Evaluation of the Xpert HCV VL Fingerstick point-of-care assay and dried blood spot HCV-RNA testing as simplified diagnostic strategies among people who inject drugs in Catalonia, Spain

Saludes, Verónica; Antuori, Adrián; Lazarus, Jeffrey V.; Folch, Cinta; González-Gómez, Sara; González, Noemí; Ibáñez, Núria; Colom, Joan; Matas, Lurdes; Casabona, Jordi; Martró, Elisa

doi:10.1016/j.drugpo.2020.102734

Cited by 42 publications

(41 citation statements)

References 34 publications

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“…These have been successfully evaluated in studies of PWIDs in Australia and Spain. ( 28,29 ) In the study from Spain, investigators found that POC and DBS were 98.4% and 93.7% sensitive for detecting HCV RNA with venous plasma samples as the gold‐standard comparison. Eighty percent of patients received their POC testing results on the same day, which was preferred by most participants.…”

Section: Innovations In Micro‐eliminationmentioning

confidence: 99%

“…Eighty percent of patients received their POC testing results on the same day, which was preferred by most participants. ( 28 ) The feasibility of self‐sampling DBS at home is currently being evaluated. ( 30 ) The novel approach of POC‐RNA testing as one‐step, rapid screening in high‐prevalence PWID populations coupled with rapid (same‐day) DAA initiation are underway in Australia (http://ClinicalTrials.gov, NCT03492112).…”

Section: Innovations In Micro‐eliminationmentioning

confidence: 99%

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Innovations in Hepatitis C Screening and Treatment

et al. 2020

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New therapies offer hope for a cure to millions of persons living with hepatitis C virus (HCV) infection. HCV elimination is a global goal that will be difficult to achieve using the traditional paradigms of diagnosis and care. The current standard has evolved toward universal HCV screening and treatment, to achieve elimination goals. There are several steps between HCV diagnosis and cure with major barriers along the way. Innovative models of care can address barriers to better serve hardly reached populations and scale national efforts in the United States and abroad. Herein, we highlight innovative models of HCV care that aid in our progress toward HCV elimination.

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Section: Innovations In Micro‐eliminationmentioning

confidence: 99%

Section: Innovations In Micro‐eliminationmentioning

confidence: 99%

Innovations in Hepatitis C Screening and Treatment

et al. 2020

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“…Rapid tests represent an interesting alternative for HCV screening among high-risk populations given the advantage of simplicity, quick performance at room temperature, and the limited need of equipment and training for health professionals. Furthermore, point-of-care HCV RNA viral load tests are becoming increasingly available, allowing quick and reliable detection of active HCV infection from venipuncture and finger-stick capillary whole-blood samples without requiring special laboratory infrastructure ( Wang et al, 2011 ; Cooper, 2017 ; Grebely et al, 2017b ; Saludes et al, 2020 ). In particular, these point-of-care diagnostics for HCV antibodies and HCV RNA are interesting quick and easy testing tools that should be used as part of the national elimination strategy in Tunisia to expand access to HCV diagnosis and treatment among hard-to-reach groups such as PWID.…”

Section: Discussionmentioning

confidence: 99%

Distribution of HCV Genotypes Among People Who Inject Drugs in Tunisia: New Evidence for Scaling Up Prevention and Treatment Toward National Elimination Goal

