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Aguilera A, Fuentes A, Cea M, Carracedo R, Viñuela L, Ordóñez P, López-Fabal F, Sáez E, Cebrián R, Pérez-Revilla A, Pereira S, De Salazar A, García F. Real-life validation of a sample pooling strategy for screening of hepatitis C. Clin Microbiol Infect 2023; 29:112.e1-112.e4. [PMID: 36210627 DOI: 10.1016/j.cmi.2022.09.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 08/30/2022] [Accepted: 09/09/2022] [Indexed: 12/27/2022]
Abstract
OBJECTIVES To test a real-life sample pooling screening strategy which contributes to increasing the diagnostic capacity of clinical laboratories and expanding access to massive screening of hepatitis C. METHODS After evaluating the sensitivity of the pooling strategy for seven different commercial assays which are used to determine the concentration of hepatitis C virus (HCV)-RNA in the plasma or serum, consecutive samples submitted for HCV diagnosis during the first 3 weeks of November 2021 were tested for HCV antibodies and, in parallel and in a blinded way, were pooled into 100 samples and tested for HCV-RNA. When the result was positive, a strategy to un-mask the positive(s) pool(s), which needed up to 15 total HCV-RNA tests, was used. RESULTS All platforms were able to detect the presence of HCV-RNA in a single sample from a patient with viremic HCV present in pools of up to at least 10 000 HCV-RNA-free samples. A total of 1700 samples (17 pools) were analysed, with an overall prevalence of anti-HCV and HCV-RNA of 0.24%. After pooling, we could detect all samples previously detected using standard diagnosis tests (reflex testing) with a specificity and sensitivity of 100% (CI, 99.78-100%). Given the median current prices of anti-HCV and HCV-RNA on the market in Spain as well as personnel costs, testing using the pooling strategy would have resulted in a save of 3320€. CONCLUSIONS Here, we demonstrated that by improving cost effectiveness, with no loss of sensitivity and specificity, the strategy of pooling samples may serve as an appropriate tool for use in large-scale screening of HCV.
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Affiliation(s)
- Antonio Aguilera
- Servicio de Microbiología, Complexo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain; Departamento de Microbiología, Universidade de Santiago de Compostela, Santiago de Compostela, Spain; Instituto de Investigación Sanitaria de Santiago, Santiago de Compostela, Spain
| | - Ana Fuentes
- Servicio de Microbiología, Hospital Universitario Clínico San Cecilio, Granada, Spain; Instituto de Investigación Biosanitario Ibs.Granada, Spain
| | - María Cea
- Servicio de Microbiología, Complexo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
| | - Raquel Carracedo
- Servicio de Microbiología, Complexo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
| | - Laura Viñuela
- Servicio de Microbiología, Hospital Universitario Clínico San Cecilio, Granada, Spain; Instituto de Investigación Biosanitario Ibs.Granada, Spain
| | - Patricia Ordóñez
- Complejo Hospitalario Arquitecto Marcide-Profesor Novoa Santos, Ferrol, Spain
| | | | - Elena Sáez
- Laboratorio Central de la Comunidad de Madrid (URSALUD), Madrid, Spain
| | - Rubén Cebrián
- Servicio de Microbiología, Hospital Universitario Clínico San Cecilio, Granada, Spain; Instituto de Investigación Biosanitario Ibs.Granada, Spain
| | | | - Sara Pereira
- Servicio de Microbiología, Complexo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
| | - Adolfo De Salazar
- Servicio de Microbiología, Hospital Universitario Clínico San Cecilio, Granada, Spain; Instituto de Investigación Biosanitario Ibs.Granada, Spain; Ciber de Enfermedades Infecciosas, ISCIII, Spain
| | - Federico García
- Servicio de Microbiología, Hospital Universitario Clínico San Cecilio, Granada, Spain; Instituto de Investigación Biosanitario Ibs.Granada, Spain; Ciber de Enfermedades Infecciosas, ISCIII, Spain.
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