HCV in the UK: Ag test performs well, but linkage to care is poor

  • Adland E & al.
  • BMC Infect Dis
  • 14 Sep 2018

  • curated by Yael Waknine
  • Univadis Clinical Summaries
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • 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 design

  • Study of 38,509 individuals tested for HCV over a 33-month period (2013-2016) at a large UK teaching hospital.
  • Funding: None. 

Key results

  • 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%.

Limitations

  • May not be generalizable outside the UK.

Please confirm your acceptance

To gain full access to GPnotebook please confirm:

By submitting here you confirm that you have accepted Terms of Use and Privacy Policy of GPnotebook.

Submit