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Balbinot P, Pellicano R, Patussi V, Caputo F, Testino G. Alcohol use disorders, self-help groups as a supplement to pharmacological and psychological therapy? A retrospective study in a population with alcohol related liver disease. Minerva Gastroenterol (Torino) 2023; 69:479-485. [PMID: 36255286 DOI: 10.23736/s2724-5985.22.03292-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
BACKGROUND According to the new criteria in the Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-V), the prevalence of alcohol use disorders (AUDs) is 20-30% in men and 10-15% in women worldwide.2,3 The anticraving therapy/psychotherapy combination is currently used routinely in clinical practice. However, the results after one year are unsatisfactory. Meta-analytic studies found failure rates of 57 to 75%. These percentages vary in relation to the intensity and length of the treatment. In addition, the abstinence rates gradually decrease over time. In this study, the clinical outcome of alcohol related liver disease (ALD) patients who spontaneously attended self-help groups (SHGs) (club of alcoholics in treatment - multi-family community/ alcoholics anonymous) regularly versus those who did not want to start the path or did not complete it was evaluated. METHODS From January 2005 to December 2010, 1337 alcohol use disorder patients affected by compensated alcohol related liver disease, were prospectively followed and retrospectively assessed. Two hundred thirty-one patients were enrolled: 74 attended self-help groups assiduously, 27 attended sporadically and 130 refused participation in SHGs. RESULTS Constant attendance at SHGs compared to non-attendance allows for a significant increase (<0.0001) in the period of sobriety found in the median of distribution. Frequent attendance at SHGs is effectively "preventive," reducing the fraction of relapses by about 30%. The percentage of cases of cirrhosis is significantly different (P=0.0007) between those who have regularly attended SHG meetings (about 1% of patients) and those who have never attended or only occasionally (various percentages between 21 and 31% of patients); in both groups the incidence of new cases would seem to be 0.014 cases/ year. Similar difference in percentages regarding the onset of hepatocellular carcinomas (HCCs), although with a lower level of significance (P=0.017) among those who attended regularly, 4% of patients with an incidence of 0.006 cases/ year, compared to those who have never attended or only occasionally: over 14% of patients with an incidence of 0.022 cases/year. CONCLUSIONS This study suggests the importance of attending SHGs not only for the long-term achievement of alcoholic abstention, but also in positively influencing the course of alcohol-related diseases.
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Affiliation(s)
- Patrizia Balbinot
- Unit of Addiction and Hepatology, Alcohological Regional Center, IRCCS San Martino University Hospital, ASL3 Liguria, Genoa, Italy
- Mutual-Self-Help Study Center, Community Programs and Caregiver Training, ASL3 Liguria, Genoa, Italy
| | - Rinaldo Pellicano
- Unit of Gastroenterology, Molinette Hospital, Città della Salute e della Scienza, Turin, Italy -
| | | | - Fabio Caputo
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
- Department of Translational Medicine, Center for the Study and Treatment of Alcohol-Related Diseases, University of Ferrara, Ferrara, Italy
- Department of Internal Medicine, Santissima Annunziata Hospital, University of Ferrara, Ferrara, Italy
| | - Gianni Testino
- Unit of Addiction and Hepatology, Alcohological Regional Center, IRCCS San Martino University Hospital, ASL3 Liguria, Genoa, Italy
- Mutual-Self-Help Study Center, Community Programs and Caregiver Training, ASL3 Liguria, Genoa, Italy
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Narayanamurthy V, Jeroish ZE, Bhuvaneshwari KS, Samsuri F. Hepatitis C virus (HCV) diagnosis via microfluidics. ANALYTICAL METHODS : ADVANCING METHODS AND APPLICATIONS 2021; 13:740-763. [PMID: 33511975 DOI: 10.1039/d0ay02045a] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Humans are subjected to various diseases; hence, proper diagnosis helps avoid further disease consequences. One such severe issue that could cause significant damage to the human liver is the hepatitis C virus (HCV). Several techniques are available to detect HCV under various categories, such as detection through antibodies, antigens, and RNA. Although immunoassays play a significant role in discovering hepatitis viruses, there is a need for point-of-care tests (POCT). Some developing strategies are required to ensure the appropriate selection of POCT for HCV detection, initiate appropriate antiviral therapy, and define associated risks, which will be critical in achieving optimal outcomes. Though molecular assays are precise, reproducible, sensitive, and specific, alternative strategies are required to enhance HCV diagnosis among the infected population. Herein, we described and assessed the potential of various microfluidic detection techniques and confirmatory approaches used in present communities. In addition, current key market players in HCV chip-based diagnosis and the future perspectives on the basis of which the diagnosis can be made easier are presented in the present review.
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Affiliation(s)
- Vigneswaran Narayanamurthy
- Fakulti Teknologi Kejuruteraan Elektrik dan Elektronik, Universiti Teknikal Malaysia Melaka, Hang Tuah Jaya, 76100 Durian Tunggal, Melaka, Malaysia.
