Update on hepatitis B and C virus diagnosis

Lm, Villar; Hm, Cruz; Barbosa, Jakeline Ribeiro; Cs, Bezerra; Mm, Portilho; P, Scalioni Lde

doi:10.5501/wjv.v4.i4.323

Cited by 62 publications

(69 citation statements)

References 177 publications

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“…The quality of all these assays is described in detail elsewhere . All PCR positive results were tested for HCV genotype by TRUGENE HCV 5′NC Genotyping kit (SIEMENS) that had a lower limit of detection of 5000 IU/mL of HCV‐RNA . All PCR confirmed HCV‐infected patients were excluded from subsequent two‐monthly screenings.…”

Section: Methodsmentioning

confidence: 99%

Screening haemodialysis patients for hepatitis C in Vietnam: The inconsistency between common hepatitis C virus serological and virological tests

Duong

McLaws

2018

Journal of Viral Hepatitis

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Selecting the appropriate screening method and interval for the early detection of hepatitis C virus (HCV) infection in low-resourced haemodialysis settings is a challenge. The challenge occurs when patients are classified as HCV-RNA positive but negative to HCV-core antigen (HCV-coreAg), anti-HCV and genotyping tests. We aim to clarify the inconsistency between HCV-RNA, HCV-coreAg, anti-HCV and HCV genotyping tests in haemodialysis patients and determine the reliability of HCV-coreAg as a routine two-monthly screening strategy. Haemodialysis patients were tested every 2 months between 2012 and 2014 at the largest district haemodialysis unit in Ho Chi Minh City, Vietnam, for aminotransferases, anti-HCV antibodies, HCV-coreAg, HCV-RNA and HCV genotype. HCV-coreAg and anti-HCV results were tested against HCV-RNA for sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV). All 201 patients participated in the study. The HCV-coreAg test performed better than the anti-HCV test for sensitivity (100% vs 31%), NPV (100% vs 90%) and accuracy (100% vs 90%). The HCV-coreAg and anti-HCV tests performed no differently for specificity (100% and 98%, respectively) or PPV (100% and 73%, respectively). Kappa values for HCV-coreAg and anti-HCV tests were 1 and 0.39, respectively. Early detection of HCV for the purpose of infection prevention requires a high level of sensitivity and HCV-coreAg performed better in our chronic haemodialysis population as a two-monthly screening method than routine anti-HCV testing. HCV-coreAg test is less labour-intensive with a higher level of accuracy in patients with low viral loads making it cost effective for low-resourced settings. Repeating genotyping may be required in HCV-coreAg positive patients with a low viral load.

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Section: Methodsmentioning

confidence: 99%

Screening haemodialysis patients for hepatitis C in Vietnam: The inconsistency between common hepatitis C virus serological and virological tests

Duong

McLaws

2018

Journal of Viral Hepatitis

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“…Appropriate indications for HCV VL and genotype were determined after consultation with infectious disease experts at our institution as well as a literature review. Testing indications for HCV VL included either suspicion of acute HCV or the need to distinguish between chronic and cleared HCV in patients with positive antibodies but no prior VL . We advised that HCV genotype be reserved for patients imminently starting HCV therapy to guide the treatment regimen .…”

Section: Methodsmentioning

confidence: 99%

Impact of nonintrusive clinical decision support systems on laboratory test utilization in a large academic centre

Eaton

Chida

Apfel

et al. 2018

Evaluation Clinical Practice

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Background: The near-universal prevalence of electronic health records (EHRs) has made the utilization of clinical decision support systems (CDSS) an integral strategy for improving the value of laboratory ordering. Few studies have examined the effectiveness of nonintrusive CDSS on inpatient laboratory utilization in large academic centres. Methods: Red blood cell folate, hepatitis C virus viral loads and genotypes, and type and screens were selected for study. We incorporated the appropriate indications for these labs into text that accompanied the laboratory orders in our hospital’s EHR. Providers could proceed with the order without additional clicks. An interrupted time-series analysis was performed, and the primary outcome was the rate of tests ordered on all inpatient medicine floors. Results: The rate of folate tests ordered per monthly admissions showed no significant level change at the time of the intervention with only a slight decrease in rate of 0.0109 (P = .07). There was a 43% decrease in the rate of hepatitis C virus tests per monthly admissions immediately after the intervention with a decrease of 0.0135 tests per monthly admissions (P = .02). The rate of type and screens orders per patient days each month had a significant downward trend by 0.114 before the intervention (P = .04) but no significant level change at the time of the intervention or significant change in rate after the intervention. Discussion: Our study suggests that nonintrusive CDSS should be evaluated for individual laboratory tests to ensure only effective alerts continue to be used so as to avoid increasing EHR fatigue.

