丙型肝炎病毒核心抗原：物质使用障碍患者中丙型肝炎病毒RNA检测的潜在替代方法。

Hepatitis C virus core antigen: A potential alternative to HCV RNA testing among persons with substance use disorders.

作者信息

Talal Andrew H, Chen Yang, Zeremski Marija, Zavala Roberto, Sylvester Clewert, Kuhns Mary, Brown Lawrence S, Markatou Marianthi, Cloherty Gavin A

机构信息

Division of Gastroenterology and Hepatology, Weill Cornell Medicine, New York, NY, USA; Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, University at Buffalo, State University of New York, Buffalo, NY, USA; START Treatment & Recovery Centers, Brooklyn, NY, USA.

Department of Biostatistics, University at Buffalo, State University of New York, Buffalo, NY, USA.

出版信息

J Subst Abuse Treat. 2017 Jul;78:37-42. doi: 10.1016/j.jsat.2017.04.011. Epub 2017 Apr 20.

DOI:10.1016/j.jsat.2017.04.011

PMID:28554601

Abstract

BACKGROUND

The hepatitis C virus (HCV) core antigen (HCVcAg) may be an alternative diagnostic method to HCV RNA especially in populations such as substance users, the homeless or in resource-limited settings.

AIMS

To evaluate performance of HCVcAg test in patients with opioid use disorder (OUD) on methadone in order to document its performance characteristics in the target population and to ensure that its specificity remains consistent across different populations.

METHODS

HCVcAg levels from 109 methadone-maintained patients were compared to HCV RNA levels.

RESULTS

Mean age was 53.8±7.8years, 59.6% were male, 68.8% African American, and 44% HCV-infected. HCVcAg was detectable in 47 of 48 HCV-infected, and undetectable in all HCV RNA negative patients. The HCVcAg assay had sensitivity of 97.9% and specificity of 100%. Correlation with HCV RNA levels was excellent (r=0.88, 95% CI 0.76; 0.95, p<0.01).

CONCLUSION

HCVcAg has excellent performance for the diagnosis of HCV infection in patients with OUD on methadone.

摘要

背景

丙型肝炎病毒（HCV）核心抗原（HCVcAg）可能是一种替代HCV RNA的诊断方法，尤其是在药物使用者、无家可归者等人群或资源有限的环境中。

目的

评估HCVcAg检测在接受美沙酮治疗的阿片类物质使用障碍（OUD）患者中的性能，以记录其在目标人群中的性能特征，并确保其特异性在不同人群中保持一致。

方法

比较109例接受美沙酮维持治疗患者的HCVcAg水平和HCV RNA水平。

结果

平均年龄为53.8±7.8岁，59.6%为男性，68.8%为非裔美国人，44%感染HCV。48例HCV感染患者中有47例可检测到HCVcAg，所有HCV RNA阴性患者均未检测到。HCVcAg检测的灵敏度为97.9%，特异性为100%。与HCV RNA水平的相关性极佳（r=0.88，95%CI 0.76；0.95，p<0.01）。