Title: Prevalence-based Screening by Anti-HCV Reflex HCV Antigen Test and Accessible Post-
screening Care towards Elimination of Hepatitis C in Rural Villages
Version: 1 Date: 15 Feb 2025
Reviewer:  Federico García
Reviewer's report:
The authors present an interesting strategy to reach the infected population in rural villages using
reflex testing based on core antigen.
Minor comments:
Only around 15% of the population was screened. Given the high prevalence of chronic active
HCV, please discuss possible reasons for this low uptake and suggest measures to improve it.
The way the results are presented is confusing. In the abstract, it appears that 75 patients were
HCV Ag positive, while the actual number was 125. The figure of 75 corresponds to the number
of patients who attended the outreach clinic. Additionally, only six of the 125 viremic patients
were not linked to care. These results should be presented more clearly.
The strategy can only be implemented using the Abbott testing platform, as no other major
laboratory provider offers both anti-HCV and HCV core antigen testing within the same
platform. Please discuss.
HCV RNA levels and HCV genotype distribution are reported in the results section; however,
there is no corresponding description in the methods section. Please provide this information.
Although I agree with the conclusion that "We also verified that the HCV antigen assay is a
reliable tool for identifying viremic patients," I believe that no results in the study support this
statement. Since there is no HCV-RNA testing for patients who are anti-HCV positive but HCV
antigen negative, the authors cannot rule out the possibility that some patients with low-level
HCV-RNA may have been missed.
Title: Prevalence-based Screening by Anti-HCV Reflex HCV Antigen Test and Accessible Post-
screening Care towards Elimination of Hepatitis C in Rural Villages
Version: 1 Date: 15 Feb 2025
Reviewer:  Federico García
Reviewer's report:
The authors present an interesting strategy to reach the infected population in rural villages using
reflex testing based on core antigen.
Minor comments:
Only around 15% of the population was screened. Given the high prevalence of chronic active
HCV, please discuss possible reasons for this low uptake and suggest measures to improve it.
The way the results are presented is confusing. In the abstract, it appears that 75 patients were
HCV Ag positive, while the actual number was 125. The figure of 75 corresponds to the number
of patients who attended the outreach clinic. Additionally, only six of the 125 viremic patients
were not linked to care. These results should be presented more clearly.
The strategy can only be implemented using the Abbott testing platform, as no other major
laboratory provider offers both anti-HCV and HCV core antigen testing within the same
platform. Please discuss.
HCV RNA levels and HCV genotype distribution are reported in the results section; however,
there is no corresponding description in the methods section. Please provide this information.
Although I agree with the conclusion that "We also verified that the HCV antigen assay is a
reliable tool for identifying viremic patients," I believe that no results in the study support this
statement. Since there is no HCV-RNA testing for patients who are anti-HCV positive but HCV
antigen negative, the authors cannot rule out the possibility that some patients with low-level
HCV-RNA may have been missed.
Please review this paper.
user
Title: Prevalence-based Screening by Anti-HCV Reflex HCV Antigen Test and Accessible Post-
screening Care towards Elimination of Hepatitis C in Rural Villages
Version: 1 Date: 15 Feb 2025
Reviewer:  Federico García
Reviewer's report:
The authors present an interesting strategy to reach the infected population in rural villages using
reflex testing based on core antigen.
Minor comments:
Only around 15% of the population was screened. Given the high prevalence of chronic active
HCV, please discuss possible reasons for this low uptake and suggest measures to improve it.
The way the results are presented is confusing. In the abstract, it appears that 75 patients were
HCV Ag positive, while the actual number was 125. The figure of 75 corresponds to the number
of patients who attended the outreach clinic. Additionally, only six of the 125 viremic patients
were not linked to care. These results should be presented more clearly.
The strategy can only be implemented using the Abbott testing platform, as no other major
laboratory provider offers both anti-HCV and HCV core antigen testing within the same
platform. Please discuss.
HCV RNA levels and HCV genotype distribution are reported in the results section; however,
there is no corresponding description in the methods section. Please provide this information.
Although I agree with the conclusion that "We also verified that the HCV antigen assay is a
reliable tool for identifying viremic patients," I believe that no results in the study support this
statement. Since there is no HCV-RNA testing for patients who are anti-HCV positive but HCV
antigen negative, the authors cannot rule out the possibility that some patients with low-level
HCV-RNA may have been missed.
assistant