Abstract：
Hepatitis C virus core antigen (HCVcAg) testing can simplify and decrease costs of HCV infection confirmation compared to molecular testing (nucleic acid testing). We piloted HCVcAg testing for the confirmation of active infection. The study was conducted during June through December 2022 among the police and the general population of Islamabad, Pakistan age 18 years and older. Initial screening for HCV antibody was conducted using a rapid diagnostic test (RDT) for all consenting participants. Those who tested positive had venous blood samples tested for HCVcAg, platelets and aspartate aminotransferase (AST). Persons with HCVcAg values ≥3 fmol/L were defined as viremic, and they were offered treatment with direct acting antiviral (DAA) medications, sofosbuvir and daclatasvir. Aspartate aminotransferase to platelet ratio index (APRI) was calculated for each HCV infected person, and those with an APRI score <1.5 received treatment for 12 weeks, while those with APRI ≥ to 1.5 received 24 weeks of treatment. A total of 15,628 persons were screened for anti-HCV using RDT and 643 (4.1%) tested positive. HCVcAg values of ≥3 fmol/L was found in 399/643 (62.1%), and all were offered and accepted treatment. Of those treated, 273/399 (68.4%) returned for a follow-up SVR and HCVcAg was not detected in 261/273, a 95.6% cure rate. The pilot study demonstrated the effectiveness of reaching and treating an urban population using RDT for screening and HCVcAg for confirmation of infection and test of cure.
摘要：
与分子检测（核酸检测）相比，丙型肝炎病毒核心抗原（HCVcAg）检测可以简化并降低HCV感染确认的成本。我们试行了HCVcAg检测，以确认活动性感染。该研究于2022年6月至12月在伊斯兰堡的警察和普通民众中进行，巴基斯坦18岁及以上。使用快速诊断测试（RDT）对所有同意的参与者进行HCV抗体的初始筛查。检测阳性的人静脉血样本检测为HCVcAg,血小板和天冬氨酸转氨酶（AST）。HCVcAg值≥3fmol/L的人被定义为病毒血症，他们接受了直接作用抗病毒（DAA）药物治疗，sofosbuvir和daclatasvir.计算每个HCV感染者的天冬氨酸氨基转移酶与血小板比率指数（APRI），APRI评分<1.5的患者接受治疗12周，而APRI≥1.5的患者接受了24周的治疗。共有15628人使用RDT进行了抗HCV筛查，643人（4.1％）检测呈阳性。在399/643（62.1％）中发现了≥3fmol/L的HCVcAg值，所有人都被提供并接受了治疗。在接受治疗的人中，273/399（68.4％）返回用于后续SVR，在261/273中未检测到HCVcAg，治愈率为95.6％。试点研究证明了使用RDT进行筛查和HCVcAg确认感染和治愈测试来达到和治疗城市人口的有效性。
