title: Core antigen tests for hepatitis C virus: a meta-analysis.
abstract: Diagnosis and monitoring of hepatitis C virus (HCV) infection relies mainly on the detection of HCV antibodies and HCV RNA. HCV antibody test has a longer window period and is not applicable in the immunosuppressed population. Although HCV RNA test reduces the window period, it is still not widely recommended because of its high cost and requirement of specific equipment. HCV core antigen is another direct virological marker which has been investigated in recent years. HCV core antigen assay is as simple as the HCV antibodies assay and can detect HCV infection only 1 day delay compared to the HCV RNA assay. In order to evaluate the application of HCV core antigen test in HCV diagnosis and management, we performed this meta-analysis. Twenty five articles were finally included in meta-analysis. All statistical analyses were performed with MetaDisc 1.4 and Stata 11.0. The pooled sensitivity of HCV core antigen assay was 0.84 (95 % CI, 0.83-0.85), and the pooled specificity was 0.98 (95 % CI, 0.97-0.98). HCV core antigen assays may not displace HCV RNA assays to be a definitive diagnosis of HCV infection until now. Considering the higher sensitivity (0.926) and specificity (0.991) of subgroup, HCV-cAg detection is a promising method as a confirmatory test for HCV antibody positive, therapy-naive individuals. Explored by meta-regression and subgroup analysis, possible sources of heterogeneity of specificity was found, while the heterogeneity of sensitivity was still significant.
authors.affiliation: Department of Neurosurgery, Xiaoshan First Affiliated Hospital of Medical School of Hangzhou Normal University, Xiaoshan 311201, Zhejiang, China.
authors.forename: Shuijun
authors.initials: S
authors.lastname: Gu
authors.forename: Jun
authors.initials: J
authors.lastname: Liu
authors.forename: Huijun
authors.initials: H
authors.lastname: Zhang
authors.forename: Baoluo
authors.initials: B
authors.lastname: Gu
authors.forename: Hanjiang
authors.initials: H
authors.lastname: Lai
authors.forename: Hongliang
authors.initials: H
authors.lastname: Zhou
authors.forename: Chaoqi
authors.initials: C
authors.lastname: He
authors.forename: Yingying
authors.initials: Y
authors.lastname: Chen
mesh_terms: D016174:Hepacivirus / Q000276:immunology*; D006526:Hepatitis C / Q000175:diagnosis* / Q000276:immunology*; D018936:Hepatitis C Antigens / Q000276:immunology*; D006801:Humans; D007159:Immunologic Tests / Q000379:methods*; D017594:Publication Bias; D012680:Sensitivity and Specificity; D014758:Viral Core Proteins / Q000276:immunology*
chemical_list: D018936:Hepatitis C Antigens; D014758:Viral Core Proteins