Sezione di Gastroenterologia & Epatologia, PROMISE, University of Palermo, Palermo, Italy.
Sezione di Virologia PROMISE, University of Palermo, Palermo, Italy.
Liver Int. 2019 Dec;39(12):2240-2243. doi: 10.1111/liv.14242. Epub 2019 Sep 20.
HCV-RNA assessment during therapy with Direct-Acting Antiviral (DAA) regimens still relies on assays requiring blood collection and transport to a specialised laboratory, which may compromise linkage to care. GeneXpert-HCV Viral Load (GXHVL) (Cepheid) is a plasma-based assay used at point of care (POC) with a sensitivity of ≤10 IU/mL, and, results available within 2 hours. Fifty-nine consecutive HCV-patients ready for DAAs treatment were enrolled. HCV-RNA was simultaneously tested using Roche TaqMan RT-PCR (venous blood sample) and GXHVL (capillary blood collected by fingerstick), at baseline (BL), week 4 (W4) of therapy, end of therapy (EOT) and week 12 of follow-up (W12FU). Both assays demonstrated undetectable HCV-RNA in all patients at EOT and identified the single case of HCV-relapse at W12FU. GXHVL used as a point-of-care assay in the outpatient setting provides results fully comparable to the laboratory-based test. Its excellent performance and ease of use suggest its adoption in non-specialist settings where simplicity of care is paramount to implement HCV eradication campaigns.
在使用直接作用抗病毒(DAA)方案进行治疗期间,HCV-RNA 的评估仍然依赖于需要采集血液并运送到专门实验室的检测方法,这可能会影响患者与治疗的关联。GeneXpert-HCV 病毒载量(GXHVL)(Cepheid)是一种基于血浆的即时检测(POC)方法,其灵敏度≤10 IU/mL,检测结果可在 2 小时内获得。本研究共纳入了 59 例准备接受 DAA 治疗的 HCV 患者。在基线(BL)、治疗第 4 周(W4)、治疗结束时(EOT)和随访第 12 周(W12FU)时,同时使用罗氏 TaqMan RT-PCR(静脉血样)和 GXHVL(指尖采血)检测 HCV-RNA。两种检测方法均在 EOT 时在所有患者中检测到不可检测的 HCV-RNA,并在 W12FU 时发现了 1 例 HCV 复发的病例。在门诊环境中作为即时检测方法使用的 GXHVL 提供了与基于实验室的检测完全可比的结果。其出色的性能和易用性表明,它可以在非专科环境中使用,在这些环境中,护理的简便性对于实施 HCV 消除运动至关重要。