Three-Stage Pooled Plasma Hepatitis C Virus RNA Testing for the Identification of Acute HCV Infections in At-Risk Populations

Sun, Hsin‐Yun; Chiang, Chieh; Huang, Sheng-Hsiu; Guo, Wen-Jin; Chuang, Yi‐Fang; Huang, Yi‐Chia; Yang, Chia‐Jui; Su, Li‐Hsin; Chen, Yi-Ting; Chen, Yea‐Wen; Hsu, Fu-Chiun; Ho, Shu-Yuan; Liu, Wen-Chun; Su, Yi‐Ching; Chang, Sui‐Yuan; Hung, Chien‐Ching; Yu, Ming‐Lung

doi:10.1128/spectrum.02437-21

Cited by 14 publications

(21 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…With the rapid spread of HCV infection mainly among PLWH who are MSM worldwide in the past 2 decades ( 20 ), the HCVcAg assay has also been evaluated as an alternative HCV screening tool to identify new HCV infections among PLWH ( 21 , 22 ) or for PLWH with acute HCV infections ( 23 ). Despite the compromised performance in the specimens with lower plasma HCV RNA loads, the HCVcAg assay could also be a cost-saving diagnostic tool for recently acquired HCV infections, given the high HCV RNA loads in the setting of recently acquired HCV infections, with a mean plasma HCV RNA load of 6.4 log 10 IU/mL ( 15 , 24 ), especially in the high-risk populations requiring repeat testing. Among PLWH with acute HCV infection, the sensitivity of the HCVcAg assay ranges from 89% to 100% and its specificity from 95% to 100% ( 21 – 23 ).…”

Section: Discussionmentioning

confidence: 99%

“…Further assessments of the turnaround time required and direct and indirect costs incurred between pooled-plasma HCV RNA testing and individual HCVcAg testing are warranted in different epidemiologic and clinical settings. In our study, it took about 9 h to go through stages 1 to 3 (approximately 2.7 h for each stage; see Materials and Methods) for pooled-plasma HCV RNA testing to get the results and 30 min for the HCVcAg assay ( 15 ). Fourth, since the prevalence of a disease of interest will have an impact on the performance of an assay, our findings can only be applied to settings with an overall prevalence of HCV viremia of 3.8% (62/1,639 in our study) of all samples tested and may not be generalizable to other populations with different prevalences of HCV viremia.…”

Section: Discussionmentioning

confidence: 99%

“…To ensure scale-up of HCV testing and treatment without unnecessary delays and restrictions, efforts should be made to increase the access to and reduce the costs for HCV testing and treatment, particularly in resource-constrained settings. We have recently demonstrated the feasibility and cost reductions of regular (every 3 months) pooled-plasma HCV RNA testing to identify HCV infections among at-risk PLWH with sexually transmitted infections (STIs), elevated aminotransferases within the past 6 months, or past HCV infections ( 15 ). However, whether the HCVcAg assay could also play a role in this setting remains less investigated.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Performance of Hepatitis C Virus (HCV) Core Antigen Assay in the Diagnosis of Recently Acquired HCV Infection among High-Risk Populations

et al. 2022

Self Cite

View full text Add to dashboard Cite

The HCV core antigen assay has a high specificity of 99.4% and negative predictive value of 99.5% but a lower sensitivity of 87.1% and positive predictive value of 85.7% in the diagnosis of recently acquired HCV infection in high-risk populations. Our findings are informative for many countries confronted with limited resources to timely identify acute HCV infections and provide effective direct-acting antivirals to halt onward transmission.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Performance of Hepatitis C Virus (HCV) Core Antigen Assay in the Diagnosis of Recently Acquired HCV Infection among High-Risk Populations

et al. 2022

Self Cite

View full text Add to dashboard Cite

show abstract

“…To detect HCV reinfection, PLWH underwent testing for plasma HCV RNA periodically after completing their DAA treatment. During the observation period between June 2019 and December 2021, pooled plasma HCV RNA testing was performed every 3 months to detect HCV viremia [ 21 ]. In short, plasma samples from 20 individuals were pooled together for HCV RNA testing, and subsequent testing of mini-pools consisting of 5 samples would be performed if the initial testing was positive; and testing of individual samples would be performed for the mini-pooled samples tested positive for HCV RNA.…”

Section: Methodsmentioning

confidence: 99%

Sexually-transmitted hepatitis C virus reinfections among people living with HIV in Taiwan: the emerging role of genotype 6

