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Pisa P, Kinge CW, Chasela C, Mothibi E, Thaung YM, Thwin HT, Aung NM, Chew KW, Gandhi MM, Clint C, Minior T, Lwin AA, Freiman MJ, Kyi KP, Sein YY, Marange F, van der Horst C, Mohamed S, Barralon M, Sanne I. Evaluation of GeneXpert and advanced biological laboratories UltraGene HCV diagnostic detection and performance against Roche real time PCR in Myanmar. J Clin Virol 2024; 171:105653. [PMID: 38408420 DOI: 10.1016/j.jcv.2024.105653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 02/06/2024] [Accepted: 02/10/2024] [Indexed: 02/28/2024]
Abstract
BACKGROUND Developing countries experience limited access to HCV laboratory tests for different reasons. Providing near to real-time HCV testing and results especially to at-risk populations including those in rural settings for timely initiation to treatment is key. Within a rural Myanmar setting, we compared HCV diagnostic detection and quantification of the GeneXpert, and Advanced Biological Laboratories UltraGene-HCV assays against the gold standard and reference method Roche real-time HCV in Myanmar. METHODS Blood samples from 158 high-risk individuals were assessed using three different methods at baseline. Results were checked for normality and log transformed. Log differences and bias between methods were calculated and correlated. Pearson's correlation coefficient was used to determine the association of HCV viral loads across all methods. The level of agreement with the standard method (Roche real time HCV) was assessed using Bland-Altman analyses. RESULTS There was a strong positive correlation coefficient between all three methods with GeneXpert and Roche having the strongest, r = 0.96, (p<0.001). Compared to Roche, ABL (mean difference, 95 % limits of agreement; -0.063 and -1.4 to 1.3 Log10IU/mL) and GeneXpert (mean difference, 95 % limits of agreement; -0.28 and -0.7 to 1.8 Log10IU/mL) showed a good level of agreement with the GeneXpert being slightly superior. CONCLUSION We demonstrate the excellent performance and no-inferiority, in terms of levels of agreements of both GeneXpert and ABL compared to the Roche platform and supporting the use of the POC assays as alternative a cost-effective methods in HCV detection and diagnosis in developing and low resource settings countries.
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Affiliation(s)
- Pedro Pisa
- Department of Strategic Information, Right to Care, Centurion, South Africa; Department of Human Nutrition, University of Pretoria, Faculty of Health Sciences, Pretoria, South Africa
| | - Constance Wose Kinge
- Department of Implementation Science, Right to Care, Centurion, South Africa; Department of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Charles Chasela
- Department of Implementation Science, Right to Care, Centurion, South Africa; Department of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | - Eula Mothibi
- Department of Implementation Science, Right to Care, Centurion, South Africa
| | | | - Hnin T Thwin
- Community Partners International, Yangon, Myanmar
| | - Nay M Aung
- Community Partners International, Yangon, Myanmar
| | - Kara W Chew
- David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Malini M Gandhi
- David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | | | | | - Aye A Lwin
- U.S. Agency for International Development, USA
| | - Morgan J Freiman
- Department of Medical Research, Ministry of Health and Sports, Yangon, Myanmar
| | - Khin P Kyi
- Myanmar Liver Foundation, Yangon, Myanmar
| | - Yi Y Sein
- Department of Medical Research, Ministry of Health and Sports, Yangon, Myanmar
| | | | | | - Sofiane Mohamed
- Advanced Biological Laboratories (ABL) SA.17, rue des Jardiniers, Luxembourg 1835
| | - Matthieu Barralon
- Advanced Biological Laboratories (ABL) SA.17, rue des Jardiniers, Luxembourg 1835
| | - Ian Sanne
- Clinical HIV Research Unit, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Min Thaung Y, Chasela CS, Chew KW, Minior T, Lwin AA, Sein YY, Drame N, Marange F, van der Horst C, Thwin HT, Freiman MJ, Gandhi MM, Bijl M, Wose Kinge C, Rosen S, Thura S, Mohamed S, Xulu T, Naing AY, Barralon M, Cavenaugh C, Kyi KP, Sanne I. Treatment outcomes and costs of a simplified antiviral treatment strategy for hepatitis C among monoinfected and HIV and/or hepatitis B virus-co-infected patients in Myanmar. J Viral Hepat 2021; 28:147-158. [PMID: 32935438 PMCID: PMC7746582 DOI: 10.1111/jvh.13405] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 09/01/2020] [Indexed: 12/13/2022]
Abstract
Access to hepatitis C virus (HCV) testing and treatment is limited in Myanmar. We assessed an integrated HIV and viral hepatitis testing and HCV treatment strategy. Sofosbuvir/velpatasvir (SOF/VEL) ± weight-based ribavirin for 12 weeks was provided at three treatment sites in Myanmar and sustained virologic response (SVR) assessed at 12 weeks after treatment. Participants co-infected with HBV were treated concurrently with tenofovir. Cost estimates in 2018 USD were made at Yangon and Mandalay using standard micro-costing methods. 803 participants initiated SOF/VEL; 4.8% were lost to follow-up. SVR was achieved in 680/803 (84.6%) by intention-to-treat analysis. SVR amongst people who inject drugs (PWID) was 79.7% (381/497), but 92.5% among PWID on opioid substitution therapy (OST) (74/80), and 97.4% among non-PWID (298/306). Utilizing data from 492 participants, of whom 93% achieved SVR, the estimated average cost of treatment per patient initiated was $1030 (of which 54% were medication costs), with a production cost per successful outcome (SVR) of $1109 and real-world estimate of $1250. High SVR rates were achieved for non-PWID and PWID on OST. However, the estimated average cost of the intervention (under the assumption of no genotype testing and reduced real-world effectiveness) of $1250/patient is unaffordable for a national elimination strategy. Reductions in the cost of antivirals and linkage to social and behavioural health services including substance use disorder treatment to increase retention and adherence to treatment are critical to HCV elimination in this population.
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Affiliation(s)
| | - Charles S. Chasela
- Right to Care/EQUIP HealthPretoriaSouth Africa,Department of Epidemiology and BiostatisticsSchool of Public HealthFaculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Kara W. Chew
- David Geffen School of Medicine at UCLALos AngelesCAUSA
| | - Thomas Minior
- U.S. Agency for International DevelopmentWashingtonDCUSA
| | - Aye A. Lwin
- Advanced Biological Laboratories (ABL) SARue des jardiniersLuxembourg
| | | | - Ndeye Drame
- School of Public HealthBoston UniversityBostonMAUSA
| | | | | | | | | | | | - Murdo Bijl
- Asian Harm Reduction NetworkKachinMyanmar
| | - Constance Wose Kinge
- Division of Epidemiology and SurveillanceNational Institute for Occupational HealthJohannesburgSouth Africa,Hepatitis Virus Diversity Research UnitDepartment of Internal MedicineSchool of Clinical MedicineFaculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Sydney Rosen
- School of Public HealthBoston UniversityBostonMAUSA,Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Si Thura
- Community Partners InternationalYangonMyanmar
| | - Sofiane Mohamed
- Advanced Biological Laboratories (ABL) SARue des jardiniersLuxembourg
| | | | | | - Matthiue Barralon
- Advanced Biological Laboratories (ABL) SARue des jardiniersLuxembourg
| | | | | | - Ian Sanne
- Right to Care/EQUIP HealthPretoriaSouth Africa,School of Public HealthBoston UniversityBostonMAUSA,Department of MedicineFaculty of Health SciencesUniversity of the WitwatersrandJohannesburg,Immunology Research Division, Department of Medical ResearchMinistry of Health and SportsYangonMyanmar
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