Significant Improvement in Diagnosis of Hepatitis C Virus Infection by a One-Step Strategy in a Central Laboratory

The remarkable effectivity of current antiviral therapies has led to consider the elimination of hepatitis C virus (HCV) infection. However, HCV infection is highly underdiagnosed; therefore, a global strategy for eliminating it requires improving the effectiveness of HCV diagnosis to identify hidde...

Descripción completa

Detalles Bibliográficos
Autores: López-Martínez, Rosa, Arias-García, Andrea, Rodríguez-Algarra, Francisco, Castellote, Laura, Rando-Segura, Ariadna|||0000-0003-4555-7286, Tarraso, Guillermo, Vargas-Accarino, Elena|||0000-0002-2521-0368, Montserrat-Lloan, Isabel, Blanco-Grau, Albert|||0000-0002-4213-3827, Caballero, Andrea|||0000-0003-2891-6347, Ferrer Costa, Roser|||0000-0002-8925-3172, Pumarola Suñé, Tomàs|||0000-0002-5171-7461, Buti, Maria|||0000-0002-0732-3078, Esteban, Rafael|||0000-0001-5280-392X, Quer, Josep|||0000-0003-0014-084X, Casis-Saez, Ernesto, Rodríguez Frías, Francisco|||0000-0002-9128-7013
Tipo de recurso: artículo
Fecha de publicación:2019
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:226669
Acceso en línea:https://ddd.uab.cat/record/226669
https://dx.doi.org/urn:doi:10.1128/JCM.01815-19
Access Level:acceso abierto
Palabra clave:Hepatitis C virus
Diagnosis
Reflex testing
Viral load
One-step diagnosis
Descripción
Sumario:The remarkable effectivity of current antiviral therapies has led to consider the elimination of hepatitis C virus (HCV) infection. However, HCV infection is highly underdiagnosed; therefore, a global strategy for eliminating it requires improving the effectiveness of HCV diagnosis to identify hidden cases. The remarkable effectivity of current antiviral therapies has led to consider the elimination of hepatitis C virus (HCV) infection. However, HCV infection is highly underdiagnosed; therefore, a global strategy for eliminating it requires improving the effectiveness of HCV diagnosis to identify hidden cases. In this study, we assessed the effectiveness of a protocol for HCV diagnosis based on viral load reflex testing of anti-HCV antibody-positive patients (known as one-step diagnosis) by analyzing all diagnostic tests performed by a central laboratory covering an area of 1.5 million inhabitants in Barcelona, Spain, before (83,786 cases) and after (45,935 cases) the implementation of the reflex testing protocol. After its implementation, the percentage of anti-HCV-positive patients with omitted HCV RNA determination remarkably decreased in most settings, particularly in drug treatment centers and primary care settings, where omitted HCV RNA analyses had absolute reductions of 76.4 and 20.2%, respectively. In these two settings, the percentage of HCV RNA-positive patients identified as a result of reflex testing accounted for 55 and 61% of all anti-HCV-positive patients. HCV RNA results were provided in a mean of 2 days. The presence of HCV RNA and age of ≥65 years were significantly associated with advanced fibrosis, assessed using the serological FIB-4 index (odds ratio [OR], 5.92; 95% confidence interval [CI], 3.4 to 10.4). The implementation of viral load reflex testing in a central laboratory is feasible and significantly increases the diagnostic effectiveness of HCV infections, while allowing the identification of underdiagnosed cases.

Similares en LA Referencia