1
|
Muñoz-Chimeno M, Valencia J, Rodriguez-Recio A, Cuevas G, Garcia-Lugo A, Manzano S, Rodriguez-Paredes V, Fernandez B, Morago L, Casado C, Avellón A, Ryan P. HCV, HIV AND HBV rapid test diagnosis in non-clinical outreach settings can be as accurate as conventional laboratory tests. Sci Rep 2023; 13:7554. [PMID: 37160925 PMCID: PMC10170094 DOI: 10.1038/s41598-023-33925-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 04/20/2023] [Indexed: 05/11/2023] Open
Abstract
Point of care rapid diagnostic tests (POC-RDT) for Hepatitis C virus (HCV), Human Immunodeficiency virus (HIV) and Hepatitis B virus (HBV), are ideal for screening in non-clinical outreach settings as they can provide immediate results and facilitate diagnosis, allowing high risk population screening. The aim of this study was to compare POC-RDT with laboratory conventional tests. A total of 301 vulnerable evaluable subjects (drug users, migrants and homeless population) were recruited at a mobile screening unit in outreach settings in Madrid. Fingerprick whole blood capillary samples were tested using the SD BIOLINE HCV POC-RDT, Determine HIV Early Detect and Determine HBsAg 2, and the results were assessed against the LIAISON XL HCV, HIV and Murex-HBsAg-Quant, reference assays, respectively. The feasibility and user satisfaction of the POC-RDT were evaluated through a questionnaire. The resolved sensitivity and resolved specificity and their 95% confidence intervals (95% CI) were as follows, respectively: SD-BIOLINE-HCV: 98.8% (95% CI 93.4, 100.0) and 100.0% (95% CI 98.3, 100.0); Determine HIV Early Detect: 100% (95% CI 85.2, 100.0) and 100% (95% CI 98.7, 100); and Determine HBsAg 2: 66.7% (95% CI 9.4, 99.2) and 100.0% (95% CI 98.7, 100.0). As expected, the number of subjects with a confirmed positive result for HBsAg was very low (n = 4). Therefore, the analytical sensitivity has been evaluated in addition: The Determine HBsAg 2 test demonstrated 100% sensitivity for standard concentrations ≥ 0.125 IU/mL. The subject questionnaire yielded positive feedback for most subjects. The POC-RDT fingerprick blood collection method was well received, and the tests demonstrated a comparable clinical performance with conventional tests in outreach settings and vulnerable high-risk populations.
Collapse
Affiliation(s)
- Milagros Muñoz-Chimeno
- Hepatitis Unit, National Center of Microbiology, Carlos III Institute of Health, Madrid, Spain
| | | | - Alvaro Rodriguez-Recio
- Hepatitis Unit, National Center of Microbiology, Carlos III Institute of Health, Madrid, Spain
| | | | - Alejandra Garcia-Lugo
- Hepatitis Unit, National Center of Microbiology, Carlos III Institute of Health, Madrid, Spain
| | | | | | | | - Lucía Morago
- Hepatitis Unit, National Center of Microbiology, Carlos III Institute of Health, Madrid, Spain
| | - Concepción Casado
- Molecular Virology Unit, National Center of Microbiology, Carlos III Institute of Health, Madrid, Spain
| | - Ana Avellón
- Hepatitis Unit, National Center of Microbiology, Carlos III Institute of Health, Madrid, Spain.
- CIBERESP Epidemiology and Public Health, Madrid, Spain.
| | - Pablo Ryan
- Infanta Leonor Hospital, Madrid, Spain.
- CIBER Infectious Diseases (CB 21/13/00044), Madrid, Spain.
- Complutense University of Madrid, Madrid, Spain.
| |
Collapse
|
2
|
Calleja Panero JL, Lens García S, Fernández Bermejo M, Crespo J. Definition of the profiles of hepatitis C virus patients based on the identification of risky practices in Spain. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2020; 111:731-737. [PMID: 31526012 DOI: 10.17235/reed.2019.6169/2019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The absolute number of patients infected with the hepatitis C virus and its prevalence in Spain according to risk practices are not precise. The objective of the study was to estimate the current direct-action antiviral candidates, according to risky practices. The exposed population was determined according to each risky practice and age, based on the data obtained in two epidemiological studies and other bibliographic sources. The overall prevalence of positive serology for the Hepatitis C virus according to the analyzed data was 1.1% (41% with an active infection). The most at-risk group are intravenous drug users (60,368-82,454). It is estimated that between 37,387 to 51,065 patients would be infected via sexual transmission, between 55,505 and 75,812 patients following a blood transfusion and around 18,528 to 25,307 patients by socio-family transmission. According to these data, more than half (55-79%) of the subjects with risky practices would have significant fibrosis (≥ F2). It is estimated that more than half a million people have a positive serology for the Hepatitis C virus and 144,191 to 227,773 antiviral treatments are expected in the coming years. The identification of people with risky practices is key to increase the percentage of diagnosed cases.
