Toronto Centre for Liver Disease, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON M5G 2C4, Canada.
Viral Hepatitis Care Network (VIRCAN) Study Group, Toronto Centre for Liver Disease, Toronto, ON M5G 2C4 Canada.
Viruses. 2019 Sep 6;11(9):830. doi: 10.3390/v11090830.
In order to expand hepatitis C virus (HCV) screening, a change in the diagnostic paradigm is warranted to improve accessibility and decrease costs, such as utilizing dried blood spot (DBS) collection. In our study, blood from 68 patients with chronic HCV infection was spotted onto DBS cards and stored at the following temperatures for one week: -80 °C, 4 °C, 21 °C, 37 °C, and alternating 37 °C and 4 °C; to assess whether temperature change during transportation would affect sensitivity. Sample was eluted from the DBS cards and tested for HCV antibodies (HCV-Ab) and HCV core antigen (core-Ag). HCV-Abs were detected from 68/68 DBS samples at -80 °C, 4 °C, 21 °C, and 67/68 at 37 °C and alternating 37 °C and 4 °C. Sensitivity of core-Ag was as follows: 94% (-80 °C), 94% (4 °C), 91% (21 °C), 93% (37 °C), and 93% (37 °C/4 °C). Not only did temperature not greatly affect sensitivity, but sensitivities are higher than previously reported, and support the use of this assay as an alternative to HCV RNA. We then completed a head-to-head comparison ( = 49) of venous versus capillary samples, and one versus two DBS. No difference in core-Ag sensitivity was observed by sample type, but there was an improvement when using two spots. We conclude that HCV-Abs and core-Ag testing from DBS cards has high diagnostic accuracy and could be considered as an alternative to HCV RNA in certain settings.
为了扩大丙型肝炎病毒（HCV）的筛查范围，需要改变诊断模式，以提高可及性并降低成本，例如利用干血斑（DBS）采集。在我们的研究中，将 68 例慢性 HCV 感染患者的血液点在 DBS 卡上，并在以下温度下储存一周：-80°C、4°C、21°C、37°C 和 37°C 与 4°C 交替；以评估运输过程中的温度变化是否会影响敏感性。从 DBS 卡洗脱样本并检测 HCV 抗体（HCV-Ab）和 HCV 核心抗原（core-Ag）。在-80°C、4°C、21°C 和 37°C 及 37°C 和 4°C 交替的条件下，从 68/68 个 DBS 样本中检测到 HCV-Abs，在 37°C 及 37°C 和 4°C 交替的条件下，从 67/68 个 DBS 样本中检测到 HCV-Abs。core-Ag 的敏感性如下：94%（-80°C）、94%（4°C）、91%（21°C）、93%（37°C）和 93%（37°C/4°C）。温度不仅没有显著影响敏感性，而且敏感性高于之前的报道，支持该检测法作为 HCV RNA 的替代方法。然后，我们完成了静脉与毛细血管样本（n=49）和一个与两个 DBS 样本的头对头比较。样本类型对 core-Ag 敏感性无差异，但使用两个斑点时有所提高。我们的结论是，DBS 卡上 HCV-Ab 和 core-Ag 的检测具有很高的诊断准确性，在某些情况下可以替代 HCV RNA。
