Journal of Viral Hepatitis最新文献

{"title":"Hepatitis B Care and Treatment in Zanzibar, Tanzania: A Demonstration Project Following 2015 WHO Treatment Guidelines, 2017–2021","authors":"Sanaa S. Said,&nbsp;Shaun Shadaker,&nbsp;Brian J. McMahon,&nbsp;Paige A. Armstrong,&nbsp;Geoff A. Beckett,&nbsp;Saleem Kamili,&nbsp;Aaron M. Harris","doi":"10.1111/jvh.14051","DOIUrl":"https://doi.org/10.1111/jvh.14051","url":null,"abstract":"<div>\u0000 \u0000 <p>Zanzibar, a low-resource semiautonomous region of Tanzania, has an estimated prevalence of hepatitis B virus (HBV) infections of 3.6%. To assess the feasibility of care and treatment, a 5-year hepatitis B demonstration project was implemented in Zanzibar during January 2017–December 2021, following the 2015 WHO HBV care and treatment guidelines. Participants included adults (aged ≥ 18 years) who tested positive for HBV surface antigen and tested negative for HIV and hepatitis C antibody. Participants were examined for clinical signs of liver disease and testing was conducted at baseline to assess treatment eligibility and every 6–12 months thereafter. Tenofovir disoproxil fumarate (TDF) was provided at no cost to treatment-eligible participants. Clinical and laboratory data were analysed to assess improvement in proximal disease outcomes. Among 596 participants enrolled, the median age was 32 years (IQR 26–39) and 365 (61%) were male. Of those enrolled, 268 (45%) returned for ≥ 1 follow-up visit, with a median of 511 days of follow-up. Overall, 58 patients initiated treatment: 15 met treatment criteria based on liver cirrhosis alone; 13 by APRI &gt; 1.5; among those with HBV DNA results, six met criteria based on HBV DNA levels and ALT activity; 24 met ≥ 2 criteria. Significant decreases in ALT activities, APRI scores and HBV DNA levels were observed among those treated. This hepatitis B care and treatment programme was demonstrated to be feasible in a low-resource setting. Despite challenges, testing and linkage to care is critical to decrease the global burden of hepatitis B.</p>\u0000 </div>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142861882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Health Systems Strengthening Approach to Address the High Burden of Hepatitis C in Pakistan","authors":"Mahnoor Qureshi","doi":"10.1111/jvh.14050","DOIUrl":"https://doi.org/10.1111/jvh.14050","url":null,"abstract":"<p>Hepatitis C virus infection is a serious liver disease that can progress to cirrhosis and, in chronic cases, lead to liver cancer or liver failure. Pakistan has the second highest burden of HCV in the world, a rising number of liver cancer cases and a unique pattern of healthcare-associated HCV transmission. Unfortunately, the country is not on track to meet the WHO's target of complete elimination of HCV by 2030. The current reliance on vertical programmes for hepatitis elimination may seem effective in the short term, but is often unsustainable, ineffective and contributes to the fragmentation of the health system. This review proposes a health system strengthening approach to HCV detection and prevention in the country. It critically evaluates the country's health system and the existing evidence on HCV prevention and treatment, proposing evidence-based strategies for decentralising HCV services and integrating them into the primary healthcare infrastructure. It examines the effectiveness of methods such as task shifting and targeted interventions while suggesting changes to healthcare practices to reduce healthcare-associated transmission of HCV and other blood-borne pathogens.