Strong Correlation between Liver and Serum Levels of Hepatitis C Virus Core Antigen and RNA in Chronically Infected Patients

Virology Department, Amiens University Hospital, South Hospital, Amiens, France.
Journal of clinical microbiology (Impact Factor: 3.99). 12/2011; 50(2):465-8. DOI: 10.1128/JCM.06503-11
Source: PubMed


HCV core antigen (Ag) and HCV RNA levels were evaluated in matched liver biopsy samples and sera from 22 patients with hepatitis
C infection by using the quantitative Architect HCV Ag immunoassay and a real-time RT-qPCR assay, respectively. The data showed
a strong correlation between liver and serum compartments of HCV Ag levels (r = 0.80) and HCV RNA levels (r = 0.87). In summary, the serum HCV Ag and RNA levels reflect the intrahepatic values.

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Available from: Veronique Descamps, Oct 08, 2015
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    • "In our experience the correlation (r = 0.818) was weaker than reported by others, as previous studies with the same HCVAg assay reported r values up to 0.90 or even higher [14,32]. This does not seem to be ascribed to the relatively high rate (30%) of samples from treated patients in our selection, since the relationship between these two indexes of active HCV infections appears stronger in treated than in untreated patients. "
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    ABSTRACT: A good correlation between HCV core antigen (HCVAg) and different HCV-RNA assays has been described, but little data are available in HCV/HIV co-infection. We aimed to evaluate HCVAg in comparison with HCV-RNA and to determine their kinetics during antiviral treatment in selected HCV/HIV co-infected patients. 355 samples from 286 HCV/HIV co-infected subjects for whom HCV-RNA (Abbott RealTime) was requested were analysed also for HCVAg (Abbott ARCHITECT) in order to evaluate the correlation between the two parameters both in patients treated or untreated for chronic hepatitis C and according to different HCV genotypes. The differences between percentages were evaluated by chi square or Fisher's exact test, while mean and median values were compared by Student's t test or the Mann-Whitney test, respectively. All differences were considered significant for a p value <0.05. HCVAg was detectable on 288/315 sera (91.4%) positive for HCV-RNA and in 5 out of40(12.5%) sera with undetectable HCV-RNA for a total concordance of 90.1%. The correlation was fair both in untreated (r = 0.742) and in treated (r = 0.881) patients and stronger for genotypes 1 and 4 than for genotype 3. Both HCV-RNA and HCVAg levels were significantly higher (p = 0.028 and p = 0.0098, respectively) in patients infected by genotype 1 than by genotype 3. The mean ratio of Log values between HCV-RNA (IU/mL) and HCVAg (fmol/liter) was 2.27 + 1.09 in untreated and 2.20 + 0.82 in treated patients (p = n.s.),consistent with a sensitivity of HCVAg corresponding to about 1,000 IU/mL of HCV-RNA, and ranged from 2.21 to 2.32 among HCV genotypes with no significant differences; five samples (1.4%; 2 genotype 1a or 1c, 3 genotype 3a) showed highly divergent values. The analysis of 18 monitoring profiles from patients treated with PEG-IFN and Ribavirin showed similar trends, except in one case in which relapse could be predicted by HCVAg and not by HCV-RNA. These results suggest that HCVAg represents an adequate tool for determining an ongoing HCV infection also in HIV co-infected patients, with lower costs and faster turnaround time that HCV-RNA.
    BMC Infectious Diseases 04/2014; 14(1):222. DOI:10.1186/1471-2334-14-222 · 2.61 Impact Factor
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    • "However, HCV-Cp and HCV RNA titers in serum are neither directly equivalent nor simply stoichiometrically related; thus, changes in either one are likely indicative of a change in biologic status, as reported for the HCV-infected general population [35]. RNA-free Cp-containing structures may be present in serum; however, although the serum level of HCV-Cp mirrors its intrahepatic concentration, it cannot be strictly considered a direct marker of viral replication [36]. "
