Journal Article > ResearchFull Text
AIDS. 2018 November 16; Volume 33 (Issue 2); DOI:10.1097/QAD.0000000000002070
Loarec A, Carnimeo V, Molfino L, Kizito W, Muyindike WR, et al.
AIDS. 2018 November 16; Volume 33 (Issue 2); DOI:10.1097/QAD.0000000000002070
: A multicentric, retrospective case-series analysis (facility-based) in five sites across Kenya, Malawi, Mozambique, and Uganda screened HIV-positive adults for hepatitis C virus (HCV) antibodies using Oraquick rapid testing and viral confirmation (in three sites). Results found substantially lower prevalence than previously reported for these countries compared with previous reports, suggesting that targeted integration of HCV screening in African HIV programs may be more impactful than routine screening.This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0.
Conference Material > Abstract
Carnimeo V, Lissouba P
Epicentre Scientific Day 2024. 2024 May 23
INTRODUCTION
In Carnot, Central African Republic, MSF collaborates with the Ministry of Health at the District Hospital (DH), providing comprehensive care for chronic diseases, including integrated HIV services. Since 2016, HIV differentiated treatment models (DTMs) have been introduced, including multi-monthly dispensing of antiretroviral therapy, Community ART Groups (CAGs), and decentralized care. A multi-methods study was conducted to describe and understand the continuum of care of patients in the cohort, including retention indicators, treatment adherence, perceptions of DTMs and reasons for late presentation to care.
METHODS
Programmatic data of the HIV cohort in Carnot between 2011 and 2022 was analysed retrospectively. A cross-sectional survey was conducted on a random sample of active patients who underwent a clinical examination, CD4, viral load (VL) and ARV resistance tests to estimate the proportion of virological failures and resistance profiles. Lastly, semi-structured interviews were conducted with key informants, health care workers, active patients, and patients late for their appointments (<6months).
RESULTS
In 2023, the cohort included 4,745 patients on treatment, with 35.5% (N=1,684) lost-to-follow-up. The probability of retention in care decreased over time and adherence to care (% of late appointment to the health centre) was lower than 80%. Among the 341 patients surveyed, 96% of them were on a treatment based on dolutegravir (DTG), and 12% (N=40, 95%CI 8-16) had virological failure. Among those, nearly one third (29.6%) presented drug resistances to the class of molecules currently used and 2.4% presented resistance to DTG, indicating that lack of adherence was likely the cause of virological failure. DTMs were not optimally implemented, and perceptions were mixed. Reasons for late presentations to appointments included access and service-related barriers, stigmatisation and socio-economic vulnerability, however, patients facing these barriers were often excluded from accessing DTM.
CONCLUSION
Despite DTMs, patients’ retention in care remains low. Strategies for better implementation and equitable access for patients are urgently needed.
In Carnot, Central African Republic, MSF collaborates with the Ministry of Health at the District Hospital (DH), providing comprehensive care for chronic diseases, including integrated HIV services. Since 2016, HIV differentiated treatment models (DTMs) have been introduced, including multi-monthly dispensing of antiretroviral therapy, Community ART Groups (CAGs), and decentralized care. A multi-methods study was conducted to describe and understand the continuum of care of patients in the cohort, including retention indicators, treatment adherence, perceptions of DTMs and reasons for late presentation to care.
METHODS
Programmatic data of the HIV cohort in Carnot between 2011 and 2022 was analysed retrospectively. A cross-sectional survey was conducted on a random sample of active patients who underwent a clinical examination, CD4, viral load (VL) and ARV resistance tests to estimate the proportion of virological failures and resistance profiles. Lastly, semi-structured interviews were conducted with key informants, health care workers, active patients, and patients late for their appointments (<6months).
RESULTS
In 2023, the cohort included 4,745 patients on treatment, with 35.5% (N=1,684) lost-to-follow-up. The probability of retention in care decreased over time and adherence to care (% of late appointment to the health centre) was lower than 80%. Among the 341 patients surveyed, 96% of them were on a treatment based on dolutegravir (DTG), and 12% (N=40, 95%CI 8-16) had virological failure. Among those, nearly one third (29.6%) presented drug resistances to the class of molecules currently used and 2.4% presented resistance to DTG, indicating that lack of adherence was likely the cause of virological failure. DTMs were not optimally implemented, and perceptions were mixed. Reasons for late presentations to appointments included access and service-related barriers, stigmatisation and socio-economic vulnerability, however, patients facing these barriers were often excluded from accessing DTM.
CONCLUSION
Despite DTMs, patients’ retention in care remains low. Strategies for better implementation and equitable access for patients are urgently needed.
Protocol > Research Study
Gupta E, Carnimeo V, Samukcham I, Loarec A, Mahajan S, et al.
