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Hepatitis C Diagnosis: Simplified Solutions, Predictive Barriers, and Future Promises
 
 
Article

Evaluation of Hepatitis C Virus Core Antigen Assay in a Resource-Limited Setting in Pakistan

1
Department of Medicine, Aga Khan University, Stadium Road, Karachi 74800, Pakistan
2
Kirby Institute, Viral Hepatitis Clinical Research Program, UNSW Sydney, Sydney, NSW 2052, Australia
3
Abbott Diagnostics, Abbott Park, IL 60064-3500, USA
*
Author to whom correspondence should be addressed.
Academic Editor: Carmen de Mendoza
Diagnostics 2021, 11(8), 1354; https://doi.org/10.3390/diagnostics11081354
Received: 8 June 2021 / Revised: 11 July 2021 / Accepted: 12 July 2021 / Published: 28 July 2021
(This article belongs to the Special Issue New Diagnostics and Testing Strategies for Hepatitis C Virus (HCV))
The diagnosis of Hepatitis C virus (HCV) infection can be challenging due to its cost and a lack of access to centralized testing. There is an urgent need to develop simplified HCV testing algorithms. The aim of this study was to evaluate the performance characteristics of a Hepatitis C core antigen (HCVcAg) assay in a decentralized, resource-limited setting. This is a descriptive cross-sectional study from a highly endemic area of Karachi, Pakistan. Between October 2019 and July 2020, subjects aged 12 years and above who screened positive for HCV antibodies were simultaneously tested for HCV RNA (Xpert HCV Viral Load, GeneXpert® IV, Cepheid, France) and HCVcAg (ARCHITECT HCV Ag assay, Abbott® Diagnostics) to confirm active HCV infection. An Abbott ARCHITECT® i1000SR Immunoassay Analyser was installed at a local district hospital as a point-of-care (POC) facility for HCVcAg testing, while samples for HCV RNA were tested in a central lab. Two hundred individuals (mean age 46.4 ± 14.5 years, 71.5% females), who screened positive for HCV antibody, were included in the study. HCV RNA was detected in 128 (64.0%) while HCVcAg was reactive in 119 (59.5%) cases. Performance of the Immunoassay Analyser was excellent with a higher throughput and quicker readout value compared to the GeneXpert System. The sensitivity and specificity of HCVcAg (≥10 fmol/L) at HCV RNA thresholds of ≥12 was 99.1% (95% CI: 95–100%) and 87.6% (95%CI: 78.4–94%). A strong agreement was observed between the HCVcAg assay and HCV RNA. The ARCHITECT HCV Ag assay showed high sensitivity and specificity compared to HCV RNA in a decentralized, resource-limited setting. It can therefore be used as a confirmatory test in HCV elimination programs, particularly for low-income countries such as Pakistan. View Full-Text
Keywords: Hepatitis C; HCV Core antigen; GeneXpert® IV; dededecentralized Hepatitis C; HCV Core antigen; GeneXpert® IV; dededecentralized
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MDPI and ACS Style

Abid, A.; Uddin, M.; Muhammad, T.; Awan, S.; Applegate, T.; Dore, G.J.; Cloherty, G.; Hamid, S. Evaluation of Hepatitis C Virus Core Antigen Assay in a Resource-Limited Setting in Pakistan. Diagnostics 2021, 11, 1354. https://doi.org/10.3390/diagnostics11081354

AMA Style

Abid A, Uddin M, Muhammad T, Awan S, Applegate T, Dore GJ, Cloherty G, Hamid S. Evaluation of Hepatitis C Virus Core Antigen Assay in a Resource-Limited Setting in Pakistan. Diagnostics. 2021; 11(8):1354. https://doi.org/10.3390/diagnostics11081354

Chicago/Turabian Style

Abid, Adeel, Murad Uddin, Taj Muhammad, Safia Awan, Tanya Applegate, Gregory J. Dore, Gavin Cloherty, and Saeed Hamid. 2021. "Evaluation of Hepatitis C Virus Core Antigen Assay in a Resource-Limited Setting in Pakistan" Diagnostics 11, no. 8: 1354. https://doi.org/10.3390/diagnostics11081354

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