Dried blood spots, valid screening for viral hepatitis and human immunodeficiency virus in real-life

Mössner, Belinda Klemmensen; Staugaard, Benjamin; Jensen, Jeanette Dupont; Lillevang, Søren Thue; Christensen, Peer Brehm; Holm, Dorte Kinggaard

doi:10.3748/wjg.v22.i33.7604

Cited by 65 publications

(101 citation statements)

References 28 publications

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“…This technique is also not dependent on the need for specialist skills in venepuncture, resulting in many more staff being able to perform the test . DBST has very good sensitivity (>96%) and specificity (>98%) for HCV and has been shown to be a cost‐effective screening tool for HCV within the prison setting, making it a good testing system in prisons …”

Section: Discussionmentioning

confidence: 99%

Increased diagnosis and treatment of hepatitis C in prison by universal offer of testing and use of telemedicine

Morey

Hamoodi

Jones³

et al. 2018

Journal of Viral Hepatitis

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Summary With recent advances in antiviral therapy, there is an opportunity to eliminate hepatitis C virus (HCV) from the UK population. HCV is common in incarcerated individuals, with previous estimates suggesting ~7% of the UK prison population is anti‐HCV antibody positive. Increasing diagnosis and treatment of HCV in prison is a priority in seeking to eliminate transmission in the general population. Thus the study aimed to assess the impact implementation of: (a) A universal offer of blood borne virus testing (UOBBVT) using dry blood spot testing for prisoners at reception to increase diagnosis; (b) Telemedicine clinics (TC) within North East England (NEE) prisons to increase HCV treatment rates. UOBBVT was initially implemented at Her Majesty's Prison (HMP) Durham, commencing March 2016. From March 2016 to February 2017, 2831 of 4280 (66%) new receptions were offered blood borne virus (BBV) testing. Of these, 1495 (53% of offered) accepted BBV testing, of whom 95 (6.4%) were HCV antibody positive, with 47 of those 95 (49.5%) HCV RNA positive, suggesting a prevalence of active infection in the tested population of 3.1% (95% CI 2.4%‐4.2%). Between August 2015 and October 2017, 80 individuals were seen in the TC and 57 (71%) commenced antiviral therapy. Of those with known outcome (n = 29), 100% achieved sustained virological response. In the year prior to implementation, only four patients received HCV treatment. In conclusion, a universal offer of BBV testing to inmates presenting at HMP reception coupled with linkage into specialist care via TC can substantially increase rates of testing, diagnosis and treatment of HCV in this high‐prevalence population.

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Section: Discussionmentioning

confidence: 99%

Increased diagnosis and treatment of hepatitis C in prison by universal offer of testing and use of telemedicine

Morey

Hamoodi

Jones³

et al. 2018

Journal of Viral Hepatitis

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“…In HIV+ individuals, high median CD4 and CD8 cell count were found in those individuals that had discordant results for anti‐HBs between serum and DBS. Another study also observed high mean values of CD8 in the HIV+ group who were vaccinated against HBV, but the response to HBV vaccination is more accurate among individuals with undetectable plasma HIV‐1 RNA …”

Section: Discussionmentioning

confidence: 94%

“…Dried blood spots (DBSs) represent a potential alternative to serum for anti‐HBs detection since the collection is less invasive, requires less trained staff, and samples can be stored without refrigeration for transport . Anti‐HBs detection in DBS presented sensitivities from 42% to 98% …”

Section: Introductionmentioning

confidence: 99%

Assessing hepatitis B immunity using dried blood spot samples from HIV+ individuals

Flores

Cruz

Miguel

et al. 2018

Journal of Medical Virology

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This study aims to evaluate the utility of an optimized enzyme immunoassay (EIA) to detect and quantify antibodies against hepatitis B surface antibody (anti-HBs) in dried blood spots (DBSs) within the context of human immunodeﬁciency virus (HIV) status. Serum and DBS samples were obtained from 56 HIV+ and 99 HIV- patients and subjected to EIA for the detection of anti-HBs, where sample volume and cut off value were modified for DBS testing. Sensitivities of anti-HBs detection in DBS were 79.8% and 76.8% in HIV- and HIV+ subjects, respectively. Concordant results for anti-HBs in serum and DBS presented high mean CD8 cell counts, HIV viral load and optical density (OD) values of anti-HBs. Anti-HBs titers were significantly higher in serum, whether or not anti-HBs titers were detected in DBS. It was possible to detect anti-HBs in DBS as low as 17.4 and 27.3 IU/mL among HIV+ and HIV- subjects, respectively. In conclusion, DBS can be used to detect and quantify anti-HBs in HIV-infected individuals, which could increase access to diagnosis and vaccination.

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“…In this context, access to hepatitis C diagnosis using alternative biological samples, such as saliva and dried blood spot (DBS), could facilitate access to diagnosis for infected individuals who are asymptomatic . Saliva and DBS are easy to collect and transport and do not require specially trained personnel or complex infrastructure for sample collection …”

Section: Introductionmentioning

confidence: 99%

Performance of ANTI‐HCV testing in dried blood spots and saliva according to HIV status

Flores

Cruz

Marques

et al. 2017

Journal of Medical Virology

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The use of saliva and dried blood spots (DBS) could increase access to HCV diagnosis for high-risk populations, such as HIV-infected individuals, but the performance of these assays has not been well established in this group. This study aims to evaluate HIV status, particularly TCD4 cell count and viral load, in the performance of anti-HCV testing using DBS and saliva. A total of 961 individuals classified as HCV+, HIV+, or HIV/HCV+, as well as negative controls, donated serum, DBS, and saliva samples for anti-HCV testing using a commercial enzyme immunoassay. Sample volume was modified for DBS and saliva, and an ROC curve was used for cut-off determination in saliva. Anti-HCV sensitivities were greater than 93% using DBS and saliva in the HCV+ group, while they were 83.3% and 95.6% for HCV/HIV+ individuals for DBS and saliva assays, respectively. Specificity varied from 91.7% to 100% using saliva and DBS in HIV monoinfected and control subjects. When only anti-HCV/HCV RNA+ serum samples, that is, true positives, were considered, the sensitivities were 98.3% and 100% for DBS and saliva, respectively, in the HCV+ group and 91.6% and 94.8% for DBS and saliva, respectively, in the HIV/HCV+ group. High absorbance values were observed among those presenting with HCV RNA in serum and low HIV viral load (less than 50 copies/mL). In conclusion, DBS and saliva samples could be used for anti-HCV detection, particularly to identify active HCV cases, but low sensitivity was observed for anti-HCV testing using DBS in the HIV/HCV+ group.

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Dried blood spots, valid screening for viral hepatitis and human immunodeficiency virus in real-life

Cited by 65 publications

References 28 publications

Increased diagnosis and treatment of hepatitis C in prison by universal offer of testing and use of telemedicine

Increased diagnosis and treatment of hepatitis C in prison by universal offer of testing and use of telemedicine

Assessing hepatitis B immunity using dried blood spot samples from HIV+ individuals

Performance of ANTI‐HCV testing in dried blood spots and saliva according to HIV status

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