Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Sep 2;70(8):e20240370.
doi: 10.1590/1806-9282.20240370. eCollection 2024.

The usefulness of anti-HCV signal to cut-off ratio in predicting hepatitis C viremia and the effect of genotype differences on signal to cut-off ratio

Burak Sarıkaya  1 , İrem Demiralp Yatar  1 , Soner Yılmaz  2 , Yasin Tiryaki  3 , Vahibe Aydın Sarıkaya  4 , Rıza Aytaç Çetinkaya  5 , Duygu Kırkık  6
Affiliations

The usefulness of anti-HCV signal to cut-off ratio in predicting hepatitis C viremia and the effect of genotype differences on signal to cut-off ratio

Burak Sarıkaya et al. Rev Assoc Med Bras (1992). .

Abstract

Objective: In the hepatitis C virus (HCV) diagnostic algorithm, an anti-HCV screening test is recommended first. In countries with low HCV prevalence, anti-HCV testing can often give false-positive results. This may lead to unnecessary retesting, increased costs, and psychological stress for patients.

Methods: In this study, the most appropriate S/Co (signal-cutoff) value to predict HCV viremia in anti-HCV test(+) individuals was determined, and the effect of genotype differences was evaluated. Of the 96,515 anti-HCV tests performed between 2020 and 2023, 934 were reactive. A total of 332 retests and 65 patients without HCV-ribonucleic acid (RNA) analysis were excluded. Demographic data were calculated for 537 patients, and 130 patients were included in the study.

Results: The average age of 537 patients was 55±18 years, and 57.1% were women. The anti-HCV positivity rate was 0.62% (602/96,515), and the actual anti-HCV positivity rate was 0.13% (130/96,515). Anti-HCV levels were higher in HCV-RNA(+) patients than in HCV-RNA-negative individuals (p<0.0001) (Table 1). Receiver operating characteristic curve analysis identified the optimal S/Co value to be 10.86 to identify true positive cases. Sensitivity was 96.1%, specificity was 61.2%, positive predictive value (PPV) was 44.2%, and negative predictive value (NPV) was 98% (Figure 2). A total of 107 (82.3%) of the patients were identified as GT1, and the most common subtype was GT1b (n=100).

Conclusion: If anti-HCV S/Co is ≥10.86, direct HCV RNA testing may be recommended; However, the possibility of false positivity should be considered in patients with a S/Co value below 10.86.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest: the authors declare there is no conflicts of interest.

Figures

Figure 1
Figure 1. A schematic flowchart describing the inclusion and exclusion design.
Figure 2
Figure 2. Receiver operating characteristic analysis of anti-hepatitis C virus S/Co values according to HCV RNA results.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. World Health Organization . Updated recommendations on treatment of adolescents and children with chronic HCV infection, and HCV simplified service delivery and diagnostics. Licence: CC BY-NC-SA 3.0 IGO. Geneva: World Health Organization; 2022. - PubMed
    1. Centers for Disease Control and Prevention (CDC) Testing for HCV infection: an update of guidance for clinicians and laboratorians. MMWR Morb Mortal Wkly Rep. 2013;62(18):362–365. - PMC - PubMed
    1. European Association for the Study of the Liver Electronic address: easloffice@easloffice.eu; Clinical Practice Guidelines Panel: Chair:; EASL Governing Board representative:; Panel members:. EASL recommendations on treatment of hepatitis C: Final update of the series☆ . J Hepatol. 2020;73(5):1170–1218. doi: 10.1016/j.jhep.2020.08.018. - DOI - PubMed
    1. Şanlıdağ T, Akçalı S, Ecemiş T, Süer K, Erbay Dündar P, Arıkan A, et al. Investigation of the correlation between anti-HCV levels (S/Co) with HCV-RNA in the diagnosis of hepatitis C virus (HCV) infection. Mikrobiyol Bul. 2016;50(3):508–510. doi: 10.5578/mb.26509. - DOI - PubMed
    1. Tozun N, Ozdogan O, Cakaloglu Y, Idilman R, Karasu Z, Akarca U, et al. Seroprevalence of hepatitis B and C virus infections and risk factors in Turkey: a fieldwork TURHEP study. Clin Microbiol Infect. 2015;21(11):1020–1026. doi: 10.1016/j.cmi.2015.06.028. - DOI - PubMed