Analytical performance characteristics and clinical utility of a novel assay for total hepatitis C virus core antigen quantification

Abstract

The detection and quantification of hepatitis C virus (HCV) core antigen in serum or plasma by the use of different assay formats have previously been shown to represent useful markers of viral replication. In the present study, the intrinsic performance characteristics and the potential clinical utility of a novel assay for the quantification of total HCV core antigen were comprehensively assessed by using clinical serum samples and specimens contained in various evaluation panels. The Architect HCV Ag assay showed a specificity of 100%. The intra- and interassay coefficients of variation ranged from 3.6 to 8.0% and from 4.7 to 9.5%, respectively. Except for HCV genotype 2 isolates, the analytical sensitivity was always less than 10 fmol core antigen/liter, corresponding to approximately 500 to 3,000 IU of HCV RNA/ml. Linearity was guaranteed throughout the dynamic range (10 to 20,000 fmol/liter). When seroconversion panels were tested, the assay was not inferior to HCV RNA detection and reduced the preseroconversion period by 4 to 16 days. The results obtained by core antigen and HCV RNA quantification for 385 clinical specimens were correlated by regression analysis (r = 0.857), but the calculated conversion equation differed significantly from the line of identity. Monitoring of viral kinetics by use of either core antigen or RNA concentrations in 38 HCV-infected patients undergoing antiviral combination therapy resulted in very similarly shaped curves in all cases. Finally, the Architect HCV Ag assay was also shown to enable high-throughput screening of in vitro HCV RNA replication. With these results taken together, the Architect HCV Ag assay proved to be a specific, reproducible, highly sensitive, and clinically applicable test format which will find its future place in the context of virological HCV diagnostics.

FIG. 1.

Linear range of quantification by the Architect HCV Ag assay. Nine serial dilutions of two high-titer samples containing either HCV subtype 1a (A) or 1b (B) isolates were tested in triplicate in three separate runs. The observed mean values (filled circles) were plotted against the expected values (dotted lines) by using logarithmic scales.

FIG. 2.

Scatter plot of log₁₀ core antigen concentration (fmol/liter) and RNA concentration (IU/ml) determined in 385 samples by the Architect HCV Ag and Versant HCV RNA 3.0 (bDNA) assays, respectively. The correlation coefficient and conversion equation given in the inset were calculated by nonparametric Passing/Bablok regression analysis.

FIG. 3.

Viral kinetics estimated by testing for HCV core antigen (▪) and RNA (⧫) in four individuals receiving antiviral combination therapy with pegylated alpha interferon and ribavirin. (A) Rapid virological response (RVR); (B) sustained virological response (SVR); (C) results for a patient who developed a relapse after the cessation of antiviral treatment; (D) results for a subject not responding to therapy. GT, HCV genotype.

FIG. 4.

Huh 7 cells stably transfected with an AD78-based HCV full-length construct were treated for 48 h with alpha interferon (A) or the protease inhibitor BILN 2061 (B). The impact of this antiviral therapy on in vitro HCV replication was monitored by determination of both the core antigen and the RNA concentrations. The values shown are the means ± SDs of three replicates and are expressed as a percentage relative to the results for nontreated cells.