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvh.14050","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142861883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Misuse of the Lower Limit of Detection in HBV DNA Testing and Anti-HBe Positive Status Will Significantly Impact the Diagnosis of Occult HBV Infection","authors":"Bo Wang,&nbsp;Xinru Wang,&nbsp;Li Xiao,&nbsp;Jianchun Xian","doi":"10.1111/jvh.14046","DOIUrl":"10.1111/jvh.14046","url":null,"abstract":"<div>\u0000 \u0000 <p>The diagnosis of occult hepatitis B virus (HBV) infection (OBI) is influenced by factors such as the lower limit of detection (LOD) of the HBV DNA test. However, in clinical practice and scientific research, the lower limit of quantification (LOQ) is often misused as the LOD. This study aims to investigate the impact of misuse of the LOD of the HBV DNA test on the detection rate of OBI, as well as the risk factors for OBI. Four hundred twelve patients who were HBsAg-negative and had undergone high-sensitivity HBV DNA testing were included in this study. HBV DNA was detected using the Cobas 6800 System with an LOD of 2.4 IU/mL and an LOQ of 10 IU/mL. The effect of using the LOQ as the LOD on the detection rate of OBI was compared, and univariate and multivariate logistic regression analyses were used to explore the risk factors for OBI. (1) Of the 412 patients, 63.3% (<i>n</i> = 261) were male, with a median age of 47 (range 34–55) years. A total of 473 HBV DNA test results were obtained, with 366 individuals undergoing only one HBV DNA test and the remaining 46 patients undergoing 2 to 5 HBV DNA tests (resulting in a total of 107 test results). (2) Considering only the first HBV DNA test result, the detection rate of OBI was 4.1% (17/412). However, when the LOQ (10 IU/mL) was used as the LOD, the detection rate of OBI was only 1.5% (6/412) (<i>p</i> &lt; 0.001). (3) Univariate analysis showed that there were statistically significant differences in age, anti-HBe positivity rate and anti-HBc positivity rate between OBI and non-OBI individuals (<i>p</i> &lt; 0.05). Multivariate regression analysis showed that anti-HBe positivity was an independent risk factor for OBI in this study (odds ratio [OR] = 3.807, 95% confidence interval [CI]: 1.065–13.617, <i>p</i> = 0.040), while anti-HBs positivity was a protective factor against OBI (OR = 0.271, 95% CI: 0.093–0.787, <i>p</i> = 0.016). (4) Among the 46 patients who underwent repeated testing, a total of seven individuals were found to be HBV DNA-positive in the first test, and six individuals tested positive for HBV DNA one or more times in subsequent tests. When OBI was confirmed by ≥ 1 out of 1–5 tests with detectable HBV DNA, the detection rate of OBI in this study could increase from 4.1% to 5.6%. The detection rate of OBI among HBsAg-negative adult patients attending hepatology departments in this region is 4.1%. Misusing the LOQ as LOD can significantly decrease the detection rate of OBI. The presence of anti-HBe positivity and undergoing multiple HBV DNA tests can lead to a significant increase in the detection rate of OBI.</p>\u0000 </div>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive Factors for HBsAg Loss in Chronic HBeAg-Negative Hepatitis B Virus Infection: Insights From a 5-Year French Cohort","authors":"Xavier Causse,&nbsp;Pascal Potier,&nbsp;Antoine Valéry,&nbsp;Hélène Labadie,&nbsp;Gilles Macaigne,&nbsp;Jean-François Cadranel,&nbsp;Thierry Fontanges,&nbsp;Lina Mouna,&nbsp;Anne-Marie Roque-Afonso,&nbsp;the PIBAC Study Group of Association Nationale des Hépato-Gastroentérologues des Hôpitaux Généraux (ANGH)","doi":"10.1111/jvh.14041","DOIUrl":"10.1111/jvh.14041","url":null,"abstract":"<p>Prognostic factors for the long-term evolution of chronic hepatitis B e antigen (HBeAg)-negative hepatitis B virus (HBV) infection may vary depending on local epidemiology. We aimed to identify these factors in France, where the epidemiology is influenced by diverse immigration. Hepatitis B surface antigen (HBsAg)-positive, HBeAg-negative adults with normal transaminase levels and viral loads &lt; 20,000 IU/mL for 1 year, without viral co-infection or advanced liver disease, were enrolled for a 5-year follow-up. A total of 564 patients were recruited from 23 centres (54.4% women, mean age 42.3 ± 12 years, 47.7% from sub-Saharan Africa). HBV DNA was detectable but &lt; 2000 IU/mL for most (71.3%). Genotypes E (27.8%) and A (20.0%) were predominant. The mean HBsAg titre was 3.8 ± 3.4 log IU/mL, &gt; 1000 IU/mL in 60% of cases, and higher in genotype E (<i>p</i> &lt; 