Usefulness of dried blood spot samples for monitoring hepatitis C treatment outcome and reinfection among people who inject drugs in a test-and-treat program

Not, Anna; Saludes, Verónica; Gálvez, Mont; Miralpeix, Anna; Bordoy, Antoni E.; González, Noemi; González Gómez, Sara; Muntané, Laura; Reyes-Urueña, Juliana; Majó, Xavier; Colom, Joan; Forns, Xavier; Lens, Sabela; Martró, Elisa

Usefulness of dried blood spot samples for monitoring hepatitis C treatment outcome and reinfection among people who inject drugs in a test-and-treat program

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dc.contributor.author Not, Anna
dc.contributor.author Saludes, Verónica
dc.contributor.author Gálvez, Mont
dc.contributor.author Miralpeix, Anna
dc.contributor.author Bordoy, Antoni E.
dc.contributor.author González, Noemi
dc.contributor.author González Gómez, Sara
dc.contributor.author Muntané, Laura
dc.contributor.author Reyes-Urueña, Juliana
dc.contributor.author Majó, Xavier
dc.contributor.author Colom, Joan
dc.contributor.author Forns, Xavier
dc.contributor.author Lens, Sabela
dc.contributor.author Martró, Elisa
dc.date.accessioned 2024-02-08T07:56:39Z
dc.date.available 2024-02-08T07:56:39Z
dc.date.issued 2023
dc.description.abstract Dried blood spots (DBS) are a reliable tool to diagnose viremic hepatitis C virus (HCV) infection. We evaluated the clinical performance of a DBS-based molecular assay for the assessment of cure and reinfection after on-site treatment at a harm reduction center (HRC). Genotyping from DBS samples was also assessed to discriminate reinfection from treatment failure. People who inject drugs (PWID) from an ongoing test-and-treat pilot at the largest HRC in Barcelona were included in the study. HCV-RNA detection from DBS collected after treatment (with follow-up at 12, 36, and 60 weeks) was compared with a molecular point-of-care test using finger-stick blood (GeneXpert). Baseline and follow-up DBS samples were genotyped by NS5B sequencing or commercial real-time PCR. Among treated patients, 193 follow-up DBS samples were tested. The DBS-based assay showed 100% specificity (129/129), and sensitivity ranged from 84.4% to 96.1% according to different viral load cut-offs (from detectable to 3000 IU/mL). Sensitivity as test of cure (follow-up 12) ranged from 85.1% to 97.4%. Among the 64 patients with recurrent viremia, 10.9% had low viral loads (≤1000 IU/mL); HCV genotyping allowed us to classify 73.5% of viremic cases either as reinfection or as treatment failure. DBS samples are useful to assess cure and differentiate reinfection from relapse after HCV antiviral treatment in the real world, facilitating decentralization of treatment and posttreatment follow-up in PWID. However, a fraction of patients presented with low viral loads, limiting viremia detection and genotyping in DBS and, therefore, repeat testing is recommended.
dc.description.sponsorship The authors thank all the participants who kindly participated in the present study, and the staff members at the harm reduction center involved in the study. Additionally, they thank the Translational Genomics Unit at Germans Trias i Pujol Research Institute (IGTP), and Harvey Evans for English style corrections. The study was funded by the Conquering Hepatitis Via Microelimination program (CHIME) by Gilead Sciences (IN-ES-987-5349). The funding body had no role in study design, data collection, data analysis, data interpretation, or writing of the report. The Germans Trias i Pujol Research Institute (IGTP) and the Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) have received support from the CERCA Program/Generalitat de Catalunya. A. N. holds a PFIS grant (Ref. FI20/00211, Instituto de Salud Carlos III, Fondo Social Europeo).
dc.format.mimetype application/pdf
dc.identifier.citation Not A, Saludes V, Gálvez M, Miralpeix A, Bordoy AE, González N, et al. Usefulness of dried blood spot samples for monitoring hepatitis C treatment outcome and reinfection among people who inject drugs in a test-and-treat program. J Med Virol. 2023 Feb;95(2):e28544. DOI: 10.1002/jmv.28544
dc.identifier.doi http://dx.doi.org/10.1002/jmv.28544
dc.identifier.issn 0146-6615
dc.identifier.uri http://hdl.handle.net/10230/58998
dc.language.iso eng
dc.publisher Wiley
dc.relation.ispartof J Med Virol. 2023 Feb;95(2):e28544
dc.rights © 2023 The Authors. Journal of Medical Virology published by Wiley Periodicals LLC. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subject.keyword HCV
dc.subject.keyword dried blood spots
dc.subject.keyword People who inject drugs
dc.subject.keyword Point-of-care test
dc.subject.keyword Reinfection
dc.subject.keyword Sustained virological response
dc.title Usefulness of dried blood spot samples for monitoring hepatitis C treatment outcome and reinfection among people who inject drugs in a test-and-treat program
dc.type info:eu-repo/semantics/article
dc.type.version info:eu-repo/semantics/publishedVersion

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