Collapse
Affiliation(s)
| | | | | | - Javier Crespo
- Servicio de Aparato Digestivo, Hospital Universitario Marqués de Valdecilla, Santander., España
| |
Collapse
|
3
|
Ruiz-Extremera Á, Díaz-Alcázar MDM, Muñoz-Gámez JA, Cabrera-Lafuente M, Martín E, Arias-Llorente RP, Carretero P, Gallo-Vallejo JL, Romero-Narbona F, Salmerón-Ruiz MA, Alonso-Diaz C, Maese-Heredia R, Cerrillos L, Fernández-Alonso AM, Camarena C, Aguayo J, Sánchez-Forte M, Rodríguez-Maresca M, Pérez-Rivilla A, Quiles-Pérez R, Muñoz de Rueda P, Expósito-Ruiz M, García F, García F, Salmerón J. Seroprevalence and epidemiology of hepatitis B and C viruses in pregnant women in Spain. Risk factors for vertical transmission. PLoS One 2020; 15:e0233528. [PMID: 32437468 PMCID: PMC7241747 DOI: 10.1371/journal.pone.0233528] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 05/06/2020] [Indexed: 12/13/2022] Open
Abstract
Background & aim Worldwide, measures are being implemented to eradicate hepatitis B (HBV) and C (HCV) viruses, which can be transmitted from the mother during childbirth. This study aims to determine the prevalence of HBV and HCV in pregnant women in Spain, focusing on country of origin, epidemiological factors and risk of vertical transmission (VT). Methodology Multicentre open-cohort study performed during 2015. HBV prevalence was determined in 21870 pregnant women and HCV prevalence in 7659 pregnant women. Epidemiological and risk factors for VT were analysed in positive women and differences between HBV and HCV cases were studied. Results HBV prevalence was 0.42% (91/21870) and HCV prevalence was 0.26% (20/7659). Of the women with HBV, 65.7% (44/67) were migrants. The HBV transmission route to the mother was unknown in 40.3% of cases (27/67) and VT in 31.3% (21/67). Among risk factors for VT, 67.7% (42/62) of the women had viraemia and 14.5% (9/62) tested HBeAg-positive. All of the neonates born to HBV-positive mothers received immunoprophylaxis, and none contracted infection by VT. In 80% (16/20) of the women with HCV, the transmission route was parenteral, and nine were intravenous drug users. Viraemia was present in 40% (8/20) of the women and 10% (2/20) were HIV-coinfected. No children were infected. Women with HCV were less likely than women with HBV to breastfeed their child (65% vs. 86%). Conclusions The prevalences obtained in our study of pregnant women are lower than those previously documented for the general population. Among the women with HBV, the majority were migrants and had a maternal family history of infection, while among those with HCV, the most common factor was intravenous drug use. Despite the risk factors observed for VT, none of the children were infected. Proper immunoprophylaxis is essential to prevent VT in children born to HBV-positive women.
Collapse
Affiliation(s)
- Ángeles Ruiz-Extremera
- Hospital Universitario San Cecilio, Granada, Spain
- CIBER de Enfermedades Hepáticas y Digestivas (CIBEREHD), CIBER, Madrid, Spain
- Universidad de Granada, Granada, Spain
- Instituto de Investigación Biosanitaria Ibs.GRANADA, Granada, Spain
| | | | | | | | | | | | | | | | | | | | - Clara Alonso-Diaz
- Hospital Universitario Doce de Octubre, Madrid, Spain
- RED SAMID (ISCIII ref. RD/16/0022), Spain
| | | | | | | | | | - Josefa Aguayo
- Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | | | | | | | | | - Paloma Muñoz de Rueda
- Hospital Universitario San Cecilio, Granada, Spain
- CIBER de Enfermedades Hepáticas y Digestivas (CIBEREHD), CIBER, Madrid, Spain
- Instituto de Investigación Biosanitaria Ibs.GRANADA, Granada, Spain
| | - Manuela Expósito-Ruiz
- Instituto de Investigación Biosanitaria Ibs.GRANADA, Granada, Spain
- Unidad de Apoyo a la Investigación, Hospital Universitario Virgen de las Nieves, Granada, Spain
- Fundación para la Investigación Biosanitaria de Andalucía Oriental (FIBAO), Granada, Spain
| | - Federico García
- Hospital Universitario San Cecilio, Granada, Spain
- Instituto de Investigación Biosanitaria Ibs.GRANADA, Granada, Spain
- RED de SIDA (ISCIII ref. RD/16/0025/0040), Spain
| | - Fernando García
- Hospital Universitario San Cecilio, Granada, Spain
- Instituto de Investigación Biosanitaria Ibs.GRANADA, Granada, Spain
- RED de SIDA (ISCIII ref. RD/16/0025/0040), Spain
| | - Javier Salmerón
- Hospital Universitario San Cecilio, Granada, Spain
- CIBER de Enfermedades Hepáticas y Digestivas (CIBEREHD), CIBER, Madrid, Spain
- Universidad de Granada, Granada, Spain
- Instituto de Investigación Biosanitaria Ibs.GRANADA, Granada, Spain
| |
Collapse
|