%0 Journal Article
%T Hepatitis C Virus Core Antigen Test in Monitoring of Dialysis Patients
%A Gioacchino Li Cavoli
%A Carmela Zagarrigo
%A Onofrio Schillaci
%A Francesca Servillo
%A Angelo Tralongo
%A Mario Coglitore
%A Filippo Spadaro
%A Concetta Scimeca
%A Natalia Li Destri
%A Ugo Rotolo
%J Hepatitis Research and Treatment
%D 2012
%I Hindawi Publishing Corporation
%R 10.1155/2012/832021
%X Hepatitis C virus infection is a persistent worldwide public health concern. The prevalence of HCV infection is much higher in patients on chronic haemodialysis (HD) than in the general population. HCV infection can detrimentally affect patients throughout the spectrum of chronic kidney disease. Despite the control of blood products, hepatitis C virus transmission is still being observed among patients undergoing dialysis. Detection systems for serum HCV antibodies are insensitive in the acute phase because of the long serological window. Direct detection of HCV depends on PCR test but this test is not suitable for routine screening. Recent studies have highlighted the importance of HCV core antigen detection as an alternative to PCR. Few studies exist about the efficacy of HCV core antigen test in dialysis population. We studied the utility of HCV core antigen test in routine monitoring of virological status of dialysis patients. We screened 92 patients on long-term dialysis both by PCR HCV-RNA and HCV core antigen test. The sensitivity of HCVcAg test was 90%, the specificity 100%, the positive predictive power 100%, the negative predictive power 97%, and the accuracy 97%. We think serological detection of HCV core antigen may be an alternative to NAT techniques for routine monitoring of patients on chronic dialysis. 1. Introduction Hepatitis C virus (HCV) infection is a persistent public health concern. HCV infects approximately 170 million people worldwide [1]. The prevalence of HCV infection is much higher in patients on chronic haemodialysis (HD) than in the general population. The estimated prevalence of HCV infection in HD patients is 7.8% in the USA [2], 5.2% in Germany [3], and 10% in Japan [4]. A recent study from Australia and New Zealand [5] in HD patients (n = 23,046) reported an independent and significant association between anti-HCV positive serologic status and all-cause mortality over a 10-year followup (HR, 1.25, 95% CI 1.07¨C1.46, ). Despite the control of blood products, HCV transmission is still being observed among HD patients. HCV infection is usually diagnosed based on the detection of anti-HCV antibody, while it goes undetected in the first 4¨C6 weeks of infection (so-called window period). Furthermore, patients positive for anti-HCV antibody include both those who are actively infected and those who have recovered from infection [6]. Kidney Disease Improving Global Outcomes (KDIGO) clinical practice guidelines for the prevention, diagnosis, evaluation, and treatment of hepatitis C in chronic kidney disease [7] recommended the
%U http://www.hindawi.com/journals/heprt/2012/832021/