HCV Core Antigen Diagnostic Performance for Acute/Recent HCV Infection in People With HIV-1: A Systematic Review and Meta-Analysis - Scorecard - MDSpire
Advertisement
HCV Core Antigen Diagnostic Performance for Acute/Recent HCV Infection in People With HIV-1: A Systematic Review and Meta-Analysis
Clinical Scorecard: Evaluating the Diagnostic Accuracy of HCV Core Antigen for Acute HCV Infection in Individuals with HIV-1: A Systematic Review and Meta-Analysis
At a Glance
Category
Detail
Condition
Acute or recent Hepatitis C virus (HCV) infection
Key Mechanisms
Detection of HCV core antigen (HCVcAg) as a marker of active HCV infection, compared to nucleic acid amplification tests (NAATs)
Target Population
People with HIV-1 (PWH) at risk for acute or recent HCV infection
Care Setting
Clinical and resource-limited settings requiring cost-effective and timely HCV diagnostic tools
Key Highlights
HCVcAg shows high sensitivity (87.1%–100%) and specificity (95.0%–100%) for diagnosing acute or recent HCV infection in PWH.
Pooled meta-analysis sensitivity was 92% and specificity 99%, supporting HCVcAg as a reliable diagnostic tool.
HCVcAg testing offers a shorter assay time and lower cost alternative to NAATs, facilitating earlier diagnosis and treatment initiation.
Guideline-Based Recommendations
Diagnosis
Use HCVcAg testing as an adjunct or alternative to NAATs for early detection of acute or recent HCV infection in PWH.
Confirm acute HCV infection with NAATs when possible, as NAATs remain the gold standard.
Consider HCVcAg testing in settings where NAATs are limited by cost or accessibility.
Management
Prompt initiation of direct-acting antiviral (DAA) therapy upon diagnosis of acute HCV infection to prevent progression and transmission.
Integrate HCVcAg testing into routine screening protocols for PWH to identify acute infections early.
Monitoring & Follow-up
Monitor HCVcAg levels to detect reinfection or treatment response in PWH.
Regular screening in high-risk PWH populations to identify new or recurrent infections.
Risks
Potential for false negatives during very early infection due to window period limitations.
Lower positive predictive value in populations with low HCV incidence; confirmatory testing recommended.
Patient & Prescribing Data
People with HIV-1 at risk of or suspected to have acute or recent HCV infection
Early diagnosis via HCVcAg testing supports timely DAA treatment initiation, reducing liver disease progression and transmission risk.
Clinical Best Practices
Incorporate HCVcAg testing into HCV screening algorithms for PWH, especially in resource-limited settings.
Use HCVcAg testing to overcome limitations of anti-HCV antibody testing in acute infection and reinfection detection.
Confirm positive HCVcAg results with NAATs when feasible to ensure diagnostic accuracy.
Educate high-risk PWH populations on the importance of regular HCV screening and early treatment.
