Cost-Effectiveness of HCV Core Antigen versus PCR for Monitoring Treatment Response in DAAS-Treated Egyptian Patients

Background and study aim: PCR is currently the non-debatable proof for diagnosis of HCV infection as well as conclusion of treatment outcomes. HCV core antigen (HCVcAg) testing is a neglected, less expensive and less time-consuming test that’s presumed to achieve the same aims. The aim of this study is to find the cost-effectiveness of HCV core antigen testing in the monitoring of treatment response as an alternative to the gold-standard PCR test. Patients and Methods: 48 patients indicated for DAAs-therapy in the period from January- to July 2018. Pre- and post-treatment routine investigations including HCV-RNA levels as well as HCVcAg were done. Results: There was a high statistically-significant difference (p<0.001) within the studied group as regards pre- and post-treatment results of HCV-RNA with a total SVR12 rate of 95.8% (46/48 patients). There was a high statistically-significant varaiation (p<0.001) as regards pre- and post-treatment levels of HCVcAg of the studied group. HCVcAg was detected in 89.5% of the included patients before treatment (43/48 patients). The 5 cases that tested negative for HCVcAg had HCV-RNA levels Conclusion: HCVcAg is a sensitive, specific test, less expensive (cost 0.46 that of PCR per single sample) but false negative results of HCVcAg existed with low viremia (< 2000 IU/ml).