Ayfer Bakır, Muhammed Furkan Kürkçü, Gizem Korkut
Journal of Academic Research in Medicine - 2025;15(3):152-157
Objective: For the diagnosis of hepatitis C virus (HCV), the detection of HCV antibodies by serological tests is primarily performed using enzyme immunoassays and chemiluminescence-based methods, and positive results are confirmed by HCV ribonucleic acid (RNA) testing. This study aimed to evaluate the performance of the anti-HCV test and to determine the optimal signal-to-cut-off (S/CO) ratio for predicting viremia. Methods: Anti-HCV levels in serum samples were analyzed using the electrochemiluminescent immunoassay method, while HCV RNA was detected in plasma samples using real-time polymerase chain reaction. Results: A total of 1,010 anti-HCV-reactive patients (474 males, 536 females) were included. The median age was 52 years for males and 62 years for females (p<0.001). HCV RNA positivity was detected in 16.6% (168/1,1010) of the patients. The median anti-HCV S/CO value was 48.70 in HCV-RNA-positive individuals and 37.65 in HCV-RNA-negative individuals (p<0.001). All patients with an S/CO ratio <1.25 were HCV RNA negative, whereas those with an S/CO ratio >293 were HCV RNA positive. Receiver operating characteristic analysis yielded an area under the curve (AUC) of 0.59 (95% confidence interval: 0.55-0.82), with an optimal S/CO of 8.23 yielding 95.2% sensitivity and 36% specificity. Conclusion: The optimal S/CO value yielding the highest sum of sensitivity and specificity was determined to be 8.23. Although an S/CO of 8.23 showed promise for detecting viremia in our cohort, the relatively low AUC of 0.59 suggests that its utility may be limited and that it should be interpreted cautiously, particularly in low-prevalence populations.
