HCV Core Antigen Diagnostic Performance for Acute/Recent HCV Infection in People With HIV-1: A Systematic Review and Meta-Analysis.

IF 3.8 4区医学 Q2 IMMUNOLOGY

Open Forum Infectious Diseases Pub Date : 2025-10-17 eCollection Date: 2025-10-01 DOI:10.1093/ofid/ofaf576

Tsung-Yu Tsai, Guan-Jhou Chen, Hsin-Yun Sun, Chien-Ching Hung

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Abstract

Background: Hepatitis C virus (HCV) core antigen (HCVcAg) has been validated to identify HCV infection, but its efficacy in diagnosing acute HCV infection among people with HIV-1 (PWH) warrants further investigation. This systematic review and meta-analysis aimed to evaluate the diagnostic performance of HCVcAg for acute or recent HCV infection among PWH.

Methods: We conducted a literature search to identify studies assessing the diagnostic performance of HCVcAg from January 2020 to May 2024. Acute or recent HCV infection was defined as the presence of negative anti-HCV antibody but positive nucleic acid amplification tests (NAATs), or anti-HCV antibody seroconversion within 1 year. Studies were included if they evaluated HCVcAg diagnostic accuracy using NAATs as the gold standard and provided sufficient data for sensitivity and specificity assessment. Studies lacking a clear definition of acute or recent infection were excluded.

Results: Four out of 229 articles met our inclusion criteria, with 1015 participants providing 1796 tests. The sensitivity of HCVcAg to diagnose acute or recent HCV infection ranged from 87.1% to 100% and specificity from 95.0% to 100%. The meta-analysis yielded a pooled sensitivity of 0.92 (95% CI, 0.78-0.98) and specificity of 0.99 (95% CI, 0.97-1.00). Based on the global incidence (8.46 per 1000 person-years) of HCV viremia among PWH, the positive and negative predictive values of HCVcAg were 0.44 (95% CI, 0.18-1.00) and 1.00 (95% CI, 0.99-1.00), respectively.

Conclusions: HCVcAg has good diagnostic performance in identifying PWH with acute or recent HCV infection, supporting its integration into HCV screening protocols for PWH.

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HCV核心抗原对HIV-1感染者急性/近期HCV感染的诊断效果：一项系统综述和荟萃分析

背景：丙型肝炎病毒（HCV）核心抗原（HCVcAg）已被证实可用于识别HCV感染，但其在诊断HIV-1 （PWH）人群中急性HCV感染的有效性有待进一步研究。本系统综述和荟萃分析旨在评估HCVcAg对PWH患者急性或近期HCV感染的诊断性能。方法：我们进行了文献检索，以确定评估2020年1月至2024年5月HCVcAg诊断性能的研究。急性或近期HCV感染定义为抗HCV抗体阴性但核酸扩增试验（NAATs）阳性，或1年内抗HCV抗体血清转化。如果以NAATs为金标准评估HCVcAg诊断准确性，并提供足够的敏感性和特异性评估数据，则纳入研究。对急性或近期感染缺乏明确定义的研究被排除在外。结果：229篇文章中有4篇符合我们的纳入标准，1015名参与者提供了1796项测试。HCVcAg诊断急性或近期HCV感染的敏感性为87.1% ~ 100%，特异性为95.0% ~ 100%。荟萃分析的总敏感性为0.92 (95% CI, 0.78-0.98)，特异性为0.99 （95% CI, 0.97-1.00）。基于PWH中HCV病毒血症的全球发病率（8.46 / 1000人-年），HCVcAg阳性和阴性预测值分别为0.44 （95% CI, 0.18-1.00）和1.00 （95% CI, 0.99-1.00）。结论：HCVcAg在识别PWH合并急性或近期HCV感染方面具有良好的诊断性能，支持将其纳入PWH的HCV筛查方案。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Open Forum Infectious Diseases Medicine-Neurology (clinical)

CiteScore

6.70

自引率

4.80%

发文量

630

审稿时长

9 weeks

期刊介绍： Open Forum Infectious Diseases provides a global forum for the publication of clinical, translational, and basic research findings in a fully open access, online journal environment. The journal reflects the broad diversity of the field of infectious diseases, and focuses on the intersection of biomedical science and clinical practice, with a particular emphasis on knowledge that holds the potential to improve patient care in populations around the world. Fully peer-reviewed, OFID supports the international community of infectious diseases experts by providing a venue for articles that further the understanding of all aspects of infectious diseases.