0.0001). During follow-up, 18 patients received antiviral treatment, 9 for viral reactivation (0.3% per year) and 9 preemptively. HBsAg loss occurred in 39 patients (1.4% per year). These patients were older (<i>p</i> &lt; 0.0001), more frequently treated for dyslipidemia, hypertension or diabetes (<i>p</i> &lt; 0.05), and had lower baseline HBV DNA (<i>p</i> = 0.0112) and HBsAg (<i>p</i> &lt; 0.0001), but similar levels of HBcrAg compared to those who did not clear HBsAg. Baseline HBsAg was the only independent predictor of HBsAg loss (<i>p</i> = 0.009). In this cohort, HBsAg &lt; 153 IU/mL predicted clearance with 87% sensitivity and specificity. In conclusion, baseline HBsAg accurately predicted seroclearance at 5 years in patients with chronic HBeAg-negative infection, regardless of genotype, sex, or geographical origin, indicating that this marker is widely applicable for reducing the frequency of patient monitoring.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11646079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A US-Based Multi-Site Pilot to Screen Hepatitis B Surface Antigen-Positive Patients for Hepatitis D","authors":"Maggie Li,&nbsp;Bijou Hunt,&nbsp;Bindu Balani,&nbsp;Chinwe Ogedegbe,&nbsp;Peter Gordon,&nbsp;Joshua Hayden,&nbsp;Nancy Glick,&nbsp;Anita Chang,&nbsp;Su Wang,&nbsp;Mitchell Caponi,&nbsp;Lisa Yarber-Cambron,&nbsp;Sandeep Bhat,&nbsp;Tyshea Ward,&nbsp;Madhu Suryadevara","doi":"10.1111/jvh.14043","DOIUrl":"10.1111/jvh.14043","url":null,"abstract":"<p>Hepatitis D (HDV) is a severe infection with well-recognised clinical ramifications that remains relatively neglected and underdiagnosed; consequently, the epidemiology of HDV is poorly characterised, both in the United States and globally. In 2022, a pilot project involving eight healthcare institutions was undertaken to ascertain the prevalence of HDV in healthcare institutions with an HBV seropositivity of at least 1%, describe the characteristics of patients testing positive for HDV, and evaluate diagnostic and laboratory processes of HDV screening. From August 2022 to April 2024, a total of 106,693 patients were tested for HBsAg, of whom 65,341 (61.2%) were female and 40,863 (38.3%) were male, with a mean age of 47 years. The overall HBsAg positivity rate was 1.04% (<i>n</i> = 1112). Among the HBsAg+ samples, 645 (58.0%) underwent HDV Ab testing. The HDV Ab positivity rate was 0.81% (<i>n</i> = 9), with 2 cases of HDV RNA positivity (0.18%). The incomplete testing reflects several challenges associated with screening for both HBV and HDV. Further research is necessary to better understand the epidemiology and burden of HDV in the United States and considerations for implementation.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11638661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Network Map of Intracellular Alpha-Fetoprotein Signalling in Hepatocellular Carcinoma","authors":"Krishnapriya Ramakrishnan,&nbsp;Diya Sanjeev,&nbsp;Niyas Rehman,&nbsp;Rajesh Raju","doi":"10.1111/jvh.14035","DOIUrl":"10.1111/jvh.14035","url":null,"abstract":"<div>\u0000 \u0000 <p>Alpha fetoprotein (AFP) is a glycoprotein of foetal origin belonging to the albumin protein family. Serum AFP is a long-conceived early-diagnostic biomarker for HCC with its elevated expression in different liver pathologies ranging from hepatitis viral infections to fibrosis, cirrhosis, and HCC. Beyond their utility as biomarkers, in support of its contribution to these clinical outcomes, the function of AFP as an immune suppressor and inducer of malignant transformation in HCC patients is well reported. Multiple reports show that AFP is secreted by hepatocytes, binds to its cognate receptor, AFP-receptor (AFPR), and exerts its actions. However, there is only limited information available in this context. There is an urgent need to gather more insight into the AFP signalling pathway and consider it a classical intracellular signalling pathway, among others. AFP is a highly potent intracellular molecule that has the potential to bind to many interactors like PTEN, Caspase, RAR, and so on. It has been shown that cellular AFP and secreted AFP have different roles in HCC pathophysiology, and a comprehensive map of the AFP signalling pathway is warranted for further theranostic applications.