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Odari EO, Budambula NLM, Nitschko H. Evaluation of an antigen-antibody "combination" enzyme linked immunosorbent assay for diagnosis of hepatitis C virus infections. Ethiop J Health Sci 2015; 24:343-52. [PMID: 25489199 PMCID: PMC4248034 DOI: 10.4314/ejhs.v24i4.10] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Background Development of “combination” assays detecting in parallel, within a single test, Hepatitis C Virus (HCV) antigens and antibodies, not only reduces the window period in HCV-infection but also costs. Reduction of costs is important for developing countries where money and personal resources are limited. Methods We compared the Monolisa® HCV Antigen-Antibody Ultra (Bio-Rad Laboratories Limited, Marnes La Coquette, France) with the AXSYM HCV version 3.0 (Abbot Diagnostics, Germany)-the latter assay detecting only antibodies to HCV. Seventy three HCV-PCR positive and negative samples were tested. Results Although the two assays showed comparable results, two samples from a bone marrow transplant (BMT) patient of viral loads 7.8 × 105 and 8.9 × 106 IU/mL could not be detected by the Monolisa® HCV Antigen-Antibody Ultra assay. Failure to detect the two samples with viral loads considered above threshold of detection for antigen proteins suggested a lack of sensitivity by this assay to discover viral capsid protein in patient samples. Genotyping of these samples revealed genotype 1b, a HCV-subtype which is widespread and should thus be easily detected. Conclusion We conclude that although this assay depicts high sensitivity and specificity in detecting antibodies to HCV, it seems not to add further benefit in our study population to detect HCV infections by enhanced sensitivity due the potential contingency to trace viral capsid antigens.
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Affiliation(s)
- E O Odari
- Max von Pettenkofer Institute for Hygiene and Medical Microbiology - LMU, Munich, Germany ; Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | - N L M Budambula
- Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | - H Nitschko
- Max von Pettenkofer Institute for Hygiene and Medical Microbiology - LMU, Munich, Germany
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Heiat M, Ranjbar R, Alavian SM. Classical and modern approaches used for viral hepatitis diagnosis. HEPATITIS MONTHLY 2014; 14:e17632. [PMID: 24829586 PMCID: PMC4006100 DOI: 10.5812/hepatmon.17632] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Accepted: 01/28/2014] [Indexed: 12/11/2022]
Abstract
CONTEXT Viral hepatitis diagnosis is an important issue in the treatment procedure of this infection. Late diagnosis and delayed treatment of viral hepatitis infections can lead to irreversible liver damages and occurrence of liver cirrhosis and hepatocellular carcinoma. A variety of laboratory methods including old and new technologies are being applied to detect hepatitis viruses. Here we have tried to review, categorize, compare and illustrate the classical and modern approaches used for diagnosis of viral hepatitis. EVIDENCE ACQUISITION In order to achieve a comprehensive aspect in viral hepatitis detection methods, an extensive search using related keywords was done in major medical library and data were collected, categorized and summarized in different sections. RESULTS Analyzing of collected data resulted in the wrapping up the hepatitis virus detection methods in separate sections including 1) immunological methods such as enzyme immunoassay (EIA), radio-immunoassay (RIA) immuno-chromatographic assay (ICA), and immuno-chemiluminescence 2) molecular approaches including non-amplification and amplification based methods, and finally 3) advanced biosensors such as mass-sensitive, electrical, electrochemical and optical based biosensors and also new generation of detection methods. CONCLUSIONS Detection procedures in the clinical laboratories possess a large diversity; each has their individual advantages and facilities' differences.
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Affiliation(s)
- Mohammad Heiat
- Molecular Biology Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Reza Ranjbar
- Molecular Biology Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
- Corresponding Author: Reza Ranjbar, Molecular Biology Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran, Tel: +98-2182482556, Fax: +98-2188039883, E-mail:
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Tagny CT, Mbanya D, Murphy EL, Lefrère JJ, Laperche S. Screening for hepatitis C virus infection in a high prevalence country by an antigen/antibody combination assay versus a rapid test. J Virol Methods 2014; 199:119-23. [PMID: 24487098 DOI: 10.1016/j.jviromet.2014.01.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Revised: 12/20/2013] [Accepted: 01/03/2014] [Indexed: 12/17/2022]
Abstract
In low-income-countries, screening for hepatitis C virus (HCV) infection is often based on rapid tests (RT). Their lower sensitivity compared to enzyme immunoassay (EIA) suggests that newer HCV Antigen/Antibody (Ag/Ab) combination assays might have a role in such countries. To test this idea, 1998 blood donors were tested at the University Teaching Hospital blood bank in Yaoundé, Cameroon simultaneously with a RT (HCV rapid test, Human Diagnostics, Berlin, Germany) according to standard practice (S1) and with an Ag/Ab assay (Monolisa HCV Ag/Ab Ultra, Biorad, France) (S2). All discordant, borderline and reactive samples were submitted to confirmatory testing by immunoblot and/or HCV-RNA. Of the 86 (4.3%) samples positive with one or both strategies, 29 were confirmed negative, 37 positive and 20 were false positive or resolved infection. There was a significant difference in test sensitivity (p=0.01) between S1 (70.3%) and S2 (91.9%) but not in test specificity (99.4% and 98.6%, respectively). The benefit of the Ag/Ab assay in the detection of recent HCV seronegative infections could not be evaluated since no Antigen-only donations were identified. However, better Ag/Ab test sensitivity compared to RT supports the implementation of these newer immunoassays for HCV screening in the African blood bank setting.
