{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T01:45:08Z","timestamp":1747187108048,"version":"3.40.5"},"reference-count":26,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,2,23]],"date-time":"2021-02-23T00:00:00Z","timestamp":1614038400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100001259","name":"National Kidney Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001259","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>In Malaysia, majority anti\u2010HCV positive haemodialysis patients do not undergo hepatitis C confirmation due to the high cost of HCV RNA. HCV Core Antigen might be a cost\u2010effective diagnostic test to identify HD patients who have active HCV infection eligible for Direct Acting Anti\u2010viral therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cross\u2010sectional study was conducted to assess the correlation between HCV Ag and HCV RNA and the cost implications of different diagnostic algorithms to diagnose active HCV infection using Anti\u2010HCV, HCV Ag, and HCV RNA. Pre\u2010dialysis blood was tested for both HCV Ag and HCV RNA. HCV Ag was tested with Abbott ARCHITECT HCV Ag test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Two\u2010hundred twenty\u2010seven haemodialysis patients were recruited from 20 centres with mean age of 57.68\u2009\u00b1\u200912.48\u2009years, and male constitutes 56.8% (129) of the study population. HCV Ag correlated well with HCV RNA (Spearman test coefficient 0.943, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001) with sensitivity of 93.9%, specificity 99.3%, and the accuracy was 97.36%. Cost analysis indicated that a sequential test involving Anti\u2010HCV antibody as initial screening, followed by HCV Ag on Anti\u2010HCV positive and HCV RNA on HCV Ag negative cases translated to a modest cost\u2010saving algorithm compared to standard diagnostic algorithm.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>HCV Ag correlated well with HCV RNA and can potentially be fused in an alternative diagnostic algorithm to generate cost savings methods to diagnose active HCV infection among haemodialysis patients. This alternative algorithm is especially relevant in low to middle\u2010income countries such as Malaysia to optimize the use of the healthcare resource and gains in clinical outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nep.13862","type":"journal-article","created":{"date-parts":[[2021,2,13]],"date-time":"2021-02-13T13:09:54Z","timestamp":1613221794000},"page":"463-470","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Hepatitis C virus core antigen as alternative diagnostic algorithm for active hepatitis C virus infection among haemodialysis population: Cost implications"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4012-2849","authenticated-orcid":false,"given":"Xue Z.","family":"Wong","sequence":"first","affiliation":[{"name":"Department of Medicine, Faculty of Medicine University of Malaya  Jalan University Kuala Lumpur 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