2018 July 1
P R O T O C O L S U M M A R Y
Title: Field evaluation of the performance of HCV Serological Rapid Diagnostic Tests among
HCV/HIV co-infected patients.
Aim: To evaluate the performance of serological HCV Rapid Diagnostic Tests (RDTs) to identify tests
adapted to resource-limited settings, reliable for HIV-infected patients.
Study design: Prospective evaluation of the performance of serological RDTs for HCV screening.
Primary objective:
o To evaluate the performance of serological HCV RDTs under field conditions using as reference
standard a combination of enzyme immunoassay (EIA) and recombinant immunoblot assay
(RIBA) for the detection of antibodies anti-HCV in HIV infected patients.
Secondary objectives:
o To describe the accuracy (sensitivity, specificity) of the RDTs as screening tests
o To describe the performance of the RDTs according to the HCV genotype and HCV VL
o To describe the performance of the RDTs according to the CD4 counts and HIV VL
o To describe the performance of the RDTs in presence of HBV co-infection (presence of antigen
anti-HBs (HBsAg))
o To describe the operational characteristics of the tests including ease of use, technical
complexity and inter-reader variability.
o To evaluate predictive values of each HCV RDT based on the prevalence of the testing center.
Title: Field evaluation of the performance of HCV Serological Rapid Diagnostic Tests among
HCV/HIV co-infected patients.
Aim: To evaluate the performance of serological HCV Rapid Diagnostic Tests (RDTs) to identify tests
adapted to resource-limited settings, reliable for HIV-infected patients.
Study design: Prospective evaluation of the performance of serological RDTs for HCV screening.
Primary objective:
o To evaluate the performance of serological HCV RDTs under field conditions using as reference
standard a combination of enzyme immunoassay (EIA) and recombinant immunoblot assay
(RIBA) for the detection of antibodies anti-HCV in HIV infected patients.
Secondary objectives:
o To describe the accuracy (sensitivity, specificity) of the RDTs as screening tests
o To describe the performance of the RDTs according to the HCV genotype and HCV VL
o To describe the performance of the RDTs according to the CD4 counts and HIV VL
o To describe the performance of the RDTs in presence of HBV co-infection (presence of antigen
anti-HBs (HBsAg))
o To describe the operational characteristics of the tests including ease of use, technical
complexity and inter-reader variability.
o To evaluate predictive values of each HCV RDT based on the prevalence of the testing center.
Journal Article > ResearchFull Text
J Clin Virol. 2019 February 1; Volume 111; 39-41.; DOI:10.1016/j.jcv.2018.12.008
Sun C, Iwamoto M, Calzia A, Sreng B, Yann S, et al.
J Clin Virol. 2019 February 1; Volume 111; 39-41.; DOI:10.1016/j.jcv.2018.12.008
BACKGROUND
Simplifying hepatitis C virus (HCV) screening is a key step in achieving the elimination of HCV as a global public health threat by 2030.
OBJECTIVES
The objective of this study was to demonstrate the agreement of capillary blood and venipuncture specimens when using SD Bioline© HCV, a low-cost rapid diagnostic test (RDT), prequalified by WHO in 2016 on venous blood samples.
STUDY DESIGN
Recruitment was conducted prospectively among adult patients presenting for HCV testing at the Médecins Sans Frontières (MSF) clinic of Preah Kossamak Hospital (Phnom Penh, Cambodia) between October and November 2017. Capillary and venous blood samples were collected from consenting patients and tested with SD Bioline© HCV. Two independent, blinded readers, and in the case of disagreement, a third reader, interpreted the results of each blood sample. Concordance between results was compared using Cohen's Kappa interrater reliability statistic. Discrepant sample pairs were tested with an enzyme immunoassay, the reference standard, at the Institute Pasteur of Cambodia.
RESULTS
Among 421 pairs of samples collected, reader disagreement occurred for 0.7% (n = 3) of the participants. Sixty-four percent of capillary and venous blood sample pairs tested positive for HCV, with a Kappa statistic of 0.985 between the two methods. Three participants with discrepant sample pair results tested positive with EIA.
CONCLUSIONS
Capillary and venous blood samples were concordant when tested with HCV SD Bioline© in a clinical context. This simplified testing approach is essential to the scale-up of HCV screening and useful in resource-limited settings or among populations for whom venipuncture is problematic.
Simplifying hepatitis C virus (HCV) screening is a key step in achieving the elimination of HCV as a global public health threat by 2030.
OBJECTIVES
The objective of this study was to demonstrate the agreement of capillary blood and venipuncture specimens when using SD Bioline© HCV, a low-cost rapid diagnostic test (RDT), prequalified by WHO in 2016 on venous blood samples.