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Affiliation(s)
- Claude Tayou Tagny
- University Hospital Center, Haematology and Blood Bank Service, Yaoundé, Cameroon; Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Cameroon
| | - Dora Mbanya
- University Hospital Center, Haematology and Blood Bank Service, Yaoundé, Cameroon; Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Cameroon
| | - Edward L Murphy
- University of California, San Francisco, and Blood Systems Research Institute, San Francisco, USA
| | - Jean-Jacques Lefrère
- Department for the Study of Blood-borne Agents, Institut National de la Transfusion Sanguine, Paris, France
| | - Syria Laperche
- Department for the Study of Blood-borne Agents, Institut National de la Transfusion Sanguine, Paris, France; National Reference Center for HBV, HCV, HIV in Transfusion, Institut National de la Transfusion Sanguine, Paris, France.
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Ottiger C, Gygli N, Huber AR. Detection limit of architect hepatitis C core antigen assay in correlation with HCV RNA, and renewed confirmation algorithm for reactive anti-HCV samples. J Clin Virol 2013; 58:535-40. [PMID: 24041472 DOI: 10.1016/j.jcv.2013.08.028] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2013] [Revised: 08/07/2013] [Accepted: 08/26/2013] [Indexed: 12/21/2022]
Abstract
BACKGROUND hepatitis C infections are detected by anti-HCV screening tests. Reactive anti-HCV results give no information about the presence or absence of hepatitis C viruses, or of unspecific reactivity. To obtain information about the viral load, HCV RNA measurements, following a reactive anti-HCV result, are performed in well equipped and specialised laboratories. Anti-HCV immunoblots are the only means to exclude non specific reactivity. The measurement of HCV core antigen (HCV-Ag), as an alternative to HCV RNA, is discussed, as it can be analysed on the same instrument as anti-HCV. OBJECTIVES The detection limit of HCV-Ag is crucial to use it in lieu of HCV RNA, in regard of the different genotypes. A renewed algorithm is proposed to exclude unspecific reactivity of anti-HCV. STUDY DESIGNS Samples were tested on Architect i2000SR (Abbott) for anti-HCV and HCV-Ag. HCV RNA measurements were obtained by Cobas Ampliprep/Taqman (Roche) or m2000rt(®) (Abbott). RESULTS AND CONCLUSIONS Comparison between HCV-Ag and HCV RNA from 126 samples of 101 patients with chronic hepatitis C gave linear regression R(2) 0.89, slope 0.885 and intercept -2.258, which were independent of the genotypes. The detection limit of HCV-Ag was between 2.4 and 4.5 Log(10)IU/mL. A renewed algorithm for confirmation of reactive anti-HCV results is proposed: active or resolved hepatitis C infections or false reactivity can be differentiated by sequenced reflex testing due to HCV-Ag, anti-HCV immunoblot and HCV RNA.
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Affiliation(s)
- Cornelia Ottiger
- Cantonal Hospital of Aarau, Department of Laboratory Medicine, CH-5001 Aarau, Switzerland.
