Laboratory-based testing for hepatitis C infection using dried blood spot samples: A systematic review and meta-analysis of diagnostic accuracy.

Autor: Carty PG; Faculty of Medicine & Health Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland.; Health Information and Quality Authority, Dublin, Ireland., McCarthy M; Health Information and Quality Authority, Dublin, Ireland., O'Neill SM; Health Information and Quality Authority, Dublin, Ireland., De Gascun CF; National Virus Reference Laboratory, University College Dublin, Dublin, Ireland., Harrington P; Health Information and Quality Authority, Dublin, Ireland., O'Neill M; Health Information and Quality Authority, Dublin, Ireland., Smith SM; Department of General Practice, Health Research Board Centre for Primary Care Research, Royal College of Surgeons in Ireland, Dublin, Ireland., Teljeur C; Health Information and Quality Authority, Dublin, Ireland., Ryan M; Health Information and Quality Authority, Dublin, Ireland.; Department of Pharmacology & Therapeutics, Trinity College Dublin, Trinity Health Sciences, St James's Hospital, Dublin, Ireland.
Jazyk: angličtina
Zdroj: Reviews in medical virology [Rev Med Virol] 2022 Jul; Vol. 32 (4), pp. e2320. Date of Electronic Publication: 2021 Dec 26.
DOI: 10.1002/rmv.2320
Abstrakt: The use of dried blood spot (DBS) samples can facilitate the implementation of reflex testing by circumventing the need for centrifugation and freezing of venous blood samples. This systematic review assessed the accuracy of using DBS samples to diagnose chronic hepatitis C virus (HCV) infection. A comprehensive search was undertaken to identify articles published up to July 2020 evaluating the diagnostic accuracy of anti-HCV, HCV-RNA and HCV core antigen tests using DBS. Screening, data extraction, quality appraisal and Grading of Recommendations, Assessment, Development and Evaluations certainty of the evidence assessment were performed independently by two reviewers. Meta-analysis, meta-regression and sensitivity analyses were conducted. The evidence demonstrates that laboratory-based anti-HCV and HCV-RNA tests using DBS samples have high diagnostic accuracy. All comparisons were between DBS and venous samples. For the detection of anti-HCV, sensitivity was 95% (95% CI: 92%-97%) and specificity was 99% ([95% CI: 98%-99%]; n = 25; I 2  = 81%; moderate certainty). For the detection of HCV-RNA, the sensitivity was 95% (95% CI: 93%-97%) and specificity was 97% ([95% CI: 94%-98%]; n = 20; I 2  = 52%; moderate certainty). The sensitivity of HCV core antigen tests was 86% (95% CI: 79%-91%) and specificity was 98% ([95% CI: 94%-99%]; n = 5; I 2  = 37%; low certainty) compared with HCV-RNA (the gold standard for detecting chronic HCV). DBS samples could facilitate diagnosis of chronic HCV infection as the necessary sequential tests (anti-HCV and then HCV-RNA or HCV core antigen) can be undertaken using the same blood sample. This could reduce loss of patient follow-up and support international efforts towards HCV elimination in both high and low prevalence settings.
(© 2021 John Wiley & Sons Ltd.)
Databáze: MEDLINE
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