Comparison Of Hepatitis C Antibody Assays And Evaluation Of Agreement Between Hepatitis C Antigen And PCR Results.

BACKGROUND: Hepatitis C is associated with a wide range of health repercussions. Pakistan is one of the highly prevalent countries of Hepatitis C Virus (HCV) infection. The availability of cost-effective, robust, and reliable screening and diagnostic tests for hepatitis C is important to address the disease burden. Standardization of screening and diagnostic assays in clinical laboratories is crucial for achieving big goals. Objectives of this study are to correlate the results of two different HCV antibody (HCV Ab) assays and to examine the correlation of HCV core antigen (HCV c Ag) results with HCV PCR for HCV infection diagnosis. METHODS: This descriptive cross-sectional study was carried out from November to December 2020 at Dow University of Health Sciences. Total number of 40 HCV Ab samples were analysed by both chemiluminescence (CMIA) and electrochemiluminescence (ECLIA) immunoassays. Tests for HCV RNA PCR and HCV c Ag were performed on all samples. Results of screening and diagnostic assays were correlated and agreements were examined. Statistical analysis for agreement was carried out by using R software version 3.6.3 through AC1 Gwetz Statistic. The study was approved by the institutional ethical review committee. RESULTS: An agreement of 0.73 and 0.95 was found between two different HCV Ab immunoassays and HCV c Ag and HCV PCR, respectively. CONCLUSIONS: We found a good correlation between CMIA and ECLIA for HCV Ab. An excellent correlation was found between HCV c Ag and HCV PCR. Based on our study findings, HCV c Ag is a candidate test for the diagnosis of active HCV infection.

Bone Turnover Markers for Osteoporosis Status Assessment at Baseline in Postmenopausal Pakistani Females.

OBJECTIVE: To assess bone turnover status in osteopenic and osteoporotic postmenopausal females. STUDY DESIGN: Cross-sectional analytical study. PLACE AND DURATION OF STUDY: The Aga Khan University Hospital, Karachi, from January to December 2013. METHODOLOGY: Across-sectional study was conducted on 203 postmenopausal females undergoing bone mineral density testing (BMD) by DXAscan. Patients with clinical history of any disorder or medications affecting bone turnover were excluded. Bone turnover was assessed with osteocalcin and ß-CTx. Data was analyzed by SPSS version 19. RESULTS: Mean age of the participants was 54 ±4.66 years with a mean BMI of 28.7 ±5.5 kg/m2. Mean ß-CTx (0.28 ±0.24 ng/ml) and osteocalcin (21.5 ±10.6 ng/ml) levels were within the normal reference range. Subjects were grouped into normal (26.6%), osteopenic (44.8%), and osteoporotic (28.6%) based on the t-scores. Serum levels of osteocalcin and ß-CTx between normal, osteopenic, and osteoporotic groups were not significantly different. ß-CTx was negatively and significantly associated with only lumber spine BMD (r = -0.13, p=0.04). Positive association (< 0.0001) was noted between both markers in normal, osteopenic, and osteoporotic females. However, association of these markers with BMD in the 3 groups were not found. Multivariate linear regression showed a positive and significant effect of BMI on BMD (ß= 0.332, p= < 0.0001). ß-CTx had negative but significant effect on BMD (ß= -0.155, p= 0.018) of postmenopausal women. CONCLUSION: Association between baseline levels of BTM and rate of bone loss is variable and site dependent. ß-CTx correlates better with BMD. However, role of osteocalcin in postmenopausal osteoporosis is uncertain and needs further investigation.