Diagnostic Performances of Hepatitis C Virus-NS4 Antigen in Patients with Different Liver Pathologies

Background and Aims. Hepatitis C virus (HCV) has emerged as the major pathogen of liver disease worldwide. The aim of this study was to quantitate and evaluate the performance of HCV-NS4 antigen as an alternative approach for confirmation of viremia. Methods. Detection of HCV-NS4 was assessed in 883 patients with chronic hepatitis C. Areas under the ROC curves (AUC) were used to assess and compare diagnostic accuracy of ELISA for HCV-NS4 with quantitative HCV-RNA as a gold standard. Results. HCV-NS4 was identified at 27 kDa using Western blot. AUC for HCV-NS4 detection was 0.95 for all patients with different liver pathologies: 0.93 for liver fibrosis (LF), 0.95 for liver cirrhosis (LC) and 0.98 for hepatocellular carcinoma (HCC). The mean +/- SD (mu g/mL) of HCV-NS4 in LF was 94.2 +/- 55.6; in LC was 99.3 +/- 64.8 and in HCC was 124.9 +/- 70.3. Conclusions. HCV-NS4 antigen detection using ELISA is a reliable test in the confirmation of HCV infection. (C) 2012 IMSS. Published by Elsevier Inc.