- HCV antigen (Ag) test performs as well as the gold-standard polymerase chain reaction (PCR) RNA assay for diagnosing infection; the antibody (Ab) test carries a risk for false-positives.
- In the UK, HCV infection is over-represented among men and in prisons; linkage to care remains poor.
Why this matters
- Improved access to diagnosis and treatment is essential to achieve global targets for HCV elimination.
- Study of 38,509 individuals tested for HCV over a 33-month period (2013-2016) at a large UK teaching hospital.
- Funding: None.
- 353 HCV diagnoses were confirmed (HCV antigen [Ag]+ and/or HCV RNA+), representing 0.9% of those tested.
- In-house antibody screening (HCV-Ab) had an 87.4% positive predictive value (PPV) vs repeat HCV-Ag testing in a reference laboratory.
- HCV-Ag had 100% PPV vs PCR for HCV RNA.
- Quantitative HCV-Ag strongly correlated with viral load (r2=0.3; P<.0001>
- The most common genotypes were HCV-1 (n=194) and HCV-3 (n=191).
- Median patient age was 37 years; 84% were male.
- 36% of patients were incarcerated.
- 40% underwent hepatology review and 22% were treated.
- Overall rate of sustained virologic response at 12 weeks posttherapy (SVR12) was 84%; rate with direct-acting antivirals was 93%.
- May not be generalizable outside the UK.