OBJECTIVETo investigate the utility of the HCV core antigen ELISA in the detection of HCV infection in hemodialysis patients and to compare with Anti-HCV antibodies 3rd generation ELISA.

METHODSTwo hundred fifty hemodialysis patients were included in the study. Anti-HCV antibodies and total HCVcAg was determined by ELISA kits. HCV RNA was determined using reverse transcriptase polymerase chain reaction (RT-PCR).

RESULTSForty-three out of 250 (17.2%) patients were positive for anti-HCV antibodies and 18% were positive for HCVcAg. 13/250 (5.2%) were positive for HCVcAg but anti-HCV negative, All 13 were confirmed viremic by in-house nested RT-PCR leading to specificity of 100%. Viral load of (49258 +/- 28682) copies/ml were detected in HCVcAg positive cases was higher in comparison to (23938 +/- 10780) copies/ml in the anti-HCV positive group (P < 0.05). The viral load of 4 negative cases for HCVcAg assay but anti-HCV positive was 306 +/- 161 copies/ml which was significantly lower in comparison to HCVcAg positive group (P < 0.001).

CONCLUSIONDetection of total HCVcAg together with anti-HCV will be useful for patients undergoing hemodialysis who have a longer window period due to immunosuppressed state. HCVcAg was compatible for the HCV RNA in serum and total HCVcAg ELISA is both a cost-effective and a less labor-intensive alternative to PCR, enhancing its clinical utility.