Very Low Hepatitis C Viral Loads in Treatment-naive Persons: Do They Compromise Hepatitis C Virus Antigen Testing?

被引：16

作者：

Bertisch, Barbara ^{[1
]}

Brezzi, Matteo ^{[1
]}

Negro, Francesco ^{[2
,3
]}

Mullhaupt, Beat ^{[4
,5
]}

Ottiger, Cornelia ^{[6
]}

Kunzler-Heule, Patrizia ^{[7
]}

Schmid, Patrick ^{[8
,9
]}

Giudici, Fabio ^{[10
]}

Clerc, Olivier ^{[11
]}

Moriggia, Alberto ^{[12
]}

Roelens, Maroussia ^{[1
]}

Marinucci, Francesco ^{[13
]}

Zehnder, Cinzia ^{[14
]}

Moradpour, Darius ^{[15
]}

Keiser, Olivia ^{[1
]}

机构：

[1] Univ Geneva, Inst Global Hlth, 9 Chemin Mines, CH-1202 Geneva, Switzerland

[2] Univ Hosp Geneva, Div Gastroenterol & Hepatol, Geneva, Switzerland

[3] Univ Hosp Geneva, Div Clin Pathol, Geneva, Switzerland

[4] Univ Hosp, Swiss Hepatopancreato Biliary Ctr, Zurich, Switzerland

[5] Univ Hosp, Dept Gastroenterol & Hepatol, Zurich, Switzerland

[6] Cantonal Hosp Aarau, Dept Lab Med, Aarau, Switzerland

[7] Cantonal Hosp St Gallen, Div Gastroenterol & Hepatol, St Gallen, Switzerland

[8] Cantonal Hosp St Gallen, Div Infect Dis, St Gallen, Switzerland

[9] Cantonal Hosp St Gallen, Hosp Epidemiol, St Gallen, Switzerland

[10] Univ Bern, Inst Social & Prevent Med, Bern, Switzerland

[11] Pourtales Hosp, Dept Internal Med & Infect Dis, Neuchatel, Switzerland

[12] Fdn Epatoctr Ticino, Lugano, Switzerland

[13] Fdn Innovat New Diagnost, Geneva, Switzerland

[14] SYNLAB Suisse SA, Bioggio, Switzerland

[15] Univ Hosp Lausanne, Div Gastroenterol & Hepatol, Lausanne, Switzerland

来源：

CLINICAL INFECTIOUS DISEASES | 2020年 / 70卷 / 04期

基金：

瑞士国家科学基金会;

关键词：

hepatitis C; very low viral load; antigen; screening; cirrhosis; CORE ANTIGEN; HCV-RNA; QUANTITATIVE-DETERMINATION; CLINICAL UTILITY; DRUG-USERS; INFECTION; ASSAY; CLEARANCE; RIBAVIRIN; VIREMIA;

D O I：

10.1093/cid/ciz270

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Background. Hepatitis C virus (HCV) antigen testing is less expensive than quantitative reverse-transcription polymerase chain reaction but has lower sensitivity for very low viral load (VLVL; HCV RNA <= 3000 IU/mL). Currently the benefits of antigen testing for screening are discussed, but data on prevalence and outcomes of persons with VLVL are scarce. Methods. We assessed prevalence and predictors of VLVL by logistic regression in treatment-naive participants in the Swiss Hepatitis C Cohort Study. We analyzed if the last viral load after VLVL was low, compared cirrhosis and mortality in persons with and without VLVL, and evaluated the number of samples with VLVL that were reactive by antigen testing. Results. We included 2533 treatment-naive persons with available quantitative HCV RNA testing results. Overall, 133 persons (5.3%) had a VLVL. Age 18-40 years, female sex, and human immunodeficiency virus coinfection were associated with VLVL. Of 72 persons with a viral load available after VLVL, 14% had a VLVL and 17% had spontaneous viral clearance. The prevalence and incidence of cirrhosis and mortality were comparable in persons with and without VLVL; all 24 persons with VLVL and cirrhosis had excessive alcohol consumption or immunosuppression. Overall, 33% of samples with VLVL were reactive by antigen testing. Conclusions. The frequency of VLVL was low. Among the persons who would probably be missed by antigen screening, some had a favorable disease course, but some had immunosuppression and liver cirrhosis. The benefit of HCV antigen testing for screening may be limited by the risk of missing patients with severe liver disease.

引用

页码：653 / 659

页数：7

共 44 条

[1] Serum HCV RNA levels correlate with histological liver damage and concur with steatosis in progression of chronic hepatitis C [J].