BACKGROUND: 170 million persons worldwide are infected with hepatitis C, many of whom are undiagnosed. Although rapid diagnostic tests (RDTs) and point-of-care tests (POCTs) provide a time- and cost-saving alternative to conventional laboratory tests, their global uptake partly depends on their performance. PURPOSE: To meta-analyze the diagnostic accuracy of POCTs and RDTs to screen for hepatitis C. DATA SOURCES: MEDLINE, EMBASE, BIOSIS, and Web of Science (1992 to 2012) and bibliographies of included articles. STUDY SELECTION: All studies evaluating the diagnostic accuracy of POCTs and RDTs for hepatitis C in adults (aged ≥18 years). DATA EXTRACTION: Two independent reviewers extracted data and critiqued study quality. DATA SYNTHESIS: Of 19 studies reviewed, 18 were meta-analyzed and stratified by specimen type (whole blood, serum, plasma, or oral fluid) or test type (POCT or RDT). Sensitivity was similarly high in POCTs of whole blood (98.9% [95% CI, 94.5% to 99.8%]) and serum or plasma (98.9% [CI, 96.8% to 99.6%]), followed by RDTs of serum or plasma (98.4% [CI, 88.9% to 99.8%]) and POCTs of oral fluid (97.1% [CI, 94.7% to 98.4%]). Specificity was also high in POCTs of whole blood (99.5% [CI, 97.5% to 99.9%]) and serum or plasma (99.7% [CI, 99.3% to 99.9%]), followed by RDTs of serum or plasma (98.6% [CI, 94.9% to 99.6%]) and POCTs of oral fluid (98.2% [CI, 92.2% to 99.6%]). LIMITATION: Lack of data prevented sensitivity analyses of specific tests. CONCLUSION: Data suggest that POCTs of blood (serum, plasma, or whole blood) have the highest accuracy, followed by RDTs of serum or plasma and POCTs of oral fluids. Given their accuracy, convenience, and quick turnaround time, RDTs and POCTs may be useful in expanding first-line screening for hepatitis C. PRIMARY FUNDING SOURCE: Canadian Institutes of Health Research.
BACKGROUND: 170 million persons worldwide are infected with hepatitis C, many of whom are undiagnosed. Although rapid diagnostic tests (RDTs) and point-of-care tests (POCTs) provide a time- and cost-saving alternative to conventional laboratory tests, their global uptake partly depends on their performance. PURPOSE: To meta-analyze the diagnostic accuracy of POCTs and RDTs to screen for hepatitis C. DATA SOURCES: MEDLINE, EMBASE, BIOSIS, and Web of Science (1992 to 2012) and bibliographies of included articles. STUDY SELECTION: All studies evaluating the diagnostic accuracy of POCTs and RDTs for hepatitis C in adults (aged ≥18 years). DATA EXTRACTION: Two independent reviewers extracted data and critiqued study quality. DATA SYNTHESIS: Of 19 studies reviewed, 18 were meta-analyzed and stratified by specimen type (whole blood, serum, plasma, or oral fluid) or test type (POCT or RDT). Sensitivity was similarly high in POCTs of whole blood (98.9% [95% CI, 94.5% to 99.8%]) and serum or plasma (98.9% [CI, 96.8% to 99.6%]), followed by RDTs of serum or plasma (98.4% [CI, 88.9% to 99.8%]) and POCTs of oral fluid (97.1% [CI, 94.7% to 98.4%]). Specificity was also high in POCTs of whole blood (99.5% [CI, 97.5% to 99.9%]) and serum or plasma (99.7% [CI, 99.3% to 99.9%]), followed by RDTs of serum or plasma (98.6% [CI, 94.9% to 99.6%]) and POCTs of oral fluid (98.2% [CI, 92.2% to 99.6%]). LIMITATION: Lack of data prevented sensitivity analyses of specific tests. CONCLUSION: Data suggest that POCTs of blood (serum, plasma, or whole blood) have the highest accuracy, followed by RDTs of serum or plasma and POCTs of oral fluids. Given their accuracy, convenience, and quick turnaround time, RDTs and POCTs may be useful in expanding first-line screening for hepatitis C. PRIMARY FUNDING SOURCE: Canadian Institutes of Health Research.
Authors: Robert P Myers; Pam Crotty; Susanna Town; Janine English; Kevin Fonseca; Raymond Tellier; Mark G Swain; S Elizabeth McGregor; Steven J Heitman; Robert J Hilsden Journal: CMAJ Open Date: 2015-01-13
Authors: Paul K Drain; Emily P Hyle; Farzad Noubary; Kenneth A Freedberg; Douglas Wilson; William R Bishai; William Rodriguez; Ingrid V Bassett Journal: Lancet Infect Dis Date: 2013-12-10 Impact factor: 25.071
Authors: Pankaj Puri; Anil C Anand; Vivek A Saraswat; Subrat K Acharya; Shiv K Sarin; Radha K Dhiman; Rakesh Aggarwal; Shivaram P Singh; Deepak Amarapurkar; Anil Arora; Mohinish Chhabra; Kamal Chetri; Gourdas Choudhuri; Vinod K Dixit; Ajay Duseja; Ajay K Jain; Dharmesh Kapoor; Premashis Kar; Abraham Koshy; Ashish Kumar; Kaushal Madan; Sri P Misra; Mohan V G Prasad; Aabha Nagral; Amarendra S Puri; R Jeyamani; Sanjiv Saigal; Samir Shah; Praveen K Sharma; Ajit Sood; Sandeep Thareja; Manav Wadhawan Journal: J Clin Exp Hepatol Date: 2014-06-24