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Alghamdi AS, Sanai FM, Ismail M, Alghamdi H, Alswat K, Alqutub A, Altraif I, Shah H, Alfaleh FZ. SASLT practice guidelines: management of hepatitis C virus infection. Saudi J Gastroenterol 2012; 18 Suppl:S1-32. [PMID: 23006491 PMCID: PMC3713589 DOI: 10.4103/1319-3767.101155] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Affiliation(s)
- Abdullah S. Alghamdi
- Department of Medicine, Gastroenterology Unit, King Fahad General Hospital, Jeddah, Saudi Arabia,Address for correspondence: Dr. Abdullah Saeed Alghamdi, Department of Medicine, King Fahad General Hospital, PO BOX 50505 (450), Jeddah, Saudi Arabia. E-mail:
| | - Faisal M. Sanai
- Hepatobiliary Sciences and Liver Transplantation, King Abdulaziz Medical City, and King Saud Bin Abdulaziz University for Health Sciences, National Guard Health Affairs,Liver Disease Research Center, National Plan for Science and Technology, King Saud University, Riyadh, Saudi Arabia
| | - Mona Ismail
- Department of Medicine, Division of Gastroenterology, King Fahad Hospital of the University, College of Medicine, University of Dammam, Dammam, Saudi Arabia
| | - Hamdan Alghamdi
- Hepatobiliary Sciences and Liver Transplantation, King Abdulaziz Medical City, and King Saud Bin Abdulaziz University for Health Sciences, National Guard Health Affairs
| | - Khalid Alswat
- Liver Disease Research Center, National Plan for Science and Technology, King Saud University, Riyadh, Saudi Arabia,Department of Medicine, Gastroenterology unit, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Adel Alqutub
- Department of Medicine, Gastroenterology Unit, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Ibrahim Altraif
- Hepatobiliary Sciences and Liver Transplantation, King Abdulaziz Medical City, and King Saud Bin Abdulaziz University for Health Sciences, National Guard Health Affairs
| | - Hemant Shah
- Division of Gastroenterology, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Faleh Z. Alfaleh
- Liver Disease Research Center, National Plan for Science and Technology, King Saud University, Riyadh, Saudi Arabia,Department of Medicine, Gastroenterology unit, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Shi H, Xie L, Shi H, Yan L, Duan Z. Characterization and application of monoclonal antibody against hepatitis C virus nonstructual protein three. Hybridoma (Larchmt) 2012; 31:54-9. [PMID: 22316486 DOI: 10.1089/hyb.2011.0076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Developing assays for detecting HCV antigens could be beneficial because viral proteins appear earlier than antibodies and are more stable than RNA in the serum. Monoclonal antibody was prepared by immunization and cell fusion. Subclass, specificity, and efficiency of monoclonal antibodies were determined by ELISA. Epitope specificity of monoclonal antibodies was analyzed by ELISA additivity test. HCV antigen in serum of hepatitis patients was examined by double monoclonal antibody sandwich ELISA. Five hybridoma cell lines were screened and named HCV(1), HCV(2), HCV(3), HCV(4), and HCV(5). These five monoclonal antibodies had high specificity and efficiency. The additivity test showed that HCV(2), HCV(4), and HCV(5) recognized different epitopes, which can be matched in ELISA. Of 173 anti-HCV positive patients, 37 (21.4%) were positive for HCV antigen. Of 1498 anti-HCV negative patients, 10 (0.67%) were positive for HCV antigen. Fifty normal controls were negative for HCV antigen. HCV antigen detection had moderate agreement and correlation with HCV RNA detection (kappa=0.577, p<0.01; r=0.59, p<0.01). This result indicates that the monoclonal antibody against HCV NS(3) may be a potential diagnostic reagent, which would provide a foundation for developing a sandwich ELISA of HCV antigen detection.
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Affiliation(s)
- Hongbo Shi
- Beijing Artificial Liver Treatment and Training Centre, Beijing Youan Hospital, Affiliated Hospital of Capital Medical University, Beijing, China
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Hosseini-Moghaddam SM, Iran-Pour E, Rotstein C, Husain S, Lilly L, Renner E, Mazzulli T. Hepatitis C core Ag and its clinical applicability: Potential advantages and disadvantages for diagnosis and follow-up? Rev Med Virol 2011; 22:156-65. [DOI: 10.1002/rmv.717] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2011] [Revised: 09/18/2011] [Accepted: 09/19/2011] [Indexed: 12/20/2022]
Affiliation(s)
- SM Hosseini-Moghaddam
- Division of Infectious Diseases; University of Toronto, University Health Network, Transplant Infectious Diseases, Toronto General Hospital; Toronto ON Canada
- Urology and Nephrology Research Center (UNRC); Shahid Beheshti University of Medical Sciences; Tehran IR Iran
| | - E. Iran-Pour
- Islamic Azad University; Tehran Medical Branch; Tehran IR Iran
| | - C. Rotstein
- Division of Infectious Diseases; University of Toronto, University Health Network, Transplant Infectious Diseases, Toronto General Hospital; Toronto ON Canada
| | - S. Husain
- Division of Infectious Diseases; University of Toronto, University Health Network, Transplant Infectious Diseases, Toronto General Hospital; Toronto ON Canada
| | - L. Lilly
- Hepatology; University of Toronto, University Health Network, Transplant Hepatology, Toronto General Hospital; Toronto ON Canada
| | - E. Renner
- Hepatology; University of Toronto, University Health Network, Transplant Hepatology, Toronto General Hospital; Toronto ON Canada
| | - T. Mazzulli
- Virology, Department of Microbiology; University of Toronto, University Health Network, Mount Sinai Hospital; Toronto ON Canada
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Comparison of monolisa HCV Ag/Ab ULTRA with two anti-HCV assays for the detection of HCV infection in hospital setting. Curr Microbiol 2011; 64:148-51. [PMID: 22076114 DOI: 10.1007/s00284-011-0046-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2011] [Accepted: 10/17/2011] [Indexed: 10/15/2022]
Abstract
In this study, we compared the performance of three serological assays (Monolisa HCV Ag/Ab ULTRA, Innotest HCV Ab IV enzyme immunoassay--EIA, and Ortho HCV 3.0 enzyme-linked immunosorbent assay--ELISA) for the detection of HCV infection. Ninety plasma samples were collected, representing 63 samples from groups at risk for acquiring HCV infection and 27 HCV RNA-positive samples. The results of Ortho HCV 3.0 ELISA, Innotest HCV Ab IV, and Monolisa HCV Ag/Ab ULTRA were fully concordant for 27 HCV RNA-positive samples. Ortho HCV 3.0 ELISA test and Innotest HCV Ab IV also gave the same results for risk groups, while three samples were found to be reactive by Monolisa HCV Ag/Ab ULTRA and were consequently found negative for HCV RNA. As two of the solely Monolisa HCV Ag/Ab ULTRA-positive samples were also hepatitis B s antigen (HBsAg)-positive, neutralization of HBsAg was performed but no arguments for the HBsAg interference were observed. In conclusion, the non-specific reactive signal was observed, in three samples using Monolisa HCV Ag/Ab ULTRA, to be negative by other serological assays, and observed to be negative in an HCV RNA assessment, a result that could not be attributed to the interference with HBsAg. In the context of diagnostic testing, no test for various HCV genotypes was observed to be superior to any other.
