Effect of coexisting HIV-1 infection on the diagnosis and evaluation of hepatitis C virus

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Published on: July 16, 2012

M Bonacini1, H J Lin, F B Hollinger

  • 1Keck School of Medicine, University of Southern California, Los Angeles, 90033, USA. A43170@pol.net

Journal of Acquired Immune Deficiency Syndromes (1999)
|April 24, 2001
PubMed

Insights

The enzyme-linked immunosorbent assay (ELISA-2) test for hepatitis C virus antibodies demonstrates higher diagnostic accuracy in HIV-coinfected patients compared to those with HCV alone. This improved accuracy aids in diagnosing ongoing HCV infection in this vulnerable population.

Area of Science:

  • Virology
  • Immunology
  • Infectious Diseases

Background:

  • Hepatitis C virus (HCV) infection is a significant global health concern.
  • Human immunodeficiency virus (HIV) infection can alter the natural course and diagnostic presentation of coinfections.
  • Accurate diagnosis of HCV in coinfected individuals is crucial for timely management.

Purpose of the Study:

  • To assess the diagnostic accuracy of the anti-HCV enzyme-linked immunosorbent assay (ELISA-2) in patients with and without HIV-1 coinfection.
  • To compare the predictive value of the anti-HCV ELISA-2 test between HIV/HCV coinfected patients and those with HCV infection alone.

Main Methods:

  • A cohort study involving 369 patients tested for HCV antibodies and HCV RNA.
  • Patients were categorized into groups based on serologic tests: HIV/HBV coinfected, HIV alone, HIV/HCV coinfected, and HCV infection alone.
  • HCV RNA quantification was performed using the Amplicor HCV Monitor test.

Main Results:

  • The positive predictive value of the anti-HCV ELISA-2 test was significantly higher in HIV-infected patients (91%) compared to HCV-only patients (76%).
  • A small proportion (5.5%) of anti-HCV ELISA-2 negative, HIV-infected patients had detectable HCV RNA, often with low CD4 counts.
  • HIV/HCV coinfected patients showed higher median HCV RNA levels than HCV-only patients, with similar alanine aminotransferase (ALT) levels.

Conclusions:

  • The anti-HCV ELISA-2 test exhibits superior predictive value for diagnosing ongoing HCV infection in HIV-coinfected individuals.
  • False-negative results are uncommon but may occur in acute infections or with low CD4 counts, potentially requiring alternative diagnostic methods like ELISA-3 or RT-PCR.
  • HIV/HCV coinfection is characterized by higher viral loads and similar liver enzyme profiles compared to isolated HCV infection.
Abstract

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