a study from India. Indian J Med Microbiol. 2021;39(4):462–6. (PMID: 10.1016/j.ijmmb.2021.07.00234294505)
      Kannan A, Biswas L, Kumar A, et al. Improving diagnosis of hepatitis C virus infection using hepatitis C core antigen testing in a resource-poor setting. Rev Soc Bras Med Trop. 2021;10:54.
      Reddy AK, Dakshinamurty KV, Lakshmi V. Utility of HCV core antigen ELISA in the screening for hepatitis C virus infection in patients on hemodialysis. Indian J Med Microbiol. 2006;24:55–7. (PMID: 10.1016/S0255-0857(21)02473-716505558)
      Medhi S, Potukuchi SK, Polipalli SK, et al. Diagnostic utility of hepatitis C virus core antigen in hemodialysis patients. Clin Biochem. 2008;41:447–52. (PMID: 10.1016/j.clinbiochem.2007.12.02418267117)
      Patel J, Sharma P. Design of a novel rapid immunoassay for simultaneous detection of hepatitis C virus core antigen and antibodies. Adv Virol. 2020;165:627–41.
      Shah H, Bilodeau M, Burak KW, et al. The management of chronic hepatitis C: 2018 guideline update from the Canadian Association for the Study of the Liver. CMAJ. 2018;190:E677–87. (PMID: 10.1503/cmaj.170453298668935988519)
      Adland E, Jesuthasan G, Downs L, et al. Hepatitis virus (HCV) diagnosis and access to treatment in a UK cohort. BMC Infect Dis. 2018;18:461. (PMID: 10.1186/s12879-018-3367-3302171696137907)
      Bertisch B, Brezzi M, Negro F, et al. Swiss Hepatitis C Cohort Study. 2020. Very low hepatitis C viral loads in treatment-naive persons: do they compromise hepatitis C virus antigen testing? Clin Infect Dis 70:653–9. https://doi.org/10.1093/cid/ciz270.
    • Contributed Indexing:
      Keywords: Antibody assay; Antiviral; CLIA; Correlation coefficient; Cost effective; Diagnostic algorithm; ELISA; Elimination; Follow-up; Quantitative; RTPCR; Resource limited; Screening; Viral load assay
    • Accession Number:
      0 (Hepatitis C Antigens)
      0 (Biomarkers)
      0 (Antiviral Agents)
      0 (Hepatitis C Antibodies)
      0 (Viral Core Proteins)
    • Publication Date:
      Date Created: 20240415 Date Completed: 20240813 Latest Revision: 20240813
    • Publication Date:
      20240813
    • Accession Number:
      10.1007/s12664-024-01549-7
    • Accession Number:
      38619807