Gu Shuqin, Tao Yusha, Fan Chengxin, Dai Yifan, Li Feifei, Conklin Jamie L, Tucker Joseph D, Chou Roger, Moody M Anthony, Easterbrook Philippa, Tang Weiming
Duke Human Vaccine Institute, Duke University School of Medicine, Durham, North Carolina, USA.
Dermatology Hospital of South Medical University, Guangzhou, China.
Open Forum Infect Dis. 2024 Aug 26;11(9):ofae483. doi: 10.1093/ofid/ofae483. eCollection 2024 Sep.
Point-of-care (PoC) hepatitis B virus (HBV) DNA viral load (VL) assays represent an alternative to laboratory-based standard-of-care (SoC) VL assays to accelerate diagnosis and treatment. We evaluated the impact of using PoC versus SoC approaches on the uptake of VL testing, treatment, and turnaround times from testing to treatment across the HBV care cascade.
We searched 5 databases, 6 conference websites, and contacted manufacturers for unpublished reports, for articles with or without a comparator (SoC VL testing), and had data on the uptake of VL testing, treatment, or turnaround times between hepatitis B surface antigen (HBsAg) testing, VL testing, and treatment in the cascade. We performed a random-effects meta-analysis on rates of VL testing and treatment initiation.
Six studies, composing 9 arms, were included. Three PoC arms reported less than 1 day between screening for HBsAg positivity and VL testing, and the other one (2 arms) reported it between 7 and 11 days. Five arms reported the time to available VL test results (<1 day). Three studies reported 1-8 days between VL testing results and treatment initiation. Two studies reported the turnaround times between a positive HBsAg screening and treatment initiation (the same day and 27 days). Overall, 84.1% of those with HBsAg positivity were tested for DNA VL and 88.3% of eligible people initiated treatment.
HBV PoC DNA testing appears to be associated with a turnaround time of <1 day for receipt of VL results and appears associated with high rates of DNA testing and initiation of treatment among those eligible.
PROSPERO CRD42023398440.
即时检测（PoC）乙型肝炎病毒（HBV）DNA病毒载量（VL）检测可替代基于实验室的标准护理（SoC）VL检测，以加速诊断和治疗。我们评估了采用PoC方法与SoC方法对HBV护理流程中VL检测的接受情况、治疗以及从检测到治疗的周转时间的影响。
我们检索了5个数据库、6个会议网站，并联系制造商获取未发表的报告，以查找有或无对照（SoC VL检测）的文章，以及有关护理流程中HBsAg检测、VL检测和治疗之间VL检测的接受情况、治疗或周转时间的数据。我们对VL检测率和治疗启动率进行了随机效应荟萃分析。
纳入了6项研究，共9个组。3个PoC组报告在筛查HBsAg阳性与VL检测之间间隔不到1天，另一个组（2个组）报告间隔为7至11天。5个组报告了可获得VL检测结果的时间（<1天）。3项研究报告了VL检测结果与治疗启动之间间隔1至8天。2项研究报告了HBsAg筛查阳性与治疗启动之间的周转时间（同一天和27天）。总体而言，84.1%的HBsAg阳性者进行了DNA VL检测，88.3%的符合条件者开始治疗。
HBV PoC DNA检测似乎与获得VL结果的周转时间<1天相关，并且在符合条件者中似乎与高DNA检测率和治疗启动率相关。
PROSPERO CRD42023398440。