</p>\u0000 </div>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in Serum Rheumatoid Factor Following Eradication of Hepatitis C Virus Infection With Interferon or Direct Antiviral Therapy","authors":"Ying-Nan Tsai,&nbsp;Jamie Chieh Lo,&nbsp;Cheng-Hao Tseng,&nbsp;Song-Chou Hsieh,&nbsp;Wen-Chin Chiu,&nbsp;Chi-Ming Tai,&nbsp;Chi-Yang Chang,&nbsp;Fu-Jen Lee,&nbsp;Mindie H. Nguyen,&nbsp;Jaw-Town Lin,&nbsp;Yao-Chun Hsu","doi":"10.1111/jvh.14047","DOIUrl":"10.1111/jvh.14047","url":null,"abstract":"<div>\u0000 \u0000 <p>Hepatitis C virus (HCV) infection is associated with a myriad of extrahepatic manifestations (EHM), as well as the production of autoantibodies, including rheumatoid factor (RF). This study aims to elucidate whether serum levels of RF change before and after HCV eradication, and whether these changes differ according to the type of therapy used. This is a retrospective cohort study of adults with chronic HCV infection treated with interferon-free or interferon-based regimens. All patients had HCV viremia at baseline and documented sustained virological response (SVR) 12 or 24 weeks after completing treatment. We measured the serum levels of RF at baseline and at SVR-12 or −24 to analyse the changes after eradication. This study enrolled 297 patients (median age, 59 years; female, 48.5%; cirrhosis, 16.8%). Among them, 78 (26.3%) were RF-positive by qualitative serology at baseline. This number decreased to 49 (16.5%) at SVR-12 or −24 (<i>p</i> &lt; 0.001). Quantitatively, the median RF also decreased from 1.6 IU/mL (interquartile range [IQR], undetectable—15.8) to undetectable (IQR, undetectable—6.6 IU/mL) (<i>p</i> &lt; 0.001). Significant reductions were observed in both groups. The proportion with RF seropositivity decreased from 24.3% to 15.4% (<i>p</i> = 0.001) in patients treated with interferon-free agents (<i>n</i> = 214) and from 31.3% to 19.3% (<i>p</i> = 0.006) in patients treated with interferon-based regimens (<i>n</i> = 83), without significant difference between two groups (<i>p</i> = 0.40). Serum RF decreased after HCV eradication, regardless of treatment regimen. Our findings suggest that HCV eradication may attenuate HCV-related autoimmunity.</p>\u0000 </div>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Maternal Hepatitis B Virus Infection on Congenital Heart Disease Risk in Offspring: A National Cohort Study.","authors":"Yewan Park, Jihye Heo, Danbee Kang, Geum-Youn Gwak","doi":"10.1111/jvh.14036","DOIUrl":"https://doi.org/10.1111/jvh.14036","url":null,"abstract":"<p><p>Maternal hepatitis B virus (HBV) infection influence both maternal and fetal health. Recent studies reported increased congenital anomalies in offspring of HBV-infected mothers. This study investigated whether maternal HBV infection was associated with higher risk of congenital heart disease (CHD) in children. With the Korean National Health Insurance Service (K-NHIS) database, this retrospective cohort study included live births from 2005 to 2019, born to women under 40. Propensity score matching with a 1:3 ratio was conducted to compare HBV-infected mother's children with HBV-uninfected mother's children while adjusting for various maternal and pregnancy-related factors. Logistic regression models were used to estimate the risk. Of 2,673,059 eligible participants, 263,904 children were born to HBV-infected mothers. Risk estimation in this group showed a modestly increased risk of CHD (OR = 1.05, 95% CI = 1.02, 1.09). Notably, when pregnant mothers were treated with antiviral medication, there was an indication of reduced CHD risk, although this result was not statistically significant. The highest risk of CHD was observed in children who were themselves infected with HBV. The study indicates an association between maternal HBV infection and an increased CHD risk in offspring. The findings suggest the need to re-evaluate the timing of antiviral treatment during pregnancy to align more closely with early stages of fetal cardiac development. Further research is needed to understand the biological mechanisms of this association and to redefine clinical guidelines for managing HBV infection in pregnancy.