Abstract #579 Very Low Hepatitis C Viral Loads in Absence of Therapy: Impact on HCV Antigen Testing – Barbara Bertisch, et al.
Study Aims and Results: HCV antigen testing is a less expensive alternative to viral load testing. However, antigen testing has difficulty detecting very low viral loads (≤ 3,000 IU/ml). This Swiss study assessed the prevalence and analyzed predictors of very low viral loads (VLVL) in 2,460 treatment-naïve participants.
Overall, 5.3% had at least one VLVL. The factors most associated with VLVL are ≤ 40 years old. Gender, HCV genotype and intravenous drug use were not associated with VLVL. Participants with VLVL had a higher rate of spontaneous clearance than those without VLVL. There were 24 cases of cirrhosis, all with either excessive alcohol consumption, HIV coinfection, organ transplantation or other immunosuppressive conditions. The mortality rate was comparable to those without VLVL.
Conclusions: The occurrence of very low viral loads is low. Although the rate of spontaneous clearance is better than expected, the incidence of cirrhosis is disturbing. The use of the HCV antigen assay is questionable as a single tool for HCV detection.
Editorial Comments: Although HCV antigen testing is not the standard assay used in the U.S., this research about very low viral loads is important. Click here to read the entire abstract and view the poster.
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