Dried Blood Spots: A Tool to Ensure Broad Access to Hepatitis C Screening, Diagnosis, and Treatment Monitoring
Dried Blood Spots: A Tool to Ensure Broad Access to Hepatitis C Screening, Diagnosis, and Treatment Monitoring
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DOI：
10.1093/infdis/jiv423
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发表时间：
2016-04-01
影响因子：
6.4
通讯作者：
Chevaliez, Stephane
中科院分区：
文献类型：
--
作者：
Soulier, Alexandre;Poiteau, Lila;Chevaliez, Stephane
背景随着丙型肝炎病毒（HCV）感染的高效抗病毒疗法的出现，需要提供广泛的诊断和护理。干血斑（DBS）技术可用于采集、储存和运输全血标本。我们的目标是评估标准化HCV诊断和监测工具在DBS分析中的性能。使用DBS技术从> 500例患者中采集血清标本和全血标本，检测用于诊断和监测HCV感染的病毒学标志物。建立新的信号-截止值比后，DBS标本中抗-HCV抗体的酶免疫检测是可靠的。从绝大多数具有活跃复制的患者中检测到DBS HCV RNA，但HCV RNA水平显著低于血清标本，这意味着只有HCV RNA的存在或不存在或HCV RNA水平的变化才应考虑治疗。DBS标本中HCV核心抗原的检测不是慢性HCV感染的敏感标志物。HCV基因型测定在绝大多数DBS中是可能的。这项研究表明，使用DBS技术收集的全血标本可以放心地用于诊断和监测HCV感染。DBS可以帮助改善HCV感染的护理，因为它们适合用于大规模筛查计划，诊断和治疗监测。
Background. With the advent of highly efficient antiviral therapies for hepatitis C virus (HCV) infection, providing broad access to diagnosis and care is needed. The dried blood spot (DBS) technique can be used to collect, store, and ship whole-blood specimens. Our goal was to assess the performance of standardized HCV diagnostic and monitoring tools in the analysis of DBS.Methods. Serum specimens and whole-blood specimens collected using the DBS technique from > 500 patients were tested for virological markers used to diagnose and monitor HCV infection.Results. Enzyme immunoassay detection of anti-HCV antibodies in specimens from DBS was reliable after establishment of a new signal-to-cutoff ratio. HCV RNA was detected DBS from the vast majority of patients with active replication, but HCV RNA levels were substantially lower than in serum specimens, implying that only the presence or absence of HCV RNA or changes in the HCV RNA level should be taken into consideration for therapy. Detection of HCV core antigen in specimens from DBS was not a sensitive marker of chronic HCV infection. HCV genotype determination was possible in the vast majority of DBS.Conclusions. This study shows that whole-blood pecimens collected using the DBS technique can be confidently used to diagnose and monitor HCV infection. DBS could help improve access to care for HCV infection because they are suitable for use in large-scale screening programs, diagnosis, and therapeutic monitoring.