STUDY DESIGN
Recruitment was conducted prospectively among adult patients presenting for HCV testing at the Médecins Sans Frontières (MSF) clinic of Preah Kossamak Hospital (Phnom Penh, Cambodia) between October and November 2017. Capillary and venous blood samples were collected from consenting patients and tested with SD Bioline© HCV. Two independent, blinded readers, and in the case of disagreement, a third reader, interpreted the results of each blood sample. Concordance between results was compared using Cohen's Kappa interrater reliability statistic. Discrepant sample pairs were tested with an enzyme immunoassay, the reference standard, at the Institute Pasteur of Cambodia.
RESULTS
Among 421 pairs of samples collected, reader disagreement occurred for 0.7% (n = 3) of the participants. Sixty-four percent of capillary and venous blood sample pairs tested positive for HCV, with a Kappa statistic of 0.985 between the two methods. Three participants with discrepant sample pair results tested positive with EIA.
CONCLUSIONS
Capillary and venous blood samples were concordant when tested with HCV SD Bioline© in a clinical context. This simplified testing approach is essential to the scale-up of HCV screening and useful in resource-limited settings or among populations for whom venipuncture is problematic.
Journal Article > ResearchFull Text
J Clin Virol. 2019 September 1; Volume 111; 39-41.; DOI:10.1016/j.jcv.2018.12.008
Sun C, Iwamoto M, Calzia A, Sreng B, Yann S, et al.
J Clin Virol. 2019 September 1; Volume 111; 39-41.; DOI:10.1016/j.jcv.2018.12.008
BACKGROUND
Simplifying hepatitis C virus (HCV) screening is a key step in achieving the elimination of HCV as a global public health threat by 2030.
OBJECTIVES
The objective of this study was to demonstrate the agreement of capillary blood and venipuncture specimens when using SD Bioline© HCV, a low-cost rapid diagnostic test (RDT), prequalified by WHO in 2016 on venous blood samples.
STUDY DESIGN
Recruitment was conducted prospectively among adult patients presenting for HCV testing at the Médecins Sans Frontières (MSF) clinic of Preah Kossamak Hospital (Phnom Penh, Cambodia) between October and November 2017. Capillary and venous blood samples were collected from consenting patients and tested with SD Bioline© HCV. Two independent, blinded readers, and in the case of disagreement, a third reader, interpreted the results of each blood sample. Concordance between results was compared using Cohen's Kappa interrater reliability statistic. Discrepant sample pairs were tested with an enzyme immunoassay, the reference standard, at the Institute Pasteur of Cambodia.
RESULTS
Among 421 pairs of samples collected, reader disagreement occurred for 0.7% (n = 3) of the participants. Sixty-four percent of capillary and venous blood sample pairs tested positive for HCV, with a Kappa statistic of 0.985 between the two methods. Three participants with discrepant sample pair results tested positive with EIA.
CONCLUSIONS
Capillary and venous blood samples were concordant when tested with HCV SD Bioline© in a clinical context. This simplified testing approach is essential to the scale-up of HCV screening and useful in resource-limited settings or among populations for whom venipuncture is problematic.
Simplifying hepatitis C virus (HCV) screening is a key step in achieving the elimination of HCV as a global public health threat by 2030.
OBJECTIVES
The objective of this study was to demonstrate the agreement of capillary blood and venipuncture specimens when using SD Bioline© HCV, a low-cost rapid diagnostic test (RDT), prequalified by WHO in 2016 on venous blood samples.
STUDY DESIGN
Recruitment was conducted prospectively among adult patients presenting for HCV testing at the Médecins Sans Frontières (MSF) clinic of Preah Kossamak Hospital (Phnom Penh, Cambodia) between October and November 2017. Capillary and venous blood samples were collected from consenting patients and tested with SD Bioline© HCV. Two independent, blinded readers, and in the case of disagreement, a third reader, interpreted the results of each blood sample. Concordance between results was compared using Cohen's Kappa interrater reliability statistic. Discrepant sample pairs were tested with an enzyme immunoassay, the reference standard, at the Institute Pasteur of Cambodia.
RESULTS
Among 421 pairs of samples collected, reader disagreement occurred for 0.7% (n = 3) of the participants. Sixty-four percent of capillary and venous blood sample pairs tested positive for HCV, with a Kappa statistic of 0.985 between the two methods. Three participants with discrepant sample pair results tested positive with EIA.
CONCLUSIONS
Capillary and venous blood samples were concordant when tested with HCV SD Bioline© in a clinical context. This simplified testing approach is essential to the scale-up of HCV screening and useful in resource-limited settings or among populations for whom venipuncture is problematic.