Real-Time Polymerase Chain Reaction in Detecting Active Hepatitis C Virus Infection: A Retrospective Analysis

Area of Science:

• Hepatology
• Virology
• Molecular Diagnostics

Background:

• Hepatitis C virus (HCV) infection is a significant global health issue, leading to cirrhosis and liver cancer.
• Standard anti-HCV antibody screening cannot differentiate between active and past infections.
• Real-time polymerase chain reaction (RT-PCR) for HCV ribonucleic acid (RNA) is essential for confirming active HCV infection.

Purpose of the Study:

• To determine the prevalence of HCV RNA positivity in patients screened for HCV.
• To analyze the distribution of HCV viral load.
• To investigate associations between HCV RNA positivity, viral load, and demographic, serological, and biochemical markers.

Main Methods:

• Retrospective analysis of 383 patients screened for HCV infection at a tertiary care hospital.
• HCV RNA detection and quantification using RT-PCR.
• Anti-HCV antibody testing via chemiluminescent microparticle immunoassay (CMIA).

Main Results:

• HCV RNA positivity was found in 25.6% of individuals (98/383).
• Individuals aged ≥60 years showed a statistically significant higher prevalence of HCV RNA positivity (p < 0.001).
• A significant association was observed between high viral load (>500,000 IU/mL) and elevated liver enzymes (p = 0.030).
• 29.6% of HCV RNA-positive individuals were negative for anti-HCV antibodies.

Conclusions:

• HCV RNA testing via RT-PCR is vital for accurately diagnosing active HCV infections in tertiary care settings.
• Molecular testing offers superior reliability for confirming active disease compared to antibody screening alone.
• The study underscores the importance of considering HCV RNA testing in specific demographics, such as the elderly.