scholarly journals Diagnostic Reliability of Architect Anti-HCV Tests and Diagnostic Cost of False Positivity; A Single Center Study in Turkey.

Author(s):  
Sinem Akkaya Isik ◽  
Ersin Tural ◽  
ERCAN YENİLMEZ ◽  
RIZA AYTAÇ ÇETİNKAYA ◽  
Orhan Baylan ◽  
...  

Background:Although the sensitivity of third generation anti-HCV CIA tests is high, false positivity rates, especially in populations with low HCV infection endemicity, are still high. Objectives:We aimed to determine the S/Co cut-off value of anti-HCV in the diagnosis of real positive patients based on the CIA test kit absorbance routinely used in our laboratory and to reveal the potential cost effectiveness of confirmatory tests for false positive samples. Methods:All anti-HCV CIA test results which were performed in the microbiology laboratory of our hospital between 2016-2019 were retrospectively screened and S/Co values of the patients were recorded. Among these, the results that were confirmed with HCV-RNA real-time PCR test were included. Patients who were previously diagnosed and treated were excluded. Results:A total of 257 patients, who were tested for HCV-RNA after reactive anti-HCV test results, were included in the study. Of the cases, 84(32.68%) had positive HCV-RNA. According to the ROC analysis, the optimal S/Co value was 8.58 with the sensitivity and specificity values 95.24% and 85.55%, respectively. According to this 8.58S/Co value, anti-HCV test was reactive in 105 cases and 80(76.2%) of these cases had active HCV infection. In order to prevent the false-negativity, the additional cost of using 1.0S/Co value to our institution was 4114.64USD, meaning that we spent 1028.66USD to diagnose per true-case of active HCV infection when using 1.0S/Co value. In our institution, approximately 6.25 working hours are spent to finalize the HCV-RNA PCR test. The hours spent for S/Co of 1.0 and 8.58 were 1606.25 and 658.25, respectively. Conclusions:False positive anti-HCV results are an economic burden on health economics of countries. At least, different S/Co values might be used in accordance with the purpose of the screening (like blood donors or pre-operative screening) and prevalence of HCV infection in different laboratories and different populations.

2018 ◽  
Vol 9 (06) ◽  
pp. 20251-20256
Author(s):  
Mudassir Khan ◽  
Shahrukh Khan ◽  
Shohra Haider ◽  
Fazal Jalil ◽  
Muhsin Jamal ◽  
...  

Background: Prevalence of Hepatitis C viral infection and its major risk factors has been found out in population of Batkhela, Khyber Pakhtunkhwa, Pakistan by taking number of volunteers from the interested area. HCV prevalence has not been researched in recent time here in this area, so that’s why we contributed. Materials and Methods: Ab rapid test cassette serum/plasma (USA) kit has been used for the mentioned purpose following by ELISA and finally PCR to find out active infection of virus. ICT positive individuals were reconfirmed by ELISA and then ELISA positive samples were carefully investigated by RT-PCR for Hepatitis C Virus. Results: The study population was of 770 volunteers belonging to the mentioned area of research, 453 males and 317 females. The overall prevalence was found to be 5.32% of HCV in Batkhela. This prevalence ratio was 3.12% in males and 2.20 % in females. 3rd generation ELISA was used to refine ICT positive samples which showed that 37 of the ICT positive samples had antibodies detected by ELISA. To find out active HCV infection, ELISA positive samples were refined by real time PCR which showed 2.98% of prevalence of active HCV infection in Batkhela based on HCV RNA in their blood. Principle Conclusion: Overall prevalence was found 5.32%, contaminated reused syringes and blades at Barbour’s shop, blood transfusion, surgical operations and unhygienic food in stalls etc were found significant risk factors for acquiring HCV infection. Body weakness and pale yellow skin color was common symptom in HCV positive volunteers. Safe sexual activities, blood screening before donation and sterilizing surgical equipment’s can protect us from Hepatitis C Virus.


Author(s):  
Ranti Permatasari ◽  
Aryati Aryati ◽  
Budi Arifah

Hepatitis C (HCV) infection could be spread by blood transfusion. Screening of HCV in donor blood could prevent HCV infection to the recipient. HCV antibody test using rapid test of multiple antibody detection by immunochromatography method is an easy and rapid test that could detect four HCV antibodies separately. The aim of this study was to evaluate the diagnostic value of antibody HCV using multiple antibody detection rapid test in diagnosing HCV infection. This was an analytical observational study with a cross sectional design. The samples consisted of 42 donors’ blood serum from the Surabaya Branch of the Indonesian Red Cross which underwent HCV infection test using ELISA method. The samples were then tested using PCR HCV RNA as the gold standard and antibody HCV multiple antibodydetection rapid test The diagnostic value of HCV antibody test using multiple antibody detection rapid test by immunochromatography method showed a diagnostic sensitivity of 100%, diagnostic specificity of 75%, positive predictive value of 66.7% and negative predictive value of 100%, a diagnostic efficiency of 83.3%, with a positive probability ratio of 4 times. The most often positive antibody pattern was four (4) positive antibodies (core protein, NS3, NS4 and NS5). Core protein (CP) and NS3 were the most often positive antibodies. Based on this study result, the HCV antibody test using multiple antibody detection rapid test by immunochromatography method has a good diagnostic value.


Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 651
Author(s):  
Laura Huiban ◽  
Carol Stanciu ◽  
Cristina Maria Muzica ◽  
Tudor Cuciureanu ◽  
Stefan Chiriac ◽  
...  

(1) Background: The World Health Organization adopted a strategy for the Global Health Sector on Viral Hepatitis in 2016, with the main objective of eliminating hepatitis C virus (HCV) by 2030. In this work, we aimed to evaluate the prevalence of HCV infection and risk factors in a Romanian village using population-based screening as part of the global C virus eradication program. (2) Methods: We conducted a prospective study from March 2019 to February 2020, based on a strategy as part of a project designed to educate, screen, treat and eliminate HCV infection in all adults in a village located in Northeastern Romania. (3) Results: In total, 3507 subjects were invited to be screened by rapid diagnostic orientation tests (RDOT). Overall, 2945 (84%) subjects were tested, out of whom 78 (2.64%) were found to have positive HCV antibodies and were scheduled for further evaluation in a tertiary center of gastroenterology/hepatology in order to be linked to care. In total, 66 (85%) subjects presented for evaluation and 55 (83%) had detectable HCV RNA. Of these, 54 (98%) completed antiviral treatment and 53 (99%) obtained a sustained virological response. (4) Conclusions: The elimination of hepatitis C worldwide has a higher chance of success if micro-elimination strategies based on mass screening are adopted.


Noise Mapping ◽  
2020 ◽  
Vol 7 (1) ◽  
pp. 239-247
Author(s):  
Alberto E. García-Rivero ◽  
Ricardo Ángel Yuli-Posadas ◽  
Warren Reátegui Romero ◽  
Odón Sánchez-Ccoyllo ◽  
Wilfredo Bulege-Gutierrez ◽  
...  

AbstractThe present study is intended to get to know the levels of perimeter diurnal environmental noise of four hospitals in the city of Lima. The measurement mode used at each hospital was A-weighting, with an integration time of five minutes per recording. It was measured in the FAST mode with calibrations made at the beginning and end of the measurement day. Statistical analysis consisted of the mean comparison T test which was applied at all the hospitals considered in the study. At the four hospitals, at all the hours of measurement and both on working days and non-working days (Sunday), LAeq mean values are higher than 83 dBA. On working days, two periods of maximum noise from 08:00 to 10:00 in the morning and from 17:00 to 19:00 in the afternoon coincide with the start and end of working hours. The perimeter diurnal environmental noise levels determined at the vicinity of four hospitals show higher values in all cases to those established by the Peruvian National Environmental Standards for Noise for special protection areas both for working days and for non-working days. Noise that comes from the dense and disorganized traffic of Lima plays a fundamental role in this behaviour.


2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Anneli Uusküla ◽  
Ave Talu ◽  
Jürgen Rannap ◽  
David M. Barnes ◽  
Don Des Jarlais

Abstract Background Between December 2018 and January of 2019, we evaluated the accuracy of the point-of-care Hepatitis C (HCV) antibody test (POC; OraQuick HCV) used at a community-based needle and syringe exchange program serving persons who inject drugs in Tallinn, Estonia. Methods We compared the results of screening for HCV antibodies by OraQuick (oral swab) and enzyme immunoassay (EIA; blood draw) and assessed test results implications in a high prevalence setting. Findings Of the 100 participants, 88 (88%) had reactive POC test results, and 93 were HCV antibody positive on EIA testing. Sensitivity, specificity and negative predictive value (NPV) for the POC assay with EIA as the relevant reference test were as follows: 94.6% (95% CI 90.0–99.2%), 100% and 58.3% (95% CI 30.4–86.2%). Of the 12 testing, HCV-negative with the POC only 7 (58.3%) were true negatives. Conclusions Oral swab rapid testing HCV screening in this nonclinical setting was sensitive and specific but had unacceptably low NPV. In high prevalence settings, POC tests with high sensitivity and that directly measure HCV RNA may be warranted.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Pierluca Piselli ◽  
Diego Serraino ◽  
Mario Fusco ◽  
Enrico Girardi ◽  
Angelo Pirozzi ◽  
...  

