Academic journal article The Geographical Review

Correlation between Hepatitis C Viral Load and Hepatitis C Core Antigenaemia among Egyptians

Academic journal article The Geographical Review

Correlation between Hepatitis C Viral Load and Hepatitis C Core Antigenaemia among Egyptians

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ABSTRACT Hepatitis C virus (HCV) infection is widespread in Egypt. This study compared HCV RNA with HCVcAg for the detection and quantification of viraemia among a sample of Egyptians. Sera from 80 suspected HCV-positive individuals were tested simultaneously for HCV-RNA load using real-time polymerase chain reaction (PCR) and HCVcAg level using ELISA. Of the 80 samples, 25% were HCV-RNA-negative. HCVcAg was detected in all samples: range 0.4-2462 ng/mL, mean 460 (SD 506) ng/mL. The sensitivity and specificity of HCVcAg were 96.7% and 90.9%, respectively. There was a significant correlation between serum HCV-RNA and HCVcAg levels (r = 0.4, P< 0.0001). HCV-RNA remains the gold standard for diagnosis of active HCV infection but HCVcAg can be used where PCR is not available.

Correlation entre la charge virale de l'hepatite C et l'antigenemie du virus de l'hepatite C chez les Egyptiens

RESUME L'infection par le virus de l'hepatite C (VHC) est repandue en Egypte. La presente etude compare l'ARN du VHC et l'antigene de la nucleocapside du VHC pour la detection et la quantification de la viremie au sein d'un echantillon d'Egyptiens. Des echantillons seriques preleves sur 80 personnes suspectes d'etre positives au VHC ont ete testes simultanement pour la charge d'ARN du VHC au moyen de l'amplification en chaine par polymerase en temps reel (RT-PCR) et pour les concentrations de l'antigene de la nucleocapside par ELISA. Sur les 80 echantillons, 25 % etaient negatifs pour l'ARN du VHC. L'antigene de la nucleocapside a ete detecte dans tous les echantillons: les valeurs etaient comprises entre 0,4 et 2462 ng/mL et la moyenne etait de 460 ng/mL (E.T. 506). La sensibilite et la specificite de l'antigene de la nucleocapside etaient de 96,7 % et 90,9 % respectivement. Il y avait une correlation significative entre l'ARN du VHC serique et les concentrations d'antigene de la nucleocapside (r=0,4,p < 0,0001). L'ARN du VHC demeure la methode de reference pour le diagnostic d'infection a VHC active mais l'antigene de la nucleocapside peut etre utilise lorsque la PCR n'est pas disponible.

Introduction

Hepatitis C virus (HCV) infection is widespread in Egypt and threatens the lives of many Egyptians. Egypt has the highest prevalence of HCV infection in the world among adults (14.7%) (l). The disease causes chronic hepatic inflammation leading to liver fibrosis, cirrhosis and hepatocellular carcinoma (2). HCV infection is often further complicated by underlying hepatitis B and Shistosoma mansoni co-infection. Co-infection leads to higher morbidity and chronicity (3,4).

Virological diagnosis and monitoring of HCV infection are based on the use of a variety of virological markers. In clinical practice, 4 HCV markers can be used, namely total anti-HCV antibodies, HCV-RNA levels, HCV genotype and recently HCV core antigen (HCVcAg) levels (5).

Detection of anti-HCV antibodies using an enzyme immunoassay (EIA) is a well-known routine screening test for the diagnosis of HCV infection (6). HCV-RNA is the most reliable marker for HCV viral replication and is the gold standard for diagnosis of active HCV infection. HCV-RNA appears within 1-2 weeks of infection, before any alterations in liver enzymes occur or anti-HCV antibodies appear. RNA testing is also called nucleic acid testing (NAT) and is used to detect (qualitative assay) and quantify (quantitative assay) HCV-RNA (6). Both real-time polymerase chain reaction (RT-PCR) and NAT are advanced techniques that require special equipment, setting and expertise to perform, thus limiting their use in low/middle-income countries. Total serum HCVcAg can be detected using an ELISA-based test. HCVcAg is considered a surrogate marker of HCV replication and can be detected on average 1-2 days after HCV-RNA during the pre-seroconversion period (7). Compared with RT-PCR for the detection of HCV-RNA, the detection of HCVcAg using ELISA is a simple and cost-effective test (8) which does not require specialized equipment or expertise to perform. …

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