Soulier Alexandre, Poiteau Lila, Rosa Isabelle, Hézode Christophe, Roudot-Thoraval Françoise, Pawlotsky Jean-Michel, Chevaliez Stéphane
National Reference Center for Viral Hepatitis B, C, and Delta, Department of Virology INSERM U955, Centre Hospitalier Intercommunal de Créteil, France.
Department of Hepatology and Gastroenterology, Centre Hospitalier Intercommunal de Créteil, France.
J Infect Dis. 2016 Apr 1;213(7):1087-95. doi: 10.1093/infdis/jiv423. Epub 2015 Sep 2.
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.
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.
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.
This study shows that whole-blood specimens 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.
随着丙型肝炎病毒（HCV）感染高效抗病毒治疗方法的出现，需要广泛提供诊断和治疗服务。干血斑（DBS）技术可用于采集、储存和运送全血标本。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。
对使用DBS技术从500多名患者采集的血清标本和全血标本进行检测，以检测用于诊断和监测HCV感染的病毒学标志物。
建立新的信号与临界值比值后，DBS标本中抗HCV抗体的酶免疫测定检测结果可靠。在绝大多数病毒活跃复制的患者的DBS中检测到HCV RNA，但HCV RNA水平明显低于血清标本，这意味着在治疗时仅应考虑HCV RNA的有无或HCV RNA水平的变化。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。绝大多数DBS都可以进行HCV基因型测定。
本研究表明，使用DBS技术采集的全血标本可放心用于诊断和监测HCV感染。DBS适合用于大规模筛查项目、诊断和治疗监测，有助于改善HCV感染的治疗可及性。