Abstract Background Hepatitis C virus (HCV) infection represents a global health issue with severe implications on morbidity and mortality. This study aimed to evaluate the impact of HCV infection on all-cause, liver-related, and non-liver-related mortality in a population living in an area with a high prevalence of HCV infection before the advent of Direct-Acting Antiviral (DAA) therapies, and to identify factors associated with cause-specific mortality among HCV-infected individuals. Methods We conducted a cohort study on 4492 individuals enrolled between 2003 and 2006 in a population-based seroprevalence survey on viral hepatitis infections in the province of Naples, southern Italy. Study participants provided serum for antibodies to HCV (anti-HCV) and HCV RNA testing. Information on vital status to December 2017 and cause of death were retrieved through record-linkage with the mortality database. Hazard ratios (HRs) for cause-specific mortality and 95% confidence intervals (CIs) were estimated using Fine-Grey regression models. Results Out of 626 deceased people, 20 (3.2%) died from non-natural causes, 56 (8.9%) from liver-related conditions, 550 (87.9%) from non-liver-related causes. Anti-HCV positive people were at higher risk of death from all causes (HR = 1.38, 95% CI: 1.12–1.70) and liver-related causes (HR = 5.90, 95% CI: 3.00–11.59) than anti-HCV negative ones. Individuals with chronic HCV infection reported an elevated risk of death due to liver-related conditions (HR = 6.61, 95% CI: 3.29–13.27) and to any cause (HR = 1.51, 95% CI: 1.18–1.94). The death risk of anti-HCV seropositive people with negative HCV RNA was similar to that of anti-HCV seronegative ones. Among anti-HCV positive people, liver-related mortality was associated with a high FIB-4 index score (HR = 39.96, 95% CI: 4.73–337.54). Conclusions These findings show the detrimental impact of HCV infection on all-cause mortality and, particularly, liver-related mortality. This effect emerged among individuals with chronic infection while those with cleared infection had the same risk of uninfected ones. These results underline the need to identify through screening all people with chronic HCV infection notably in areas with a high prevalence of HCV infection, and promptly provide them with DAAs treatment to achieve progressive HCV elimination and reduce HCV-related mortality.


2021 ◽  
Vol 10 (11) ◽  
pp. 2509
Author(s):  
Pei-Yuan Su ◽  
Yang-Yuan Chen ◽  
Hsu-Heng Yen ◽  
Siou-Ping Huang ◽  
I-Ling Liu ◽  
...  

Hepatitis C virus (HCV) infection can induce insulin resistance, and patients with diabetes mellitus (DM) have a higher prevalence of HCV infection. Patient outcomes improve after HCV eradication in DM patients. However, HCV micro-elimination targeting this population has not been approached. Little is known about using electronic alert systems for HCV screening among patients with DM in a hospital-based setting. We implemented an electronic reminder system for HCV antibody screening and RNA testing in outpatient departments among patients with DM. The screening rates and treatment rates at different departments before and after system implementation were compared. The results indicated that the total HCV screening rate increased from 49.3% (9505/19,272) to 78.2% (15,073/19,272), and the HCV-RNA testing rate increased from 73.4% to 94.2%. The anti-HCV antibody seropositive rate was 5.7%, and the HCV viremia rate was 62.7% in our patient population. The rate of positive anti-HCV antibodies and HCV viremia increased with patient age. This study demonstrates the feasibility and usefulness of an electronic alert system for HCV screening and treatment among DM patients in a hospital-based setting.


2003 ◽  
Vol 49 (8) ◽  
pp. 503-507 ◽  
Author(s):  
Regina Moreira ◽  
João Renato Rebello Pinho ◽  
Jorge Fares ◽  
Isabel Takano Oba ◽  
Maria Regina Cardoso ◽  
...  

The aims of this study were to (i) evaluate the prevalence and the incidence of hepatitis C virus (HCV) infection in hemodialysis patients in two different centers in São Paulo (Brazil), (ii) determine the time required to detect HCV infection among these patients by serology or PCR, (iii) establish the importance of alanine aminotransferase determination as a marker of HCV infection, and (iv) identify the HCV genotypes in this population. Serum samples were collected monthly for 1 year from 281 patients admitted to hospital for hemodialysis. Out of 281 patients, 41 patients (14.6%) were HCV positive; six patients seroconverted during this study (incidence = 3.1/1000 person-month). In 1.8% (5/281) of cases, RNA was detected before the appearance of antibodies (up to 5 months), and in 1.1% (3/281) of cases, RNA was the unique marker of HCV infection. The genotypes found were 1a, 1b, 3a, and 4a. The presence of genotype 4a is noteworthy, since it is a rare genotype in Brazil. These data pointed out the high prevalence and incidence of HCV infection at hemodialysis centers in Brazil and showed that routine PCR is fundamental for improving the detection of HCV carriers among patients undergoing hemodialysis.Key words: HCV genotypes, hemodialysis, hepatitis C, PCR, prevalence, incidence.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Alicja E. Grzegorzewska ◽  
Adrianna Mostowska ◽  
Monika K. Świderska ◽  
Wojciech Marcinkowski ◽  
Ireneusz Stolarek ◽  
...  