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    ABSTRACT: In Hepatitis C virus (HCV)-related mixed cryoglobulinemia (MCG), the non-enveloped HCV core protein (HCV-Cp) is a constituent of the characteristic cold-precipitating immune complexes (ICs). A possible correlation between HCV-Cp, virological, laboratory and clinical parameters in both untreated MCG patients and those undergoing specific treatment was explored. HCV-Cp was quantified by a fully automated immune assay. Correlations between HCV-Cp and HCV RNA, cryocrit, and virus genotype (gt) were investigated in 102 chronically HCV-infected MCG patients. HCV-Cp concentrations strongly correlated with HCV RNA levels in baseline samples. An average ratio of 1,425 IU and 12,850 IU HCV RNA per pg HCV-Cp was estimated in HCV gt-1 and gt-2 patients, respectively. This equation allowed to estimate that, on average, HCV-Cp was associated with viral genome in only 3.4% of the former and in 35% of the latter group of patients. The direct relationship between HCV-Cp and the cryocrit level suggests that the protein directly influences the amount of cryoprecipitate. Although the therapy with rituximab (RTX) as a single agent resulted in the enhancement of HCV-Cp levels, in patients treated with RTX in combination with a specific antiviral therapy (pegylated interferon-alpha plus ribavirin) the prompt and effective clearance of HCV-Cp was documented. Our data provide evidence that HCV-Cp has a direct effect on cold-precipitation process in a virus genotype-dependence in HCV-related MCG patients.
    Arthritis research & therapy 03/2014; 16(2):R73. DOI:10.1186/ar4513 · 3.75 Impact Factor
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    • "Quantitative detection of HCV core antigen (HCVcAg) may be an alternative, which was reported to confirm viral replication in hepatitis C infected patients [9,10]. Several studies showed that levels of serum HCVcAg correlate with those of HCV RNA in CHC patients [11-13]. In acute hepatitis C cases, HCVcAg can pick up a great majority of HCV RNA positive samples [14], and closely track HCV RNA dynamics throughout the course of the disease. "
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    ABSTRACT: Earlier kinetics of serum HCV core antigen (HCVcAg) and its predictive value on sustained virological response (SVR) were investigated in patients with genotype 1 HCV infection during antiviral treatment. In a multi-centered, randomized and positive drug-controlled phase IIb clinical trial on type Y peginterferon alpha-2b (NCT01140997), forty-eight CHC patients who participated in pharmacokinetics were randomly divided into 4 cohorts and treated with PegIFNalpha (type Y peginterferon alpha-2b 90 mug, 135 mug, 180 mug and PegIFNalpha-2a 180 mug, respectively, once a week) and ribavirin (< 75 kg, 1000 mg daily and >= 75 kg, 1200 mg daily) for 48 weeks, and then followed up for 24 weeks. 32 patients infected with genotype 1 HCV and completed the whole process were included in this study. HCV RNAs were detected at baseline, and weeks 4, 12, 24, 48 and 72 using Cobas TaqMan. ARCHITECT HCVcAg was performed at 24, 48, 72, 96, 120 and 144 h in addition to the above time points. The receiver operating curves (ROCs) were performed to study the predictive values of HCVcAg decline on SVR. Following antiviral treatment, serum HCVcAg levels rapidly declined within the first week and correlated well with corresponding HCV RNA at baseline, weeks 4, 12, 24, 48 and 72 (rs = 0.969, 0.928, 0.999, 0.983, 0.985 and 0.946, respectively, P < 0.001). All of the areas under the receiver operating curves (AUROCs) were more than 0.80 and showed good predictive power on SVR at 24, 48, 72, 96, 120 and 144 h. The144 h was the best predictive time point of HCVcAg decline on SVR because of its largest AUROC (more than 0.90). Early kinetics of serum HCVcAg predicts SVR very well in genotype 1 CHC patients during antiviral treatment, and its reduction value at 144 h is an earlier and stronger predictor on SVR than rapid virological response and early virological response. (TRN: NCT01140997).
    BMC Gastroenterology 03/2014; 14(1):47. DOI:10.1186/1471-230X-14-47 · 2.37 Impact Factor
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