Clinical utility of HCV core antigen detection and quantification using serum samples and dried blood spots in people who inject drugs in Dar-es-Salaam, Tanzania
| Autor: | Mohamed, Zameer, Mbwambo, Jessie, Shimakawa, Yusuke, Poiteau, Lila, Chevaliez, Stéphane, Pawlotsky, Jean-Michel, Rwegasha, John, Bhagani, Sanjay, Taylor-Robinson, Simon, Makani, Julie, Thursz, Mark, Lemoine, Maud |
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| Přispěvatelé: | Imperial College London, Muhimbili National Hospital [Dar es Salaam, Tanzanie] (MNH), Muhimbili University of Health and Allied Sciences, Epidémiologie des Maladies Emergentes - Emerging Diseases Epidemiology, Pasteur-Cnam Risques infectieux et émergents (PACRI), Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM), Service d'hépato-gastro-entérologie [APHP Henri Mondor], Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Hôpital Henri Mondor-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre National de Référence Virus des hépatites B, C et Delta, Institut National de la Transfusion Sanguine [Paris] (INTS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Royal Free Hospital [London, UK], This study formed part of a Wellcome Trust Institutional Strategic Support Fund Global Health Fellow grant awarded to ZM. All authors are grateful to the Wellcome Trust Global Centre and the UK National Institute for Health Research (NIHR) Biomedical Facility at Imperial College London for funding and infrastructure support., The authors thank the participants and the team working at the Methadone clinic at Muhimbili National Hospital, Wellcome Trust, Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM) |
| Rok vydání: | 2017 |
| Předmět: |
Male
MESH: Hepatitis C / blood people who inject drugs HEPATITIS-C Hepacivirus Tanzania MESH: Genotype MESH: Phylogeny HCV core antigen MESH: Hepatitis C Antigens / analysis Phylogeny MESH: Hepatitis C Antigens / metabolism Viral Core Proteins virus diseases Viral Load Hepatitis C dried blood spot PREVALENCE Infectious Diseases MESH: Hepatitis C / diagnosis RNA Viral Female MESH: Viral Load Life Sciences & Biomedicine USERS MESH: Dried Blood Spot Testing / methods MESH: Viral Core Proteins / metabolism MESH: Hepacivirus / genetics Research Article Adult Genotype Immunology Sensitivity and Specificity Article MESH: Hepacivirus / physiology MESH: Tanzania Humans MESH: Viral Core Proteins / genetics Science & Technology MESH: Humans BARRIERS MESH: Hepatitis C Antigens / genetics screening HIV MESH: Adult MESH: Hepacivirus / isolation & purification 1199 Other Medical And Health Sciences MESH: Male MESH: Sensitivity and Specificity MESH: Hepatitis C / virology Africa MESH: Viral Core Proteins / analysis [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie Dried Blood Spot Testing MESH: RNA Viral / genetics Hepatitis C Antigens C VIRUS-INFECTION POINT-OF-CARE MESH: Female hepatitis C virus (HCV) |
| Zdroj: | Journal of the International AIDS Society Journal of the International AIDS Society, BioMed Central (2008-2012) ; International Aids Society (2008-) ; Wiley (2017-), 2017, 20 (1), pp.21856. ⟨10.7448/IAS.20.1.21856⟩ Journal of the International AIDS Society, 2017, 20 (1), pp.21856. ⟨10.7448/IAS.20.1.21856⟩ |
| ISSN: | 1758-2652 |
| DOI: | 10.7448/IAS.20.1.21856⟩ |
| Popis: | International audience; Introduction: A lack of access to hepatitis C virus (HCV) diagnostics is a significant barrier to achieving the World Health Organization 2030 global elimination goal. HCV core antigen (HCVcAg) quantification and dried blood spot (DBS) are appealing alternatives to conventional HCV serology and nucleic acid testing (NAT) for resource-constraint settings, particularly in difficult-to-reach populations. We assessed the accuracy of serum and DBS HCVcAg testing in people who inject drugs in Tanzania using HCV NAT as a reference.Method: Between May and July 2015, consecutive HCV-seropositive patients enrolled in the local opioid substitution treatment centre were invited to participate in the study. All had HCV RNA detection (Roche Molecular Systems, Pleasanton, CA, USA), genotyping (NS5B gene phylogenetic analysis) and HCVcAg on blood samples and DBS (Architect assay; Abbott Diagnostics, Chicago, IL, USA).Results: Out of 153 HCV-seropositive individuals, 65 (42.5%) and 15 (9.8%) were co-infected with HIV (41 (63%) were on anti-retroviral therapy (ARVs)) and hepatitis B respectively. In total, 116 were viraemic, median viral load of 5.7 (Interquartile range (IQR); 4.0-6.3) log iU/ml (75 (68.2%) were genotype 1a, 35 (31.8%) genotype 4a). The median alanine transaminase (ALT) (iU/l), aspartate transaminase (AST) (iU/l) and gamma-glutamyl transferase (GGT) (iU/l) were 35 (IQR; 23-51), 46 (32-57) and 69 (35-151) respectively. For the quantification of HCV RNA, serum HCVcAg had a sensitivity at 99.1% and a specificity at 94.1%, with an area under the receiver operating curve (AUROC) at 0.99 (95% CI 0.98-1.00). DBS HCVcAg had a sensitivity of 76.1% and a specificity of 97.3%, with an AUROC of 0.87 (95% CI 0.83-0.92). HCVcAg performance did not differ by HIV co-infection or HCV genotype. Conclusions Our study suggests that HCVcAg testing in serum is an excellent alternative to HCV polymerase chain reaction in Africa. Although HCVcAg detection and quantification in DBS has a reduced sensitivity, its specificity and accuracy are good and it could therefore be used for scaling up HCV testing and care in resource-limited African settings. |
| Databáze: | OpenAIRE |
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