Abstract Background In non-uremic subjects, IFNL4 rs368234815 predicts HCV clearance. We investigated whether rs368234815 is associated with spontaneous HCV clearance in haemodialysis patients and whether it is a stronger predictor of HCV resolution than the IFNL polymorphisms already associated with HCV clearance in dialysis subjects. We also evaluated an association of rs368234815 with patients` survival and alterations in transcription factor binding sites (TFBS) caused by IFNL polymorphisms. Methods Among 161 haemodialysis patients with positive anti-HCV antibodies, 68 (42.2%) spontaneously resolved HCV infection, whereas 93 remained HCV RNA positive. Patients were tested for near IFNL3 rs12980275, IFNL3 rs4803217, IFNL4 rs12979860, IFNL4 rs368234815, and near IFNL4 rs8099917. IFNL4 rs368234815 polymorphism (TT/TT, ΔG/TT, ΔG/ΔG) was genotyped by restriction fragment length polymorphism analysis; other IFNL polymorphisms - by high resolution melting curve analysis. We used the Kaplan-Meier method with the log-rank test for survival analysis. In silico analysis included the use of ENCODE TFBS ChIP-seq data, HOCOMOCO, JASPAR CORE, and CIS-BP databases, and FIMO software. Results The probability (OR, 95%CI, P) of spontaneous HCV clearance for rs368234815 TT/TT patients was higher than for the ΔG allele carriers (2.63, 1.38–5.04, 0.003). This probability for other major homozygotes varied between 2.80, 1.45–5.43, 0.002 for rs12980275 and 2.44, 1.27–4.69, 0.007 for rs12979860. In the additive model, rs368234815 TT/TT was the strongest predictor of HCV clearance (6.38, 1.69–24.2, 0.003). Survival analysis suggested an association of the ΔG allele with mortality due to neoplasms (log-rank P = 0.005). The rs368234815 ∆G allele caused TFBS removal for PLAGL1. Conclusions In haemodialysis patients, the association of rs368234815 with the spontaneous HCV clearance is better than that documented for other IFNL3/IFNL4 polymorphisms only in the additive mode of inheritance. However, identifying the homozygosity in the variant ∆G allele of rs368234815 means a more potent prediction of persistent HCV infection in haemodialysis subjects that we observe in the case of the variant homozygosity of other tested IFNL3/IFNL4 polymorphisms. Removal of PLAGL1 TFBS in subjects harbouring the rs368234815 ∆G allele may contribute to cancer susceptibility. The association of rs368234815 with cancer-related mortality needs further studies in HCV-exposed subjects.


2021 ◽  
pp. 15-17
Author(s):  
Stuti Kansra Arora ◽  
Mala Chhabra ◽  
Anuradha Anuradha ◽  
Arvind Achra ◽  
Nandini Duggal

Introduction:Hepatitis C virus (HCV) infection has emerged as one of the major global health challenge affecting about 2 - 3% of the world population. Epidemiological studies have shown that HCV infection is a major risk factor for development of Acute hepatitis,chronic liver disease,cirrhosis and Hepatocellular carcinoma (HCC).Early diagnosis of HCV is important to link hepatitis testing to care and treatment initiation. Aim:To compare sensitivity and specificity of rapid diagnostic test (RDT) with fourth generation ELISA Material and Method: This study was conducted in the Department of Microbiology at Atal Bihari Vajpayee Institute of Medical Sciences (formerly Post Graduate Institute of Medical Education and Research) and Dr Ram Manohar Lohia Hospital from January 2018 to December 2018.Blood samples of patients suspected with hepatitis were tested using ELISA and rapid diagnostic test Results: In our study 26378 blood samples were tested for HCV,using fourth generation ELISA.Of these,581(2.20%) samples were found to be positive by ELISA.These HCV positive samples along with equal number of ELISA negative samples were tested by rapid diagnostic test. Sensitivity and specificity of the rapid diagnostic test was found to be 72.98 % and 100% respectively. Discussion:Rapid diagnostic test can be used during emergency hours but their results must be followed by ELISA test results in a tertiary care hospital.Reporting of false negative results should be minimized for rapid linkage to treatment initiation and to avoid silent transmission of infection.


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