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. 2021 Feb 11;4(1):e229.
doi: 10.1002/hsr2.229. eCollection 2021 Mar.

The performance of hepatitis C virus (HCV) antibody point-of-care tests on oral fluid or whole blood and dried blood spot testing for HCV serology and viral load among individuals at higher risk for HCV in South Africa

Nishi Prabdial-Sing  1   2 , Lucinda Gaelejwe  1   2 , Lillian Makhathini  1 , Jayendrie Thaver  1 , Morubula Jack Manamela  1 , Susan Malfeld  1 , C Wendy Spearman  3 , Mark Sonderup  3 , Andrew Scheibe  4   5 , Katherine Young  4 , Harry Hausler  4 , Adrian J Puren  1   2
Affiliations

The performance of hepatitis C virus (HCV) antibody point-of-care tests on oral fluid or whole blood and dried blood spot testing for HCV serology and viral load among individuals at higher risk for HCV in South Africa

Nishi Prabdial-Sing et al. Health Sci Rep. .

Abstract

Background and aims: To enhance screening and diagnosis in those at-risk of hepatitis C virus (HCV), efficient and improved sampling and testing is required. We investigated the performance of point-of-care (POC) tests and dried blood spots (DBS) for HCV antibody and HCV RNA quantification in individuals at higher risk for HCV (people who use and inject drugs, sex workers and men who have sex with men) in seven South African cities.

Methods: Samples were screened on the OraQuick HCV POC test (471 whole blood and 218 oral fluid); 218 whole blood and DBS paired samples were evaluated on the ARCHITECT HCV antibody (Abbott) and HCV viral load (COBAS Ampliprep/COBAS TaqMan version 2) assays. For HCV RNA quantification, 107 dB were analyzed with and without normalization coefficients.

Results: POC on either whole blood or oral fluid showed an overall sensitivity of 98.5% (95% CI 97.4-99.5), specificity of 98.2% (95% CI 98.8-100) and accuracy of 98.4% (95% CI 96.5-99.3). On the antibody immunoassay, DBS showed a sensitivity of 96.0% (95% CI 93.4-98.6), specificity of 97% (95% CI 94.8-99.3) and accuracy of 96.3% (95% CI 93.8-98.8). A strong correlation (R 2 = 0.90) between viral load measurements for DBS and plasma samples was observed. After normalization, DBS viral load results showed an improved bias from 0.5 to 0.16 log10 IU/mL.

Conclusion: The POC test performed sufficiently well to be used for HCV screening in at-risk populations. DBS for diagnosis and quantification was accurate and should be considered as an alternative sample to test. POC and DBS can help scale up hepatitis services in the country, in light of our elimination goals.

Keywords: HCV; dried blood spot; high risk; point‐of‐care; screening.

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Conflict of interest statement

Andrew Scheibe received an honourarium from Gilead for presenting work in this field.

Figures

FIGURE 1
FIGURE 1
Flow diagram indicating the number of sample sets from collection to testing and analyses
FIGURE 2
FIGURE 2
Correlation of dried blood spots (DBS) to plasma viral load (log10IU/mL) on CAP/CTM, A, before application of the normalization coefficient to the raw DBS results, B, after application of the normalization coefficient
FIGURE 3
FIGURE 3
Bland‐Altman plot analysis of the differences between viral load in plasma and dried blood spots (DBS) (log10 IU/mL) on CAP/CTM, A, without application of normalization coefficient, B, corrected DBS (log10 IU/mL) viral load
See this image and copyright information in PMC

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