Imperial College London
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ProfessorMaudLemoine

Faculty of Medicine, Department of Metabolism, Digestion and Reproduction

Professor and Honorary Consultant in Hepatology
 
 
 
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Contact

 

+44 (0)20 3312 5212m.lemoine

 
 
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Location

 

Queen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Shimakawa:2020:cid/ciz412,
author = {Shimakawa, Y and Ndow, G and Njie, R and Njai, HF and Takahashi, K and Akbar, SMF and Cohen, D and Nayagam, S and Jeng, A and Ceesay, A and Sanneh, B and Baldeh, I and Imaizumi, M and Moriyama, K and Aoyagi, K and D'Alessandro, U and Mishiro, S and Chemin, I and Mendy, M and Thursz, MR and Lemoine, M},
doi = {cid/ciz412},
journal = {Clinical Infectious Diseases},
pages = {1442--1452},
title = {Hepatitis B core-related antigen (HBcrAg): an alternative to HBV DNA to assess treatment eligibility in Africa},
url = {http://dx.doi.org/10.1093/cid/ciz412},
volume = {70},
year = {2020}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BACKGROUND: To eliminate hepatitis B virus (HBV) infection, it is essential to scale up testing and treatment. However, conventional tools to assess treatment eligibility, particularly nucleic acid testing (NAT) to quantify HBV DNA, are hardly available and affordable in resource-limited countries. We therefore assessed the performance of novel immunoassay, hepatitis B core-related antigen (HBcrAg), as an inexpensive (US$ <10-15/assay) alternative to NAT to diagnose clinically important HBV DNA thresholds (≥2,000; ≥20,000; and ≥200,000 IU/ml), and select patients for antiviral therapy in Africa. METHODS: Using well-characterized cohort of treatment-naïve patients with chronic HBV infection in The Gambia, we evaluated the accuracy of serum HBcrAg to diagnose HBV DNA levels, and to indicate treatment eligibility determined by the American Association for the Study of Liver Diseases, based on the reference tests (HBV DNA, HBV e antigen (HBeAg), alanine transaminase (ALT), liver histopathology and/or FibroScan). RESULTS: A total of 284 treatment-naïve patients were included in the analysis. The area under the receiver operating characteristic curve (AUROC), sensitivity and specificity of serum HBcrAg were: 0.88 (95% CI: 0.82-0.93), 83.3% and 83.9% to diagnose HBV DNA ≥2,000 IU/ml; and 0.94 (0.88-0.99), 91.4% and 93.2% for ≥200,000 IU/ml. A simplified treatment algorithm using HBcrAg without HBV DNA showed high AUROC (0.91 (95% CI: 0.88-0.95)) with a sensitivity of 96.6% and specificity of 85.8%. CONCLUSIONS: HBcrAg might be an accurate alternative to HBV DNA quantification as a simple and inexpensive tool to identify HBV-infected patients in need of antiviral therapy in low- and middle-income countries.
AU  - Shimakawa,Y
AU  - Ndow,G
AU  - Njie,R
AU  - Njai,HF
AU  - Takahashi,K
AU  - Akbar,SMF
AU  - Cohen,D
AU  - Nayagam,S
AU  - Jeng,A
AU  - Ceesay,A
AU  - Sanneh,B
AU  - Baldeh,I
AU  - Imaizumi,M
AU  - Moriyama,K
AU  - Aoyagi,K
AU  - D'Alessandro,U
AU  - Mishiro,S
AU  - Chemin,I
AU  - Mendy,M
AU  - Thursz,MR
AU  - Lemoine,M
DO  - cid/ciz412
EP  - 1452
PY  - 2020///
SN  - 1058-4838
SP  - 1442
TI  - Hepatitis B core-related antigen (HBcrAg): an alternative to HBV DNA to assess treatment eligibility in Africa
T2  - Clinical Infectious Diseases
UR  - http://dx.doi.org/10.1093/cid/ciz412
UR  - https://www.ncbi.nlm.nih.gov/pubmed/31102406
UR  - https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciz412/5491470
UR  - http://hdl.handle.net/10044/1/72155
VL  - 70
ER  -
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