Chen

Sun

Chang

et al. 2022

Emerging Microbes & Infections

Self Cite

View full text Add to dashboard Cite

Hepatitis C virus (HCV) reinfections after successful treatment with direct-acting antivirals (DAAs) pose a significant challenge to HCV elimination, especially among high-risk people living with HIV (PLWH). In this study, PLWH who had achieved HCV viral clearance with DAAs were included between January 2018 and June 2021. PLWH having acquired HCV infections after 2017 were classified as “recent-infection group,” and those before 2017 as “remote-infection group,” and the incidences of HCV reinfection were compared between two groups. Clinical and behavioural characteristics were evaluated to identify associated factors with HCV reinfection. A total of 284 PLWH were included: 179 in the recent-infection group and 105 in the remote-infection group. After a median follow-up of 2.32 years (interquartile range [IQR], 0.13–3.94), the overall incidence of HCV reinfection was 5.8 per 100 person-years of follow-up (PYFU). The incidence in the recent-infection group was significantly higher than that in the remote-infection group (9.8 vs. 0.4 per 100 PYFU, p < 0.001). The leading HCV genotypes before DAA treatment were genotypes 2 (31.0%), 1b (26.8%), and 6 (21.8%); however, genotype 6 (58.8%) became predominant upon reinfection. Younger age (adjusted odds ratio [aOR] per 1-year increase, 0.95; 95% CI, 0.90–0.99), condomless receptive anal sex (aOR, 14.5; 95% CI, 2.37–88.8), rimming (aOR, 3.87; 95% CI, 1.14–13.1), and recent syphilis (aOR, 2.73; 95% CI, 1.26–5.91) were linked to HCV reinfections. In conclusion, PLWH acquiring HCV after 2017 had a significantly higher risk for sexually-transmitted HCV reinfections. The predominance of HCV genotype 6 reinfections suggests possible on-going clustered HCV infections among at-risk PLWH.

show abstract

“…The detection of HCV RNA was performed using the Roche Cobas ® 6800 system (AmpliPrep HCV Test, v2.0, Roche, USA), with a detection limit of 15 IU/ml. To facilitate early detection of HCV viremia and linkage to DAA treatments, PLWH who received a diagnosis of sexually transmitted infection (STI), had elevated aminotransferases, or achieved HCV clearance spontaneously or with DAAs were enrolled in another prospective study using three-stage pooled-plasma HCV RNA testing every three months to detect HCV viremia for 12 months after June 2019 [ 26 ]. In brief, plasma samples from 20 PLWH were pooled together for HCV RNA testing, and subsequent testing of mini-pools consisting of five samples would be performed if the initial test was positive; testing of individual samples would be performed for the mini-pooled samples tested positive for HCV RNA.…”

Section: Methodsmentioning

confidence: 99%

Hepatitis C microelimination among people living with HIV in Taiwan

Chen

et al. 2022

Emerging Microbes & Infections

Self Cite

View full text Add to dashboard Cite

To reach the WHO target of hepatitis C virus (HCV) elimination by 2025, Taiwan started to implement free-of-charge direct-acting antiviral (DAA) treatment programme in 2017. Evaluating the progress of HCV microelimination among people living with HIV (PLWH) is a critical step to identify the barriers to HCV elimination. PLWH seeking care at a major hospital designated for HIV care in Taiwan between January 2011 and December 2021 were retrospectively included. For PLWH with HCV-seropositive or HCV seroconversion during the study period, serial HCV RNA testing was performed using archived samples to confirm the presence of HCV viremia and estimate the prevalence and incidence of HCV viremia. Overall, 4199 PLWH contributed to a total of 27,258.75 person-years of follow-up (PYFU). With the reimbursement of DAAs and improvement of access to treatments, the prevalence of HCV viremia has declined from its peak of 6.21% (95% CI, 5.39–7.12%) in 2018 to 2.09% (95% CI, 1.60–2.77%) in 2021 (decline by 66.4% [95% CI, 55.4–74.7%]); the incidence has declined from 25.94 per 1000 PYFU (95% CI, 20.44–32.47) in 2019 to 12.15% per 1000 PYFU (95% CI, 8.14–17.44) (decline by 53.2% [95% CI, 27.3–70.6%]). However, the proportion of HCV reinfections continued to increase and accounted for 82.8% of incident HCV infections in 2021. We observed significant declines of HCV viremia among PLWH with the expansion of the DAA treatment programme in Taiwan. Further improvement of the access to DAA retreatments is warranted to achieve the goal of HCV microelimination.

show abstract

Three-Stage Pooled Plasma Hepatitis C Virus RNA Testing for the Identification of Acute HCV Infections in At-Risk Populations

Cited by 14 publications

References 23 publications

Performance of Hepatitis C Virus (HCV) Core Antigen Assay in the Diagnosis of Recently Acquired HCV Infection among High-Risk Populations

Performance of Hepatitis C Virus (HCV) Core Antigen Assay in the Diagnosis of Recently Acquired HCV Infection among High-Risk Populations

Sexually-transmitted hepatitis C virus reinfections among people living with HIV in Taiwan: the emerging role of genotype 6

Hepatitis C microelimination among people living with HIV in Taiwan

Contact Info

Product

Resources

About