@article{fdi:010063965,
  title = {{U}sefulness of a fourth generation {ELISA} assay for the reliable identification of {HCV} infection in {HIV}-positive adults from {G}abon ({C}entral {A}frica)},
  author = {{R}ouet, {F}. and {D}eleplancque, {L}. and {M}boumba, {B}. {B}. and {S}ica, {J}. and {M}ouinga-{O}ndeme, {A}. and {L}i{\'e}geois, {F}lorian and {G}oudeau, {A}. and {D}ubois, {F}. and {G}audy-{G}raffin, {C}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground/{O}bjectives {G}uidelines for optimized {HCV} screening are urgently required in {A}frica, especially for patients infected with {HIV}, who sometimes show false positive or false negative reactivity in anti-{HCV} antibody assays. {H}ere, we assessed the usefulness of a fourth-generation {HCV} {A}g-{A}b {ELISA} for the identification of active {HCV} infection in {HIV}-positive patients. {M}ethods {T}his cross-sectional study was conducted between 03/2010 and 01/2013 and included 762 {G}abonese {HIV}-positive adult patients. {T}he results of {ELISA} ({M}onolisa {HCV} {A}g-{A}b {ULTRA}, {B}io-{R}ad) were compared with those obtained by {RT}-{PCR} (gold standard). {T}he optimal {ELISA} signal-to-cutoff ({S}/{CO}) ratio to identify patients with active hepatitis {C} (positive {HCV} {RNA}) was determined. {S}pecimens were further tested by the {INNO}-{LIA} {HCV} core assay ({I}nnogenetics) and the {A}rchitect {HCV} {A}g kit ({A}bbott) to define the best diagnostic strategy. {R}esults {S}ixty-seven patients tested positive for {HCV} ({S}/{CO} ratio >= 1) by {ELISA}. {O}f these, 47 (70.1%) tested positive for {HCV} {RNA}. {T}he optimal {S}/{CO} associated with active {HCV} infection was 1.7. {A}t this threshold, the sensitivity of {ELISA} was 97.9%(95% confidence interval ({CI}) 90.0-99.9%), its specificity was 91.3% (95% {CI} 85.0-95.5%), and {HCV} seroprevalence rate was 7.3% (56/762) (95% {CI} 5.6-9.4%). {A}mong 57 {HCV}-seropositive patients with available {INNO}-{LIA} results, false reactivity was identified in 14 (24.6%), resolved {HCV} infection in two (3.5%), possible acute {HCV} infections in nine (15.8%) and likely chronic {HCV} infections in 32 (56.1%) patients. {HCV} core {A}g was undetectable in 14/15 (93.3%) specimens that tested negative for {HCV} {RNA} whereas it was quantified in 34 (out of 39, 87.2%) samples that tested positive for {HCV} {RNA}. {C}onclusions {O}ur study provides comprehensive guidance for {HCV} testing in {G}abon, and will help greatly clinicians to improve case definitions for both the notification and surveillance of {HCV} in patients co-infected with {HIV}.},
  keywords = {{GABON}},
  booktitle = {},
  journal = {{P}los {O}ne},
  volume = {10},
  numero = {1},
  pages = {e0116975 [12 p.]},
  ISSN = {1932-6203},
  year = {2015},
  DOI = {10.1371/journal.pone.0116975},
  URL = {https://www.documentation.ird.fr/hor/fdi:010063965},
}