Hepatitis C virus core antigen testing: role in diagnosis, disease monitoring and treatment

Area of Science:

• Hepatology
• Virology
• Clinical Diagnostics

Background:

• Hepatitis B virus (HBV) screening uses hepatitis B surface antigen to confirm infection.
• Hepatitis C virus (HCV) screening relies on anti-HCV testing, which cannot distinguish active from past infections.
• HCV RNA testing is currently required to confirm active HCV infection.

Purpose of the Study:

• To evaluate the utility of a newly available HCV core antigen assay for confirming HCV infection.
• To explore the potential of HCV core antigen testing as a cost-effective reflex test.
• To assess the feasibility of using HCV core antigen for monitoring HCV treatment.

Main Methods:

• Evaluation of a commercially available HCV core antigen assay.
• Comparison of HCV core antigen testing with HCV RNA testing in anti-HCV positive individuals.
• Analysis of preliminary data on HCV core antigen for treatment monitoring.

Main Results:

• The HCV core antigen assay can confirm infection in over 50% of anti-HCV positive individuals.
• HCV core antigen testing is less sensitive than HCV RNA assays but offers cost-effectiveness and platform compatibility.
• Early data suggest HCV core antigen may be a viable alternative to HCV RNA for treatment monitoring, potentially superior with direct antivirals.

Conclusions:

• HCV core antigen testing presents a practical and cost-effective option for confirming active HCV infection.
• Further research is needed to establish HCV core antigen assay's role in treatment monitoring.
• HCV core antigen may offer advantages over HCV RNA testing in the era of direct-acting antiviral therapies.