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“…La infección crónica se define por la presencia de HbsAg por seis o más meses y la ausencia de Ig M anti-Hbc (4,5) .…”

Section: Mensajes Claveunclassified

Costo-efectividad de dos terapias antivirales para hepatitis B crónica en el Perú: entecavir y tenofovir

Bolaños-Díaz¹,

Tejada

Sanabria

et al. 2017

Rev Peru Med Exp Salud Publica

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Objetivos. Comparar en términos de costo-efectividad a entecavir (ETV) y tenofovir (TDF) en el tratamiento del virus de la hepatitis B (HBV) en hospitales públicos del Perú. Materiales y métodos. Estructuramos un modelo de Markov, definimos la efectividad en años de vida ajustados a calidad (AVAC). Incluimos los costos directos del tratamiento en soles desde la perspectiva del Ministerio de Salud del Perú. Calculamos la relación entre costo y efectividad incrementales (ICER). Realizamos análisis de sensibilidad determinístico y probabilístico, considerando un rango de disponibilidad de pago (WTP) desde uno hasta tres veces el producto bruto interno (PBI) per-cápita, y el beneficio monetario neto (BMN) o ICER en el caso del análisis de tornado. Resultados. El tratamiento con TDF es más efectivo y menos costoso que ETV. El ETV tuvo un costo por AVAC de S/ 4482, y de S/ 1526 para TDF. El TDF mantiene un BMN progresivamente mayor conforme aumenta la WTP. La tasa de descuento fue la única variable con efecto significativo en la incertidumbre del modelo. Conclusiones. El tratamiento con TDF es más costo-efectivo que ETV en hospitales públicos del Perú. Palabras clave: Hepatitis B, antiretrovirales, Economía médica. (fuente: DeCS BIREME). COST-EFFECTIVENESS OF TWO ANTIVIRAL THERAPIES FOR CHRONIC HEPATITIS B IN PERU: ENTECAVIR AND TENOFOVIR ABSTRACTObjetives. To compare in terms of cost-effectiveness to entecavir (ETV) and tenofovir (TDF) in the treatment of hepatitis B virus (HBV) in public hospitals in Peru. Materials and methods. We structured a Markov model. We define effectiveness adjusted life years for quality (QALY). We include the direct costs of treatment in soles from the perspective of the Ministry of Health of Peru. We estimate the relationship between cost and effectiveness ratios (ICER). We performed sensitivity analyzes considering a range of willingness to pay (WTP) from one to three times the Gross Domestic Product (GDP) per capita, and a tornado analysis regarding Monetary Net Profit (BMN) or ICER. Results. Treatment with TDF is more effective and less expensive than ETV. The ETV had a cost per QALY of PEN 4482, and PEN 1526 TDF. The PTO maintains a progressively larger with increasing WTP BMN. The discount rate was the only variable with a significant effect on model uncertainty. Conclusion: Treatment with TDF is more cost-effective than ETV in public hospitals in Peru. INTRODUCCIÓNEl virus de la hepatitis B (HBV) pertenece a la familia Hepadnaviridae (ortohepadnavirus), y puede ocasionar tanto enfermedad aguda como crónica. Existen diez genotipos (A-J) que difieren en un 8%, y múltiples subgenotipos que difieren en un 4%(1,2) . La transmisión es por vía sanguínea, mediante relaciones sexuales, por procedimientos médicos con material o productos contaminados y, en menor medida, por vía transplacentaria (3) .El diagnóstico se realiza mediante la detección del antígeno superficial (HbsAg), en los casos de infección aguda se detectará además inmunoglobulina M (Ig M) contra el antígeno del núcleo (HbcA...

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Update on hepatitis B and C virus diagnosis

Cited by 62 publications

References 177 publications

Screening haemodialysis patients for hepatitis C in Vietnam: The inconsistency between common hepatitis C virus serological and virological tests

Screening haemodialysis patients for hepatitis C in Vietnam: The inconsistency between common hepatitis C virus serological and virological tests

Impact of nonintrusive clinical decision support systems on laboratory test utilization in a large academic centre

Costo-efectividad de dos terapias antivirales para hepatitis B crónica en el Perú: entecavir y tenofovir

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