Sensitivity or Rapidity - The Present need in HCV Diagnosis

: Background - Hepatitis C virus is one of the commonest etiological agents of chronic liver disease worldwide and of major public health importance. Hepatitis C virus infections are indolent and often subclinical leading to liver cirrhosis acute or fulminant hepatitis and hepatocellular carcinoma in developing countries. Among pregnant women these illnesses can lead to coagulation defects high maternal mortality and poor outcomes like still births neonatal deaths and risk of perinatal transmission. This study is planned to look for seroprevalence of HCV in pregnant women with Evaluation of Rapid card Test and ELISA methods in the detection of anti HCV antibodies.Objective-To asses the performance of Immunochromatographic card tests (ICT) and ELISA methods in the detection of anti HCV antibody in pregnant mothers.Materials and methods- This Study was conducted in the Department of Microbiology for a Period of 3 months from June 2012 to August 2012. A total of 200 serum samples from pregnant mothers were subjected to both methods and ELISA positive cases were confirmed by viral RNA detection in Qualitative PCR. The tests were performed using commercially available Immunochromatographic cards and third generation ELISA kits.Results-Out of 200 samples 1(0.5) was found to be positive for HCV antibody by both ICT and ELISA .Two samples were positive only by ELISA. Samples positive by ELISA were confirmed by Qualitative PCR. Using ELISA as Reference Sensitivity Specificity PPV NPV of the card was calculated which was 33 100 100 was 98.9 respectively.Conclusion-As the card is found to be less sensitive than ELISA it is a threat to the community that positive cases if left undetected in pregnancy would lead to maternal or foetal complications with increased Vertical transmission from mother to child. Hence Rapid card should not be relied upon and ELISA must be used for the detection of anti-HCV antibodies.