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Updated: Mar 1, 2026

A Protocol for Analyzing Hepatitis C Virus Replication
Published on: June 26, 2014
Hepatitis C virus core antigen: A potential alternative to HCV RNA testing among persons with substance use disorders
Andrew H Talal1, Yang Chen2, Marija Zeremski3
1Division of Gastroenterology and Hepatology, Weill Cornell Medicine, New York, NY, USA; Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, University at Buffalo, State University of New York, Buffalo, NY, USA; START Treatment & Recovery Centers, Brooklyn, NY, USA.
Background:
The hepatitis C virus (HCV) core antigen (HCVcAg) may be an alternative diagnostic method to HCV RNA especially in populations such as substance users, the homeless or in resource-limited settings.
Aims:
To evaluate performance of HCVcAg test in patients with opioid use disorder (OUD) on methadone in order to document its performance characteristics in the target population and to ensure that its specificity remains consistent across different populations.
Methods:
HCVcAg levels from 109 methadone-maintained patients were compared to HCV RNA levels.
Results:
Mean age was 53.8±7.8years, 59.6% were male, 68.8% African American, and 44% HCV-infected. HCVcAg was detectable in 47 of 48 HCV-infected, and undetectable in all HCV RNA negative patients. The HCVcAg assay had sensitivity of 97.9% and specificity of 100%. Correlation with HCV RNA levels was excellent (r=0.88, 95% CI 0.76; 0.95, p<0.01).
Conclusion:
HCVcAg has excellent performance for the diagnosis of HCV infection in patients with OUD on methadone.
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