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. 2018 Dec 4;18(1):622.
doi: 10.1186/s12879-018-3529-3.

Confirmation of HCV viremia using HCV RNA and core antigen testing on dried blood spot in HIV infected peoples who inject drugs in Vietnam

Truong Tam Nguyen  1   2 , Véronique Lemee  3 , Karine Bollore  4 , Hai Vinh Vu  5 , Karine Lacombe  6 , Xuan Lien Truong Thi  7 , Que Anh Luong  7 , Charline Dubos  3 , Jean-Christophe Plantier  3 , Huong Duong Thi  8 , Didier Laureillard  9 , Maud Lemoine  10 , Edouard Tuaillon  4
Affiliations

Confirmation of HCV viremia using HCV RNA and core antigen testing on dried blood spot in HIV infected peoples who inject drugs in Vietnam

Truong Tam Nguyen et al. BMC Infect Dis. .

Abstract

Background: Nucleic acid tests performed on blood samples collected on Dried Blood Spot (DBS) and detection of HCV core antigen (HCVcAg) are two approaches that may facilitate access to HCV diagnosis in low and middle incomes countries. In this study we evaluate HCV RNA and HCV antigen testing on DBS in HIV/HCV co-infected peoples who inject drugs in Vietnam.

Method: One hundred and four HIV/HCV seropositive patients managed in outpatient care at the Haiphong Viet Tiep hospital were included in this study from February to March, 2014 (ANRS 12262 study).

Results: Eighty-six subjects were tested positive for HCV RNA in serum, median (IQR): 6.9 log10 IU/ml (5.6-7.4 log10 IU/ml). Genotypes consisted of 57 G1 (69%), 3 G3 (4%), and 22 G6 (27%). HCV RNA was detected on DBS specimens in 79 out 86 subjects with chronic hepatitis C (sensitivity 92.5%; 95% CI: 85.1-96.9%). HCV RNA level on DBS and serum was moderately correlated (r = 0.24; p = 0.05) suggesting a degradation of HCV RNA due to transportation and storage conditions. HCVcAg was detected in 75/86 dB specimens (sensitivity: 87.2%; 95% CI: 78.3-93.4%), with a strong positive relationship between DBS HCVcAg and serum HCV RNA levels (r = 0.80; P < 0.0001).

Conclusions: Quantification of HCVcAg on DBS appears to benefit from substantial stability under prolonged storage conditions but with a lower analytical sensitivity compared to DBS HCV RNA testing. Detection of HCV RNA on DBS is an interesting approach for confirming viral replication in HCV seropositive persons but the impact of pre-analytical conditions on the integrity of HCV RNA needs to be controlled.

Keywords: HCV RNA; HCV core antigen; Hepatitis C virus (HCV); Human immunodeficiency virus (HIV); Vietnam.

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Conflict of interest statement

Ethics approval and consent to participate

The study protocol and written informed consent form were approved by the Ethic Committee of the Viet Tiep Hospital and the Institutional Review Board (IRB) of the Haiphong Medical Services (n° 01BVVT/HDKH). Then, the written informed consent was obtained from all participants before blood sampling. Privacy and confidentiality as well as the anonymity of the participants were ensured at all stages of data collection.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Regression analysis of HCV RNA levels and Bland-Altman plot of titer differences in paired DBS and serum samples collected in Montpellier University Hospital, France. a Linear regression analysis HCV RNA levels for 37 matched DBS–serum pairs. b Agreement between the HCV RNA quantification by plotting the differences between serum and DBS specimen averages of the two techniques using the Bland-Altman analysis
Fig. 2
Fig. 2
Assessment of HCV RNA and HCVcAg on DBS specimens collected from HIV/HCV co-infected patients care in Haiphong Viet Tiep Hospital, Vietnam. a Linear regression analysis HCV RNA levels for 86 matched DBS–serum pairs collected from subjects with chronic HCV infection. b Agreement between the HCV RNA quantification by plotting the differences between serum and DBS specimen averages of the two techniques using the Bland-Altman analysis. c Correlation between DBS HCVcAg and serum HCV RNA
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