22658797

PMC3652577

Background

In Sub-Saharan Africa, prevalence estimates of hepatitis C virus (HCV) vary widely.

Objectives

To assess the prevalence of HCV infection among HIV-infected, pregnant women screened for a large clinical trial in Lilongwe, Malawi.

Study design

Plasma from 2041 HIV-infected, pregnant women was screened for anti-HCV IgG using a chemiluminiscent immunometric assay (CIA). Specimens with a signal-cut-off ratio ≥ 1.00 were considered reactive and those with S/Co ratio < 1.00 non-reactive. All CIA-reactive specimens were tested by a recombinant immunoblot assay (RIBA) for anti-HCV and by PCR for HCV RNA.

Results

Of 2041 specimens, 110 (5.3%, 95% CI: 4.5–6.5%) were CIA reactive. Of the 109 CIA reactive specimens available for RIBA testing, 2 (1.8%) were positive, 28 (25.7%) were indeterminate, and 79 (72.5%) were negative. All CIA-reactive specimens were HCV RNA negative (n = 110). The estimated HCV prevalence based on the screening assay alone was 5.3%; based on supplemental RIBA testing, the status of HCV infection remained indeterminate in 1.4% (28/2040, 95% CI: 0.1–2.0) and the prevalence of confirmed HCV infections was 0.1% (2/2040, 95% CI: 0–0.4%).

Conclusions

HCV seroprevalence among HIV-infected, pregnant women in Malawi confirmed by supplemental RIBA HCV 3.0 is low (0.1%); CIA showed a high false-reactivity rate in this population.

CDC Public Access

U48 DP001944/DP/NCCDPHP CDC HHS/United States
R24 TW007988/TW/FIC NIH HHS/United States
P30-AI50410/AI/NIAID NIH HHS/United States
U48 DP000059/DP/NCCDPHP CDC HHS/United States
2-D43 TW01039-06/TW/FIC NIH HHS/United States
P30 AI050410/AI/NIAID NIH HHS/United States