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges and Opportunities for Treating Hepatitis C Amongst People Who Use Drugs: Experience of an Integrated Mobile Clinic in Baltimore City.","authors":"Amanda Rosecrans, Robert Harris, Anne St Clair, Molly Rice, Meredith Zoltick, Catherine Willman, Anne King, Meredith Kerr, Kathleen R Page","doi":"10.1111/jvh.14038","DOIUrl":"https://doi.org/10.1111/jvh.14038","url":null,"abstract":"<p><p>Progress in treating chronic hepatitis C virus (HCV) infection has been slow amongst people who use drugs (PWUD). This study describes the HCV treatment cascade amongst people accessing a mobile clinic offering integrated low-threshold buprenorphine and infectious disease services in Baltimore City. From May 1, 2021, to December 31, 2022, 560 people had a rapid HCV antibody test, of whom 201 (36%) had a positive result and amongst those, 117 (58%) had an HCV RNA test performed, 81 (40%) had a documented positive RNA, 45 (22%) were prescribed medication, 42 (21%) started medication, 32 (16%) completed medication, 22 (11%) had blood work to assess for sustained virologic response and 20 (10%) had a documented cure. Challenges including housing instability, insurance barriers and lack of venous access limit progress in this cascade. Providing integrated care models to meet the needs of PWUD in the community is necessary but not sufficient to make progress in improving HCV treatment. Removal of insurance restrictions, availability of point-of-care HCV RNA testing, development of rapid HCV treatment guidelines and development of long-acting injectable HCV treatment are needed to move towards a same-day, one-time test and treat model of care.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Evaluation of Point-of-Care Testing for Hepatitis C Antibodies: Navigating Hepatitis C Elimination Effort.","authors":"Kuo Chao Yew, Alyssa Shin Yee Sim, Robert Hawkins, Sanchalika Acharyya, Gerard Daquan Wong, Samuel Wei Chong Wong, Yuan Heng Lim, Wei Lyn Yang, Wei-Yen Lim, Angela Li Ping Chow","doi":"10.1111/jvh.14039","DOIUrl":"https://doi.org/10.1111/jvh.14039","url":null,"abstract":"<p><p>An HCV elimination program aims to diagnose more than 90% of Chronic HCV cases. We critically evaluated the performance of a point-of-care test (POCT) using an HCV Rapid Antibody Test. PWID from 4 Halfway Houses (HWH) in Singapore were recruited from March 2022 to April 2023. Participants were concurrently screened for HCV via venous blood for anti-HCV serology and using fingerstick capillary whole blood (FSWB) and oral mucosal transudates (OMT) for POCT, which were interpreted by trained personnel. A blinded study team member independently assessed images of POCTs. Of 207 participants, 37.3% were anti-HCV positive. Compared to anti-HCV serology, POCT performance on FSWB and OMT were: Sensitivity 81.8 (73.2-90.4), 74.0 (64.2-83.8), p = 0.014; Specificity 100.0 (100.0-100.0), 98.5 (96.3-100), p = 0.157. Sub-group analysis of strict 30-min pre-test nil-by-mouth instruction in 103 subjects reported Sensitivity 77.5 (64.6-90.4), 77.5 (64.6-90.4) and Specificity 100.0 (100.0-100.0) and 98.4 (95.3-100.0). OMT positivity and false-negative outcomes did not correlate with the sample analytical cutoff index signal distribution of anti-HCV Serology. Inter-class correlation between real-time and imaging readings of POCT for FSWB and OMT at 20 and 40 min were Kappa 0.9666, 0.9674; 0.8803, 0.8940. Proper preparation and patient selection enhance test performance. Differences in oral fluid immunoglobulin secretion, oral pathology, age, and sample collection can affect POCT OMT readings. POCT OMT is promising in serial and self-testing, complementing its convenience in testing.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}