MedicalResearch.com Interview with:
Jason Grebely PhD
Senior Research Fellow (UNSW)
Viral Hepatitis Clinical Research Program
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Globally, testing and diagnosis of hepatitis C virus infection remain low. Although point of care tests for HCV infection exist, but many of these tests only measure HCV antibodies (previous exposure), not HCV RNA (active infection). Given that 25% of individuals spontaneously clear HCV infection, efforts to enhance diagnosis of chronic HCV infection and improve the HCV care cascade requires enhanced uptake of HCV RNA testing.
We conducted the first evaluation of the Xpert HCV Viral Load test (manufactured by Cepheid) – a point-of-care hepatitis C virus test that can detect active infection – from a finger-stick sample of blood. We established that there is good sensitivity and specificity of the Xpert HCV Viral Load point-of-care test using blood samples collected by finger-stick in participants attending drug health and homelessness services in Australia.
MedicalResearch.com: What should readers take away from your report?
Response: This test represents a major advance over point of care antibody-based tests, which only indicate previous exposure to the virus but cannot detect whether you are actively infected. This new point of care platform enables detection of hepatitis C virus and diagnosis of active infection in a single visit, rather than having to come back for a second visit to obtain test results. Data have shown that on-site HCV testing with integrated care improves linkage to HCV care.
We really need to scale up testing for active hepatitis C infection in order to enhance diagnosis, get people linked to appropriate care, and provided highly curative treatment with direct-acting antivirals to prevent advanced liver disease and onward transmission of the virus.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Further validation studies are needed to further evaluate the performance of this assay in different settings and populations (eg, patients given DAA therapy, those with a sustained virological response, or those with HIV/HCV co-infection). Also, future research should evaluate the effectiveness of integrating point of care testing into interventions to enhance linkage to HCV care and treatment.
Disclosures: JG is a consultant and adviser and has received research grants from AbbVie, Bristol-Myers Squibb, Cepheid, Gilead Sciences, and Merck/MSD.
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Evaluation of the Xpert HCV Viral Load point-of-care assay from venepuncture-collected and finger-stick capillary whole-blood samples: a cohort study
Dr Jason Grebely, PhD, Francois M J Lamoury, EiCNAM, Behzad Hajarizadeh, PhD, Yasmin Mowat, BS, Alison D Marshall, MA, Sahar Bajis, MIPHa,Philippa Marks, MPHa, Janaki Amin, PhD
Available online 22 April 2017
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