Comparison of hcv diagnosis by antibody detection and rna in hiv-1 co-infected patients commencing haart

Authors:Okwuraiwe AP, Osuntoki AA, Ebuehi OAT2 and Audu RA
Int J Biol Med Res. 2017; 8(1): 5827-5829  |  PDF File

Abstract

Background: Hepatitis C virus (HCV) diagnosis either in isolation or in HIV co-infection has often been laden with misdiagnosis, false positives and negatives being reported frequently. The use of strip tests has been replaced with the more sensitive fourth generatiom enzyme linked immunosorbent assay (EIA) HCV antibody test. However, a definitive HCV diagnosis is best achieved by determination of presence of HCV viral RNA. Objective: The study is to compare two HCV serological and molecular diagnosis techniques, in a cohort of HIV-1/HCV co-infected patients commencing antiretroviral therapy. Methods: Samples which tested positive for hepatitis C antibody (HCVAb) using the ELISA technique from 100 HIV-1/HCV patients (58 male, 42 female), aged between 18 and 65 years, with (Dia.Pro Diagnostic BioProbes s.r.l) where retrospectively retrieved. PCR based HCV RNA qualitative (COBAS Amplicor, Roche Diagnostics, Branchburg, USA) and HCV RNA quantitative (COBAS Ampliprep/COBAS TaqMan, Roche Diagnostics, Branchburg, USA) assays were simultaneously carried out on the aliquots of these samples. Results: Out of the 100 HIV/HCV positive patients, only 64 (64%) were positive on the qualitative and 64 (64%) also with viral titer on quantitative assays (limit of detection 15 IU/ml). The remaining 36 (36%) had negative HCV RNA and ‘Not Detected’for the qualitative and quantitative assays respectively. These results tend to indicate an absence of active HCV infection for a significant portion of the HIV-HCV co-infected population. Conclusion: HCVAb testing should not be the only assay used to determine HCV dignosis in Nigeria. Although expensive, requiring instrumentation and longer time factor, HCV RNA (both qualitative and quantitative) is highly recommended, especially for immuno-compromised persons.