RESUMO
BACKGROUND: In order to decrease the burden of suffering and the costs derived from confirmatory molecular assays, a better strategy is badly needed to decrease the rate of false positive results of the enzyme-linked immunoassay (ELISA) for detection of hepatitis C virus (HCV) antibodies (Anti). OBJECTIVE: To establish the best cutoff of the S/CO rate in subjects with a positive result of a microparticule, third generation ELISA assay for Anti-HCV, for predicting viremia as detected by polymerase chain reaction (PCR) assay. METHODS: Using the result of the PCR assay as "gold standard", a ROC curve was build with the results of the S/CO rate values in subjects with a positive result for ELISA HCV assay. RESULTS: Fifty two subjects (30 male, 22 female, 40 +/- 12.5 years old) were included. Thirty four (65.3%) had a positive RNA HCV PCR assay. The area under the curve was 0.99 (95% CI: 0.98-1.0). The optimal cutoff for the S/CO rate was established in 29: sensitivity: 97%; specificity: 100%: PPV: 100%; NPV: 94%. CONCLUSIONS: Setting the cutoff of the S/CO in 29 results in a high predictive value for viremia as detected by PCR in subjects with a positive ELISA HVC assay. This knowledge may result in a better decision taking for the clinical follow up of those subjects with a positive result in the ELISA screening assay for HCV infection.