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Open AccessArticle

Hepatitis C Core-Antigen Testing from Dried Blood Spots

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Toronto Centre for Liver Disease, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON M5G 2C4, Canada
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Viral Hepatitis Care Network (VIRCAN) Study Group, Toronto Centre for Liver Disease, Toronto, ON M5G 2C4 Canada
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Arthur Labatt Family School of Nursing, Western University, London, ON N6A 3K7, Canada
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Gastroenterology and Hepatology, Erasmus MC University Medical Center Rotterdam, Rotterdam 3015 GD, The Netherlands
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Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada
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Public Health Ontario Laboratories, Toronto, ON M5G 1M1, Canada
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Department of Microbiology, Sunnybrook Health Sciences, Toronto, ON M4N 3M5, Canada
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Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
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Abbott Molecular, Des Plaines, IL 60018, USA
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Institute of Medical Sciences, University of Toronto, Toronto, ON M5S 1A8, Canada
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Viruses 2019, 11(9), 830; https://doi.org/10.3390/v11090830
Received: 4 August 2019 / Revised: 31 August 2019 / Accepted: 5 September 2019 / Published: 6 September 2019
(This article belongs to the Section Antivirals & Vaccines)
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 (n = 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. View Full-Text
Keywords: Chronic hepatitis C; dried blood spot; core-antigen; diagnosis; widespread screening Chronic hepatitis C; dried blood spot; core-antigen; diagnosis; widespread screening
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Biondi, M.J.; van Tilborg, M.; Smookler, D.; Heymann, G.; Aquino, A.; Perusini, S.; Mandel, E.; Kozak, R.A.; Cherepanov, V.; Kowgier, M.; Hansen, B.; Goneau, L.W.; Janssen, H.L.; Mazzulli, T.; Cloherty, G.; de Knegt, R.J.; Feld, J.J. Hepatitis C Core-Antigen Testing from Dried Blood Spots. Viruses 2019, 11, 830.

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