Comparison of an Immunochromatographic Rapid Strip Test, ELISA and PCR in the Diagnosis of Hepatitis C in HIV Patients in Hospital Settings in Cameroon

Cameroon belongs to the group of countries highly endemic for hepatitis C viruses. Coinfection of hepatitis C and HIV are also common due to the shared route of transmission of both viruses. In hospital settings in Cameroon, diagnosis prior to treatment of hepatitis C is based solely on the results obtained with an immunochromatographic rapid strip test (97%). This study was aimed at determining the validity of the results that is obtained when an immunochromatographic rapid strip test is used to diagnose hepatitis C virus infection in HIV-positive patients in comparison with more sensitive and specific methods like ELISA and PCR. In a cross-sectional study in two parts, 700 participants were enrolled, 350 were HIV-positive patients and a control group of 350 individuals not infected with HIV. All participants were screened for anti-HCV antibodies using ACON HCV strip test, an assay commonly used in 57·1% of Cameroon hospitals. While using the rapid strip test, of the 350 HIV-positive patients, 25 (7·1%) were found to be positive with the rapid strip test of whom 3(12%) were positive with an ELISA and all 3(100%) positive with the ELISA were also positive with PCR. Evaluation of the rate of false positives with the rapid strip test using ELISA as the gold standard gave a rate of 6·3%. Meanwhile in the control group, after screening with the rapid strip test, 39 (11·1%) were positive of whom 6 (15·4%) were positive with the ELISA and 3 (50%) of the 6 positive with the ELISA were positive with the PCR. Evaluation of the rate of false positives with the rapid strip test in the control group using ELISA as the gold gave a rate of 9·6%. False positive results with this immunochromatographic rapid strip test for the diagnosis of hepatitis C virus infection is therefore common and therefore reinforce the need for a confirmatory test prior to treatment in hospital settings in Cameroon.