et al. 2021

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Little is known about the distribution of hepatitis C virus (HCV) genotypes among people who inject drugs (PWID) in North African countries, including Tunisia. This study aims to describe HCV genotypes circulating among Tunisian PWID. A cross-sectional study was conducted, and 128 HCV-positive PWID were recruited between 2018 and 2019 from community-based harm reduction centers. After informed consent, sociodemographic characteristics and risk behavior data were obtained using an interviewer-administrated questionnaire. Blood samples were collected for further serological and molecular testing. Overall, five women and 123 men were included. The median age was 39.5 years. The majority of PWID (56.3%) had less than a secondary level of education, were single (57%), were unemployed (65.6%), were incarcerated at least once (93.0%), and had a history of residency in at least one foreign country (50.8%). During the previous 12 months, 82.0% reported having reused syringes at least once, 43.8% shared syringes at least once, while 56.2% had at least one unprotected sexual relation, and 28.1% had more than two different sexual partners. Tattooing was reported among 60.2%. All positive results for HCV-infection by rapid testing were confirmed by enzyme-linked immunosorbent assay (ELISA). HCV-RNA was detectable in 79.7%. Genotyping showed a predominance of genotype 1 (52%) followed by genotype 3 (34%) and genotype 4 (10%). Four patients (4%) had an intergenotype mixed infection. Subtyping showed the presence of six different HCV subtypes as follows: 1a (53.2%), 1b (6.4%), 3a (33.0%), 4a (3.2%), and 4d (4.3%). This is the first study describing circulating HCV genotypes among PWID in Tunisia. The distribution of HCV genotypes is distinct from the general population with a predominance of subtypes 1a and 3a. These findings can be used to guide national efforts aiming to optimize the access of PWID to relevant HCV prevention and treatment measures including pangenotypic regimens for patients infected with HCV genotype 3.

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“…The studies from Spain have demonstrated that POCT and DBS were 98.4% (for detectable viral loads >4 IU/mL) and 93.7% sensitive for detecting HCV RNA (i.e., >4 IU/mL), 96.7% sensitive for the quantifiable RNA threshold (i.e., ≥10 IU/mL), and 98.3% sensitive both for quantifiable RNA threshold of ≥1000 and ≥3000 IU/mL with venous plasma samples as the gold standard comparison in PWIDs [ 104 ]. Eighty percent of the participants received their HCV diagnosis results on the same day and found it very convenient [ 104 ]. Furthermore, the feasibility of self-DBS sampling at home is currently under investigation in some studies [ 96 ].…”

Section: The Real-world Clinical Performance Of Current Hcv Diagnostic Algorithmsmentioning

confidence: 99%

Hepatitis C Diagnosis: Simplified Solutions, Predictive Barriers, and Future Promises

et al. 2021

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The simplification of current hepatitis C diagnostic algorithms and the emergence of digital diagnostic devices will be very crucial to achieving the WHO’s set goals of hepatitis C diagnosis (i.e., 90%) by 2030. From the last decade, hepatitis C diagnosis has been revolutionized by the advent and approval of state-of-the-art HCV diagnostic platforms which have been efficiently implemented in high-risk HCV populations in developed nations as well as in some low-to-middle income countries (LMICs) to identify millions of undiagnosed hepatitis C-infected individuals. Point-of-care (POC) rapid diagnostic tests (RDTs; POC-RDTs), RNA reflex testing, hepatitis C self-test assays, and dried blood spot (DBS) sample analysis have been proven their diagnostic worth in real-world clinical experiences both at centralized and decentralized diagnostic settings, in mass hepatitis C screening campaigns, and hard-to-reach aboriginal hepatitis C populations in remote areas. The present review article overviews the significance of current and emerging hepatitis C diagnostic packages to subvert the public health care burden of this ‘silent epidemic’ worldwide. We also highlight the challenges that remain to be met about the affordability, accessibility, and health system-related barriers to overcome while modulating the hepatitis C care cascade to adopt a ‘test and treat’ strategy for every hepatitis C-affected individual. We also elaborate some key measures and strategies in terms of policy and progress to be part of hepatitis C care plans to effectively link diagnosis to care cascade for rapid treatment uptake and, consequently, hepatitis C cure.

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Evaluation of the Xpert HCV VL Fingerstick point-of-care assay and dried blood spot HCV-RNA testing as simplified diagnostic strategies among people who inject drugs in Catalonia, Spain

Cited by 42 publications

References 34 publications

Innovations in Hepatitis C Screening and Treatment

Innovations in Hepatitis C Screening and Treatment

Distribution of HCV Genotypes Among People Who Inject Drugs in Tunisia: New Evidence for Scaling Up Prevention and Treatment Toward National Elimination Goal

Hepatitis C Diagnosis: Simplified Solutions, Predictive Barriers, and Future Promises

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