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Rapid and Point-of-Care Tests Accurate, Convenient for Hepatitis C Screening

Rapid and point-of-care screening tests for hepatitis C have a high accuracy and quick turnaround time, suggest results of a systematic review and meta-analysis.

The researchers say that these tests "could play a substantial role in expanded global screening initiatives, which would eventually impact the control of hepatitis C virus (HCV) infection at the population level."

Writing in the Annals of Internal Medicine, Nitika Pant Pai (McGill University Health Centre, Montreal, Quebec, Canada) and colleagues explain that many people infected with hepatitis C remain undiagnosed. It has been suggested that rapid diagnostic tests (RDTs) and point-of-care tests (POCTs) are a time- and cost-saving alternative to conventional laboratory tests. However, their global uptake depends on their performance.

To investigate further, Pant Pai and team performed a meta-analysis of 19 studies assessing the diagnostic accuracy of POCTs and RDTs to screen for hepatitis C in adults.

They found that POCTs of blood (serum, plasma, or whole) had the highest accuracy, followed by RDTs of serum or plasma and POCTs of oral fluids. Indeed, the sensitivity of POCTs of blood was around 99%, followed by 98% for RDTs of serum or plasma, and 98% for POCTs of oral fluid.

Specificity of POCTs of blood was also high, at more than 99%, followed by 98.6% for RDTs of serum or plasma and 98.2% for POCTs of oral fluid.

"First generation point-of-care tests are convenient, effective and informative for clinical decision making," say Pant Pai et al. "These tests don't usually require specialized equipment, they can provide results within 30 minutes, or maximally within one patient visit or one working day, and many do not require electricity."

They add that, in light of the tests' accuracy and an "urgent need to increase hepatitis C screening in marginalized and at-risk populations and in endemic HCV settings," these tests may be useful in expanding first-line screening for hepatitis C.

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