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11
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Yang JF, Lin YY, Hsieh MH, Tsai CH, Liu SF, Yu ML, Dai CY, Huang JF, Lin WY, Lin ZY, Chen SC, Chuang WL. Performance characteristics of a combined hepatitis C virus core antigen and anti-hepatitis C virus antibody test in different patient groups. Kaohsiung J Med Sci 2011; 27:258-63. [PMID: 21757142 DOI: 10.1016/j.kjms.2010.11.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2010] [Accepted: 11/29/2010] [Indexed: 10/18/2022] Open
Abstract
We evaluated the performance of a hepatitis C virus (HCV) antigen/antibody combination test [Murex HCV Antigen/Antibody Combination Test (Murex Ag/Ab test)] by comparing it with the current third-generation HCV antibody enzyme immunoassay (anti-HCV). A total of 403 serum samples were consecutively collected from four patient groups: healthy controls (n=100); HCV-infected patients (HCV group, n=102); Human immunodeficiency virus (HIV)/HCV-infected patients (HIV/HCV group, n=100); and patients with uremia (uremia group, n=101). Performances were evaluated for the Murex Ag/Ab, anti-HCV, and HCV RNA in the HIV/HCV and uremia patient groups. In the HCV group, all 102 samples showed concordant positive and negative results for anti-HCV, Murex Ag/Ab, and HCV RNA tests. In the HIV/HCV group, all 100 samples were positive for both anti-HCV and Murex Ag/Ab tests, whereas 88 patients (88%) were HCV RNA positive. In the uremia group, 14 (69.0%) of the 23 anti-HCV-positive patients were HCV RNA positive, whereas 14 (77.8%) of the 18 Murex Ag/Ab-positive patients were HCV RNA positive. None of anti-HCV-negative or Murex Ag/Ab-negative patients were HCV RNA positive. Based on the HCV RNA assay, the sensitivities for both anti-HCV and Murex Ag/Ab assays were 100%, whereas the specificities of these two assays were 89.7% and 95.4%, respectively. With good sensitivity and specificity, the Murex Ag/Ab assay could be a useful alternative diagnostic tool, especially in immunocompromised populations, such as patients with uremia or those infected with HIV.
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Affiliation(s)
- Jeng-Fu Yang
- Department of Preventive Medicine, Kaohsiung Medical University Hospital, Taiwan.
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Tagny CT, Mbanya D, Leballais L, Murphy E, Lefrère JJ, Laperche S. Reduction of the risk of transfusion-transmitted human immunodeficiency virus (HIV) infection by using an HIV antigen/antibody combination assay in blood donation screening in Cameroon. Transfusion 2011; 51:184-90. [DOI: 10.1111/j.1537-2995.2010.02782.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Vermeersch P, Van Ranst M, Lagrou K. Evaluation of the use of a combined HCV antigen/antibody assay in routine laboratory practice. Acta Clin Belg 2010; 65:245-7. [PMID: 20954463 DOI: 10.1179/acb.2010.053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
BACKGROUND Combined hepatitis C virus (HCV) antigen/antibody (Ag/Ab) assays offer the advantage of a shorter window phase compared to traditional anti-HCV antibody assays. These assays have been extensively evaluated for the screening of healthy blood donors, but not in routine laboratory practice. METHODS We evaluated the performance of the combined HCV Ag/Ab assay Monolisa Ultra and compared it to Monolisa anti-HCV Plus (which only detects anti-HCV antibodies) in 61 HCV RNA-positive patients (genotypes 1 to 5) and in 276 consecutive AxSYM HCV-reactive patients. Discordant sera were tested with immunoblot and PCR. RESULTS All 61 PCR-positive sera were positive with AxSYM, Monolisa Ultra, and Monolisa Plus. Of the 276 consecutive AxSYM-reactive patients, 177 were confirmed as HCV-positive, 78 were HCV-negative and 21 were HCV-indeterminate. There were 4 false-positive results with Monolisa Ultra compared to 1 false-positive result with Monolisa PLus. The signal/cut-off ratio in immunoblot-negative sera was significantly higher with HCV Ultra compared to HCV Plus (p < 0.01). Sensitivity and specificity in AxSYM-reactive sera were 99.4% and 94.9% for Monolisa Ultra and 99.4% and 98.7% for Monolisa Plus. CONCLUSION When used as a secondary test, the sensitivity of the combined HCV Ag/Ab assay Monolisa Ultra was excellent, but specificity was reduced in AxSYM-reactive sera compared to Monolisa Plus.
