Antibody screening tests variably overestimate the prevalence of hepatitis C virus infection among HIV-infected adults in Ghana
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Date
2014
Journal Title
Journal ISSN
Volume Title
Publisher
John Wiley & Sons Ltd
Abstract
HIV coinfection with HCV has been poorly studied
in sub-Saharan Africa, and the reliability of available
seroprevalence estimates remains uncertain. The study aim
was to determine HCV RNA prevalence in HIV-infected
subjects receiving care in Kumasi, Ghana, and relate the
findings to HCV antibody detection. From a population of
1520 HIV-infected adults, all HBsAg-positive subjects
(n = 236) and a random subset of HBsAg-negative subject
(n = 172) were screened for HCV RNA using pooled
plasma; positive samples were genotyped by core and
NS5B sequencing. HCV antibodies were detected by three
commercial screening assays and confirmed by the line
immunoassay. HCV RNA was detected in 4/408 subjects
(1.0%, 95% confidence interval 0.0–1.9%), comprising 3/
236 (1.3%; 0.0–2.8%) HBsAg-positive and 1/172 (0.6%;
0.0–1.8%) HBsAg-negative subjects. HCV RNA-positive
subjects showed reactivity in all three antibody screening
assays. Among HCV RNA-negative subjects, 5/67 (7.5%),
5/67 (7.5%) and 19/67 (28.4%) showed antibody reactivity
by each screening assay, respectively, including two
(3.0%) with reactivity by all three assays. Only one sample
(1.5%) had confirmed antibody reactivity by line immunoassay
indicating past HCV infection. HCV-positive subjects
(three males, two females) were aged 30–46 years, by
questionnaire-based interview reported surgical procedures
and blood transfusion as risk factors for infection. HCV
genotypes were 2 (subtypes 2j, 2l, 2k/unassigned) and 1
(subtype unassigned). Without further testing, HCV antibody
screening assays variably overestimated HCV prevalence
among HIV-infected subjects in Ghana. These
findings inform the interpretation of previous seroprevalence
estimates based upon screening assays alone.
Description
An article published by John Wiley & Sons Ltd and available at doi:10.1111/jvh.12354
Keywords
Africa, antibody, genotype, RNA, serology
Citation
John Wiley & Sons Ltd Journal of Viral Hepatitis, 2015, 22, 461–468