Significance of anti-HCV signal-to-cutoff ratio in predicting hepatitis C viremia

Yeon Seok Seo, Eun Suk Jung, Jeong Han Kim, Young Kul Jung, Ji Hoon Kim, Hyonggin An, Hyung Joon Yim, Jong Eun Yeon, Kwan Soo Byun, Chang Duck Kim, Ho Sang Ryu, Soon Ho Um

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31 Citations (Scopus)


Background/Aims: Hepatitis C virus (HCV) RNA testing can be performed using qualitative or quantitative assays, and it is still unclear which is more useful as a primary test in patients positive for anti-HCV. The present study evaluated the usefulness of anti-HCV signal-to-cutoff ratio (S/CO ratio) for predicting HCV RNA results. Methods: Patients on whom a qualitative HCV RNA test was performed due to a positive anti-HCV enzyme immunoassay were enrolled. Patients were divided into viremia and no-viremia groups according to HCV RNA results. Receiver-operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic accuracy of anti-HCV S/CO for a diagnosis of viremia. Results: In total, 487 patients were enrolled. HCV RNA was positive in 301 subjects (61.8%). Age, serum ALT level, and anti-HCV S/CO ratio were significantly different between the viremia and no-viremia groups. By ROC curve analysis, anti-HCV S/CO ratio (area, 0.989; 95% confidence interval, 0.981 to 0.998) accurately predicted the presence of viremia, with a cutoff value of 10.9 (sensitivity, 94.4%; specificity, 97.3%). Conclusions: Anti-HCV S/CO ratio was found to be highly accurate at predicting HCV viremia. The anti-HCV S/CO ratio can be used to determine whether a quantitative or qualitative HCV RNA test should be used to confirm HCV viremia in patients with a positive anti-HCV by the following criteria: if the anti-HCV S/CO ratio is <10.9, a qualitative HCV RNA test can be used, and if the anti-HCV S/CO ratio is ≥10.9 a quantitative HCV RNA test can be performed.

Original languageEnglish
Pages (from-to)302-308
Number of pages7
JournalKorean Journal of Internal Medicine
Issue number4
Publication statusPublished - 2009
Externally publishedYes


  • Antibody titer
  • Enzyme immunoassay
  • Hepatitis C virus
  • Viremia

ASJC Scopus subject areas

  • Internal Medicine


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