Short communicationPrevalence of false-positive hepatitis C antibody results, National Health and Nutrition Examination Study (NHANES) 2007–2012
Section snippets
Background
Screening for HCV infection is recommended in the US for groups considered to be at risk for infection or with a higher prevalence of HCV infection than the general population [1]. Testing is recommended in certain situations for asymptomatic persons in the general population, such as baseline and follow-up testing of healthcare providers after a needlestick exposure or persons notified to receive bloodborne pathogen testing after a potential exposure resulting from an identified healthcare
Objectives
We sought to determine the prevalence of true vs false-positive anti-HCV screening tests among participants in the 2007–2012 National Health and Nutrition Examination Survey (NHANES), a nationally representative sample of the US non-institutionalized civilian population [6].
Study design
NHANES survey methods have been described elsewhere [7]; during 2007–2012 an initial screening anti-HCV test was performed on all NHANES participants aged 6 years or older [6]. Testing for anti-HCV in serum or plasma was conducted using anti-HCV chemiluminescent assay (CIA) on VITROS automated immunodiagnostic platform (Ortho Clinical Diagnostics, Raritan, NJ). Signal-to-cut-off ratios (S/CO) ≥1.0 were considered to be anti-HCV reactive [8]. Reactive specimens were tested using a confirmatory
Results
Of 22,359 NHANES participants tested for anti-HCV by CIA during 2007–2012, 479 (2.1%) were anti-HCV reactive. Of these, 477 (99.6%) had a confirmatory RIBA test and were included in further analysis.
Discussion
Screening persons in a population with low prevalence of a disease leads to many false-positives that may have health, economic and psychological impacts on patients and providers. In this sample with 1% HCV infection prevalence, the predictive value positive of the test [5] was lower than in higher prevalence populations: about seven of every ten screening-reactive anti-HCV results (68%) were true-positives and two of ten (22%) false-positives. One in 10 (10%) was “indeterminate,” of which
Competing interests
None declared.
Funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Ethical approval
Ethical approval for the National Health and Nutrition Examination Study (NHANES) was obtained from the National Center for Health Statistics (NCHS) Research Ethics Review Board (ERB). Written consent was obtained from participants.
Disclaimer
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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