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KMID : 0338420090240040302
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The Korean Journal of Internal Medicine
2009 Volume.24 No. 4 p.302 ~ p.308
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Significance of Anti-HCV Signal-to-Cutoff Ratio in Predicting Hepatitis C Viremia
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Seo Yeon-Seok
Jung Eun-Suk
Kim Jeong-Han
Jung Young-Kul
Kim Ji-Hoon
Yim Hyung-Joon
Yeon Jong-Eun
Byun Kwan-Soo
Kim Chang-Duck
Ryu Ho-Sang
Um Soon-Ho
An Hyong-Gin
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Abstract
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Background/Aims : Hepatitis C virus (HCV) RNA testing can be performed using qualitative or quantitative
assays, and it is still unclear which is more useful as a primary test in patients positive for anti-HCV. The present
study evaluated the usefulness of anti-HCV signal-to-cutoff ratio (S/CO ratio) for predicting HCV RNA results.
Methods: Patients on whom a qualitative HCV RNA test was performed due to a positive anti-HCV enzyme
immunoassay were enrolled. Patients were divided into viremia and no-viremia groups according to HCV RNA
results. Receiver-operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic
accuracy of anti-HCV S/CO for a diagnosis of viremia.
Results: In total, 487 patients were enrolled. HCV RNA was positive in 301 subjects (61.8%). Age, serum ALT
level, and anti-HCV S/CO ratio were significantly different between the viremia and no-viremia groups. By ROC
curve analysis, anti-HCV S/CO ratio (area, 0.989; 95% confidence interval, 0.981 to 0.998) accurately predicted
the presence of viremia, with a cutoff value of 10.9 (sensitivity, 94.4%; specificity, 97.3%).
Conclusions: Anti-HCV S/CO ratio was found to be highly accurate at predicting HCV viremia. The anti-HCV
S/CO ratio can be used to determine whether a quantitative or qualitative HCV RNA test should be used to
confirm HCV viremia in patients with a positive anti-HCV by the following criteria: if the anti-HCV S/CO ratio is
<10.9, a qualitative HCV RNA test can be used, and if the anti-HCV S/CO ratio is ≥10.9 a quantitative HCV RNA
test can be performed.
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KEYWORD
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Hepatitis C virus, Viremia, Enzyme immunoassay, Antibody titer
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