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Affiliation(s)
- P Vermeersch
- Laboratoriumgeneeskunde, Universitaire Ziekenhuizen Leuven, Leuven, België
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Humar A, Morris M, Blumberg E, Freeman R, Preiksaitis J, Kiberd B, Schweitzer E, Ganz S, Caliendo A, Orlowski JP, Wilson B, Kotton C, Michaels M, Kleinman S, Geier S, Murphy B, Green M, Levi M, Knoll G, Segev DL, Brubaker S, Hasz R, Lebovitz DJ, Mulligan D, O'Connor K, Pruett T, Mozes M, Lee I, Delmonico F, Fischer S. Nucleic acid testing (NAT) of organ donors: is the 'best' test the right test? A consensus conference report. Am J Transplant 2010; 10:889-899. [PMID: 20121734 DOI: 10.1111/j.1600-6143.2009.02992.x] [Citation(s) in RCA: 129] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Nucleic acid testing (NAT) for HIV, HBV and HCV shortens the time between infection and detection by available testing. A group of experts was selected to develop recommendations for the use of NAT in the HIV/HBV/HCV screening of potential organ donors. The rapid turnaround times needed for donor testing and the risk of death while awaiting transplantation make organ donor screening different from screening blood-or tissue donors. In donors with no identified risk factors, there is insufficient evidence to recommend routine NAT, as the benefits of NAT may not outweigh the disadvantages of NAT especially when false-positive results can lead to loss of donor organs. For donors with identified behavioral risk factors, NAT should be considered to reduce the risk of transmission and increase organ utilization. Informed consent balancing the risks of donor-derived infection against the risk of remaining on the waiting list should be obtained at the time of candidate listing and again at the time of organ offer. In conclusion, there is insufficient evidence to recommend universal prospective screening of organ donors for HIV, HCV and HBV using current NAT platforms. Further study of viral screening modalities may reduce disease transmission risk without excessive donor loss.
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Affiliation(s)
- A Humar
- Transplant Infectious Diseases, University of Alberta
| | - M Morris
- Infectious Diseases, University of Miami Miller School of Medicine
| | - E Blumberg
- Infectious Diseases, University of Pennsylvania
| | | | - J Preiksaitis
- Transplant Infectious Diseases, University of Alberta
| | - B Kiberd
- Queen Elizabeth II Health Sciences Centre, Nephrology
| | | | - S Ganz
- University of Miami Miller School of Medicine
| | - A Caliendo
- Emory University School of Medicine, Pathology and Lab Medicine
| | | | - B Wilson
- Association of Organ Procurement Organizations
| | - C Kotton
- Infectious Diseases, Massachusetts General Hospital
| | - M Michaels
- Pediatric Infectious Diseases, Children's Hospital of Pittsburgh
| | | | | | | | - M Green
- University of Pittsburgh School of Medicine
| | - M Levi
- University of Colorado Denver
| | | | | | | | - R Hasz
- Association of Organ Procurement Organizations (AOPO)
| | | | | | - K O'Connor
- Association of Organ Procurement Organizations (AOPO)
| | - T Pruett
- University of Virginia Health System
| | - M Mozes
- Gift of Hope Organ and Tissue Donor Network
| | - I Lee
- Infectious Diseases, University of Pennsylvania
| | | | - S Fischer
- The Warren Alpert Medical School of Brown University and Rhode Island Hospital Joint consensus recommendations endorsed by: American Society of Transplantation (AST), Canadian Society of Transplantation (CST), American Society of Transplant Surgeons (ASTS). With additional sponsorship by: United Network for Organ Sharing (UNOS), American Association of Tissue Banks (AATB), Association of Organ Procurement Organizations (AOPO)
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15
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Abstract
HCV infection is usually diagnosed by means of an enzyme immune assay for the detection of antibody against HCV. The window period between infection and seroconversion remains a dramatic problem in the transfusional and diagnostic setting. In this chapter, we report (i) procedures for assays using two different approaches designed to reduce the window period and (ii) performance in terms of specificity and sensitivity in the detection of both antibody and antigen, and we compare their efficacy with that of commercial assays.
