scholarly journals Hepatitis C Diagnosis: Simplified Solutions, Predictive Barriers, and Future Promises

Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1253
Author(s):  
Imran Shahid ◽  
Abdullah R. Alzahrani ◽  
Saeed S. Al-Ghamdi ◽  
Ibrahim M. Alanazi ◽  
Sidra Rehman ◽  
...  

The simplification of current hepatitis C diagnostic algorithms and the emergence of digital diagnostic devices will be very crucial to achieving the WHO’s set goals of hepatitis C diagnosis (i.e., 90%) by 2030. From the last decade, hepatitis C diagnosis has been revolutionized by the advent and approval of state-of-the-art HCV diagnostic platforms which have been efficiently implemented in high-risk HCV populations in developed nations as well as in some low-to-middle income countries (LMICs) to identify millions of undiagnosed hepatitis C-infected individuals. Point-of-care (POC) rapid diagnostic tests (RDTs; POC-RDTs), RNA reflex testing, hepatitis C self-test assays, and dried blood spot (DBS) sample analysis have been proven their diagnostic worth in real-world clinical experiences both at centralized and decentralized diagnostic settings, in mass hepatitis C screening campaigns, and hard-to-reach aboriginal hepatitis C populations in remote areas. The present review article overviews the significance of current and emerging hepatitis C diagnostic packages to subvert the public health care burden of this ‘silent epidemic’ worldwide. We also highlight the challenges that remain to be met about the affordability, accessibility, and health system-related barriers to overcome while modulating the hepatitis C care cascade to adopt a ‘test and treat’ strategy for every hepatitis C-affected individual. We also elaborate some key measures and strategies in terms of policy and progress to be part of hepatitis C care plans to effectively link diagnosis to care cascade for rapid treatment uptake and, consequently, hepatitis C cure.

Gut ◽  
2018 ◽  
Vol 67 (11) ◽  
pp. 2017-2024 ◽  
Author(s):  
Alba Llibre ◽  
Yusuke Shimakawa ◽  
Estelle Mottez ◽  
Shaun Ainsworth ◽  
Tan-Phuc Buivan ◽  
...  

ObjectiveRecently approved direct acting antivirals provide transformative therapies for chronic hepatitis C virus (HCV) infection. The major clinical challenge remains to identify the undiagnosed patients worldwide, many of whom live in low-income and middle-income countries, where access to nucleic acid testing remains limited. The aim of this study was to develop and validate a point-of-care (PoC) assay for the qualitative detection of HCV RNA.DesignWe developed a PoC assay for the qualitative detection of HCV RNA on the PCR Genedrive instrument. We validated the Genedrive HCV assay through a case–control study comparing results with those obtained with the Abbott RealTime HCV test.ResultsThe PoC assay identified all major HCV genotypes, with a limit of detection of 2362 IU/mL (95% CI 1966 to 2788). Using 422 patients chronically infected with HCV and 503 controls negative for anti-HCV and HCV RNA, the Genedrive HCV assay showed 98.6% sensitivity (95% CI 96.9% to 99.5%) and 100% specificity (95% CI 99.3% to 100%) to detect HCV. In addition, melting peak ratiometric analysis demonstrated proof-of-principle for semiquantification of HCV. The test was further validated in a real clinical setting in a resource-limited country.ConclusionWe report a rapid, simple, portable and accurate PoC molecular test for HCV, with sensitivity and specificity that fulfils the recent FIND/WHO Target Product Profile for HCV decentralised testing in low-income and middle-income countries. This Genedrive HCV assay may positively impact the continuum of HCV care from screening to cure by supporting real-time treatment decisions.Trial registration numberNCT02992184.


PLoS ONE ◽  
2019 ◽  
Vol 14 (2) ◽  
pp. e0212558 ◽  
Author(s):  
Víctor Granados-García ◽  
Yvonne N. Flores ◽  
Lizbeth I. Díaz-Trejo ◽  
Lucia Méndez-Sánchez ◽  
Stephanie Liu ◽  
...  

Author(s):  
Hoan T. Ngo ◽  
Pietro Strobbia ◽  
Priya Dukes ◽  
Elizabeth Freedman ◽  
Agampodi Swarnapali De Silva Indrasekara ◽  
...  

2019 ◽  
Vol 7 (1) ◽  
pp. 22 ◽  
Author(s):  
Mainul Haque ◽  
Massimo Sartelli ◽  
Seraj Haque

Antibiotics are widely used in dental caries and another dental related issues, both for therapeutic and prophylactic reasons. Unfortunately, in recent years the use of antibiotics has been accompanied by the rapid emergence antimicrobial resistance. Dental caries and periodontal diseases are historically known as the top oral health burden in both developing and developed nations affecting around 20–50% of the population of this planet and the uppermost reason for tooth loss. Dental surgeons and family practitioners frequently prescribed antimicrobials for their patients as outpatient care. Several studies reported that antibiotics are often irrationally- and overprescribed in dental diseases which is the basis of antimicrobial resistance. The aim of this review is to evaluate the use of antibiotics in dental diseases. Almost certainly the promotion of primary oral health care (POHC) in primary health care program especially among the least and middle-income countries (LMIC) may be the answer to ensure and promote rational dental care.


2019 ◽  
Vol 70 (1) ◽  
pp. e159-e160
Author(s):  
Beatrice Vetter ◽  
Elena Ivanova Reipold ◽  
Rosemary Audu ◽  
Maia Alkhazashvili ◽  
Anja De Weggheleire ◽  
...  

Author(s):  
Yvonne Jolanda Melanie Licher ◽  
Jan Simon Visser ◽  
G-Young Van ◽  
Jan Carel Diehl

AbstractIn low- and middle-income countries (LMIC), diagnostics are not always available in remote areas. Hospitals and healthcare centres are often too far from the community, and waiting times are up to a few hours even for relatively simple procedures. Moreover, travelling to the healthcare centre and taking the diagnostic test is frequently unaffordable. Point of Care Tests (POCTs) can improve the availability, accessibility and affordability of the diagnostics by providing the test at the time and place of patient care. Although many POCTs have been developed already, there remain challenges to enable the healthcare workers (HCW) and the patients to use the device in practice. In this paper, we aim to provide a systemic overview of the barriers and opportunities for the adoption of use and acceptance of the results of POCTs based on the literature. The barriers and opportunities were clustered into six themes and used to draw out recommendations for the future design.


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