HCV core antigen is a useful predictor during pegylated-interferon/ribavirin therapy in patients with hepatitis C virus genotype 1b

Abstract

Enzyme immunoassays for quantifying hepatitis C virus (HCV) core antigen (Ag) have been proposed as an alternative to HCV RNA detection. The present study aimed to investigate the early kinetics of serum HCVcAg and its usefulness in predicting virological responses.The clinical data of 135 patients with chronic hepatitis C treated with pegylated interferon alpha (PEG-IFN-α) and ribavirin was retrospectively collected. The patients were grouped according to their treatment outcomes as follows: sustained virological response (SVR), nonsustained virological response (N-SVR), and relapse.Higher HCVcAg and HCV RNA levels were observed in patients in the N-SVR group than in the other groups at baseline. HCVcAg better predicted rapid virological response (RVR) compared with HCV RNA and had a predictive value similar to that of HCV RNA for SVR and early virological response. In the relapse group, HCV RNA decreased to 0 after 48 weeks, whereas HCVcAg was still detectable, indicating that HCVcAg more sensitively predicted relapse in antiviral therapy than HCV RNA.For patients treated with PEG-INF-α and ribavirin, HCVcAg may more sensitively predict relapse than HCV RNA.

Performance of HCV Antigen Testing for the Diagnosis and Monitoring of Antiviral Treatment: A Systematic Review and Meta-Analysis

“…Florea et al [ 35 ] found 82.4% sensitivity but test demonstrated good performance in patients with HCV RNA ≥ 1000 IU/mL. Fan et al [ 36 ] found 80.2% sensitivity but it was not possible to identify the reasons for this low value.…”

“…It was also observed that HCV Ag testing has high sensitivity at end of treatment compared to 4 weeks after beginning of treatment. Fan et al [ 36 ] suggested that HCV Ag may be a more sensitive predictor of relapse than HCV RNA after antiviral treatment.…”

Antiviral Therapeutic Monitoring: Role of Hepatitis C Virus Core Antigen versus Hepatitis C Virus RNA by Polymerase Chain Reaction

“…HCV core antigen predicted rapid virologic response (RVR) better than HCV RNA, while sustained virologic response (SVR) prediction was similar to that of HCV RNA. 16 In another study, Garcia et al compared the detection of the therapeutic failure by PCR versus HCV core antigen in patients undergoing antiviral treatment. HCV core antigen demonstrated comparable sensitivity and specificity for early detection of therapeutic failure in patients undergoing antiviral treatment.…”

The utility of HCV core antigen for evaluation of viremia at 48 weeks posttreatment with direct‐acting antivirals

“…2,3 Because direct-acting antivirals (DAAs) are the standard-of-care treatment for HCV, with very high ease-of-use and efficacy (>90%-95%) for the eradication of the virus, 4 optimizing the screening and diagnostic tools for HCV infection has become a deciding point in the global elimination of HCV infection. 5,6 Currently, the commonly used diagnostic algorithm includes a screening test for anti-HCV antibodies (anti-HCV), followed by reflex HCV-RNA polymerase chain reaction (PCR) testing in antibodypositive patients. 7,8 Although HCV-RNA PCR testing is a reliable method, it is time-consuming, expensive, and requires advanced skills and equipment.…”

“…CHC infection may progress to liver cirrhosis, decompensation, or hepatocellular carcinoma, and may increase mortality 2,3 . Because direct‐acting antivirals (DAAs) are the standard‐of‐care treatment for HCV, with very high ease‐of‐use and efficacy (>90%‐95%) for the eradication of the virus, 4 optimizing the screening and diagnostic tools for HCV infection has become a deciding point in the global elimination of HCV infection 5,6 …”