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Affiliation(s)
- Filippo Ansaldi
- Department of Health Sciences, University of Genoa, Genoa, Italy
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16
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Alzahrani AJ. Simultaneous detection of hepatitis C virus core antigen and antibodies in Saudi drug users using a novel assay. J Med Virol 2008; 80:603-6. [PMID: 18297713 DOI: 10.1002/jmv.21075] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Drug users and particularly, injecting drug users, are at increased risk for infection with hepatitis C virus (HCV). The aims of the study were to simultaneously detect HCV core antigen and specific antibodies in sera from Saudi drug users using the new HCV combination assay and to compare this data with HCV core antigen, anti-HCV antibodies and HCV RNA data from the same patients. A total of 297 patients who are followed up or admitted to a drug rehabilitation hospital over a period of 3 years were included in this study. Samples were analyzed using the new HCV Ag/Ab combination assay (Meurex), HCV core Ag assay, HCV antibodies and with the HCV RNA assay. Out of the 297 samples from Saudi drug users, 111 samples (37.4%) have detectable HCV core Ag, 112 samples (37.7%) have detectable HCV antibodies, 118 have detectable HCV RNA, and 116 samples were positive by the HCV Ag/Ab combination assay (39.1%). Out of the 116 samples, HCV core Ag was detected in 110 samples (94.8%), HCV antibodies were detected in 111 (95.7%) samples and HCV RNA was detected in 114 samples (98.3%). In the control group (n = 305), only 2 (0.66%) blood donor were positive by HCV antibodies assay, HCV RNA assay as well as HCV Ag/Ab combination assay. The new HCV Ag/Ab combination assay may well improve the overall quality of diagnosis of HCV infection especially in high risk population such as drug users that necessitates rigorous testing.
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Affiliation(s)
- Alhusain J Alzahrani
- Department of Microbiology, College of Medicine, King Faisal University, Dammam, Saudi Arabia.
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17
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Alados-Arboledas JC, Calbo-Torrecillas L, López-Prieto MD, de Francisco-Ramírez JL, de Miguel-Sastre C. [Clinical assessment of Monolisa HCV Ag-Ab ULTRA (Bio-Rad) in a general hospital]. Enferm Infecc Microbiol Clin 2007; 25:172-6. [PMID: 17335695 DOI: 10.1157/13099368] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
INTRODUCTION To evaluate a new test based on simultaneous detection of HCV antibodies and antigen (Monolisa HCV Ag/Ab ULTRA; Bio-Rad, Marnes la Coquette, France). METHODS We studied samples from two groups of patients and 7 commercial HCV seroconversion panels (75 samples). Group 1: 1360 serum samples from patients referred for routine testing of anti HCV antibodies. Group 2: 333 serum samples from 183 hemodialysis patients. All samples were tested by the Ortho HCV 3.0 technique (Ortho-Clinical Diagnostics, Amersham, UK) and the Monolisa HCV Ag-Ab ULTRA technique. RESULTS Group 1: Seventy-four of 1360 serum samples were positive by Ortho HCV and 77 by Monolisa. In 1353 samples, the results with the two tests were concordant: 1281 negative and 72 positive. Five samples were positive only by Monolisa and 2 only by Ortho (overall agreement: 99.5%). Group 2: Results were concordant in 325 samples, 308 negative and 17 positive. Seven samples were positive by Monolisa and negative by Ortho. The sensitivity of the Monolisa test in hemodialysis patients was clearly higher than that of the Ortho test (100% and 70.8%, respectively). Monolisa detected HCV infection in 43 of 75 samples from the seroconversion panels; only 18 positive samples were detected by Ortho HCV. Monolisa reduced the window period by up to 72 days. CONCLUSIONS Our data indicate high agreement between the Monolisa and Ortho tests in samples from the general population. In hemodialysis patients, however, Monolisa was more sensitive. In addition, the Monolisa test significantly reduced the window period of HCV infection.
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18
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Clinical application and analysis of hepatitis C virus NS3 antigen detection by ELISA in human serum. Chin Med J (Engl) 2007. [DOI: 10.1097/00029330-200702020-00008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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19
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Dawson GJ. HCV core antigen and combination (antigen/antibody) assays for the detection of early seroconversion. J Med Virol 2007. [DOI: 10.1002/jmv.20969] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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20
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Xu R, Gan X, Fang Y, Zheng S, Dong Q. A simple, rapid, and sensitive integrated protein microarray for simultaneous detection of multiple antigens and antibodies of five human hepatitis viruses (HBV, HCV, HDV, HEV, and HGV). Anal Biochem 2006; 362:69-75. [PMID: 17239337 DOI: 10.1016/j.ab.2006.12.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2006] [Revised: 12/03/2006] [Accepted: 12/05/2006] [Indexed: 10/23/2022]
Abstract
Protein microarrays for parallel detection of multiple viral antigens and antibodies have not yet been described in the field of human hepatitis virus infections. Here, we describe a simple, rapid and sensitive integrated protein microarray with three different reaction models. The integrated protein microarray could simultaneously determine in human sera two viral antigens (HBsAg, HBeAg) and seven viral antibodies (HBsAb, HBcAb, HBeAb, HCVAb, HDVAb, HEVAb, HGVAb) of human hepatitis viruses within 20 min. The results of the protein microarray were assessed directly by the naked eye but can also be analyzed by a quantitative detector. The detection limit of this protein microarray was 0.1 ng/ml for HBsAg. Overall, >85% concordance was observed between the integrated protein microarrays and an enzyme-linked immunosorbent assay for above hepatitis viral antigen and antibody detections in human sera. This integrated protein microarray can be easily optimized for clinical use and epidemiological screening for multiple hepatitis virus infections.
