الفهرس 
Cover Page Title in EnglishOnly 14 pages are availabe for public view
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Abstract
Hepatitis C virus is considered a major health problem allover the world especially in developing countries as Egypt. Tests used for diagnosis of hepatitis C virus (HCV) are either unreliable tests with false positive and false negative results as anti-HCV antibody assays by Enzyme Linked Immune-assay (ELISA) as in early stages of the infection it cannot differentiate between active and resolved infection also it may be falsely negative in hemodialysis patients and immunocompromised patients. Other diagnostic methods are costly tests; need time, experience and training personel’s as PCR techniques. The Core antigen of (HCV) was studied and it was evaluated as a new marker for diagnosis of HCV infection through detecting Core antigen level by (ELISA), Core antigen is considered as a very conserved part of the HCV genome, and it was compared to Polymerase chain reaction (PCR) and anti-HCV antibodies for the same samples. The period of this study was about 10 months from June 2012 to April 2013 on a total number of 100 subjects . All serum samples were tested by Real time PCR and ELISA for detection the core antigen. The results were : Group I: 42 subjects with anti-HCV antibodies positive & HCV-RNA positive sera by (PCR). Group II: 38 subjects with anti-HCV antibodies positive & HCV RNA negative sera by (PCR). Group III: 20 subjectswith anti-HCV antibodies negative & HCV¬RNA negative by (PCR), this group was considered as a control group. In group I is (32) out of (42) PCR positive samples were presented as positive result for HCV core antigen which is (76.1%) and (10) samples were negative (23.8%). While in group II with PCR negative tests, HCV core antigen test was (30) negative samples out of (38) samples (78.9%) and positive samples were (8) samples which is (21%). Sensitivity and Specificity of the test were calculated by comparing it with the PCR results as a gold standard test in HCV diagnosis, the sensitivity of the test was (76.1%) and the specificity was (86.2%). Also positive predictive value of the test was calculated (80%) and negative predictive value was (82.5%). Although core antigen assay may have utility, but further studies are needed, a large study population and more definitive group of patients in Egypt are needed to draw the final conclusion. Further studies regarding the detection of the HCV-core antigen level would facilitates the distinction between active viral replication and stable infection and might be used to monitor the response of antiviral therapy are also needed.Conclusions from the present study we can conclude that: Core antigen detection by ELISA can be useful as a new test for detection of viremia in HCV infection; it can be more reliable test than anti-HCV antibodies assays in diagnosis of HCV in specific group of populations, when anti-HCV antibody may be false negative as in immunocompromised patients and those on hemodialysis. It is a simple, rapid and less expensive test than PCR and it is an easy test by using ELISA, and it does not need too much training. Approved and commercially available HCV Core antigen detection assays may be useful as a low-priced alternative test to nucleic acid detection, particularly in developing countries as in Egypt.