Significance of Anti-HCV Signal-to-Cutoff Ratio in Predicting Hepatitis C Viremia.
10.3904/kjim.2009.24.4.302
- Author:
Yeon Seok SEO
1
;
Eun Suk JUNG
;
Jeong Han KIM
;
Young Kul JUNG
;
Ji Hoon KIM
;
Hyonggin AN
;
Hyung Joon YIM
;
Jong Eun YEON
;
Kwan Soo BYUN
;
Chang Duck KIM
;
Ho Sang RYU
;
Soon Ho UM
Author Information
1. Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea. umsh@korea.ac.kr
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Hepatitis C virus;
Viremia;
Enzyme immunoassay;
Antibody titer
- MeSH:
Adult;
Aged;
Female;
Hepatitis C/*diagnosis;
Hepatitis C Antibodies/*blood;
Humans;
Immunoenzyme Techniques;
Male;
Middle Aged;
RNA, Viral/*blood;
Viremia/*diagnosis
- From:The Korean Journal of Internal Medicine
2009;24(4):302-308
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: Hepatitis C virus (HCV) RNA testing can be performed using qualitative or quantitative assays, and it is still unclear which is more useful as a primary test in patients positive for anti-HCV. The present study evaluated the usefulness of anti-HCV signal-to-cutoff ratio (S/CO ratio) for predicting HCV RNA results. METHODS: Patients on whom a qualitative HCV RNA test was performed due to a positive anti-HCV enzyme immunoassay were enrolled. Patients were divided into viremia and no-viremia groups according to HCV RNA results. Receiver-operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic accuracy of anti-HCV S/CO for a diagnosis of viremia. RESULTS: In total, 487 patients were enrolled. HCV RNA was positive in 301 subjects (61.8%). Age, serum ALT level, and anti-HCV S/CO ratio were significantly different between the viremia and no-viremia groups. By ROC curve analysis, anti-HCV S/CO ratio (area, 0.989; 95% confidence interval, 0.981 to 0.998) accurately predicted the presence of viremia, with a cutoff value of 10.9 (sensitivity, 94.4%; specificity, 97.3%). CONCLUSIONS: Anti-HCV S/CO ratio was found to be highly accurate at predicting HCV viremia. The anti-HCV S/CO ratio can be used to determine whether a quantitative or qualitative HCV RNA test should be used to confirm HCV viremia in patients with a positive anti-HCV by the following criteria: if the anti-HCV S/CO ratio is <10.9, a qualitative HCV RNA test can be used, and if the anti-HCV S/CO ratio is > or =10.9 a quantitative HCV RNA test can be performed.