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Affiliation(s)
- Rongzhen Xu
- Second Affiliated Hospital, Cancer Institute, School of Medicine, Zhejiang University, Hangzhou 310009, China.
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21
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Schnuriger A, Dominguez S, Valantin MA, Tubiana R, Duvivier C, Ghosn J, Simon A, Katlama C, Thibault V. Intérêt d'un nouveau test combiné antigène–anticorps pour le dépistage de l'infection par le virus de l'hépatite C : réduction de la fenêtre sérologique au cours de l'hépatite C aiguë chez le sujet co-infecté par le VIH. ACTA ACUST UNITED AC 2006; 54:578-86. [PMID: 17030457 DOI: 10.1016/j.patbio.2006.07.046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2006] [Accepted: 07/27/2006] [Indexed: 11/17/2022]
Abstract
BACKGROUND The aim of this study was to determine the clinical benefit of a new combined antigen-antibody immunoenzymatic assay (Monolisa HCV Ag-Ab Ultra, Biorad) in the setting of acute HCV infection in HIV infected patients. PATIENTS AND METHODS The performance of this assay was first evaluated in 160 HIV positive samples from uninfected and chronically HCV infected patients. To assess the performance of the Ag-Ab assay in the context of acute hepatitis C, 94 stored frozen serums from 20 recently diagnosed cases were retrospectively tested for HCV-RNA and presence of anti-HCV antibodies, in parallel with the new assay. RESULTS In HIV infected patients, the sensitivity and specificity of the Ultra assay was 100% with a strong discrimination between positive and negative samples. In HCV acutely infected patients, the Ag-Ab assay significantly reduced the seronegative period, allowing an earlier diagnosis compared to a 3rd generation ELISA in 65% of the cases. The combined assay became positive on the same bleed as the first HCV-RNA detection for 13 patients out of 20. Nevertheless, in one case, characterized by an absence of seroconversion over one year but a continuous viral replication above 1 million IU/ml, the combined assay did not improve HCV infection diagnosis. CONCLUSION Use of this new assay as a first line screening would significantly reduce the long seronegative window period seen in HCV infection allowing earlier HCV diagnosis and rapid clinical management. However, in case of clinical acute hepatitis C, sensitive HCV-RNA detection should remain the gold standard.
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Affiliation(s)
- A Schnuriger
- Service de virologie, groupe hospitalier Pitié-Salpêtrière, 83, boulevard de l'Hôpital, 75651 Paris cedex 13, France
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22
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Schnuriger A, Dominguez S, Valantin MA, Tubiana R, Duvivier C, Ghosn J, Simon A, Katlama C, Thibault V. Early detection of hepatitis C virus infection by use of a new combined antigen-antibody detection assay: potential use for high-risk individuals. J Clin Microbiol 2006; 44:1561-3. [PMID: 16597894 PMCID: PMC1448659 DOI: 10.1128/jcm.44.4.1561-1563.2006] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
The performance of a new combined antigen-antibody assay (Monolisa HCV Ag-Ab Ultra; Bio-Rad Laboratories) was evaluated in the context of acute hepatitis C in human immunodeficiency virus-infected patients. The combined assay became positive as early as the first PCR and earlier than a third-generation enzyme-linked immunosorbent assay in 65% of the cases. Reduction of the long period of HCV seronegativity should improve the diagnosis of hepatitis C infection, especially in high-risk populations.
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Affiliation(s)
- A Schnuriger
- Department of Virology, Hôpital La Pitié-Salpêtrière, 83, Boulevard de l'Hôpital, 75651 Paris Cedex 13, France
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23
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Quiroga JA, Castillo I, Pardo M, Rodríguez-Iñigo E, Carreño V. Combined hepatitis C virus (HCV) antigen-antibody detection assay does not improve diagnosis for seronegative individuals with occult HCV infection. J Clin Microbiol 2006; 44:4559-60. [PMID: 17021056 PMCID: PMC1698377 DOI: 10.1128/jcm.01440-06] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
A combined hepatitis C virus (HCV) antigen-antibody assay was evaluated for 115 seronegative individuals with occult HCV infection. The assay was reactive in one patient and negative to weakly reactive in three others (all four gave indeterminate results by supplemental assay) but failed to detect HCV in the remaining patients. Despite increased sensitivity the combined assay does not improve serodiagnosis of occult HCV infection.
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Affiliation(s)
- Juan A Quiroga
- Fundación para el Estudio de las Hepatitis Virales, Guzmán el Bueno 72, 28015 Madrid, Spain
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