Simultaneous administration of point-of-care rapid testing for HIV and hepatitis B and hepatitis C viruses could inform more patients attending clinics of their chronic viral infection status, according to recently published data.
“[In Europe and the U.S.], roughly two-thirds of HBV-infected, 50% of HCV-infected and 15%-30% of HIV-infected individuals are unaware of their infection status,” the researchers wrote. “Point-of-care (POC) testing could facilitate screening by reducing the material or psychological obstacles of standard testing and provide ease in obtaining results.”
In the randomized-control trial, researchers enrolled 324 adults attending a free Parisian clinic from Feb. 25, 2013 to June 21, 2013. Participants were randomly assigned to undergo standard serology-based diagnostic tests for HIV, HBV and HCV, or POC rapid testing for the same diseases. Those in the prior arm received prescriptions to have venipuncture performed at an outside laboratory and were asked to return within 8 to 10 days to receive results, while participants in the latter underwent rapid testing at the clinic and received results within 30 minutes. In addition, participants were asked questions concerning their country of origin, current health care coverage, history of testing and preferred method of screening. The primary and secondary outcomes were the percentage of participants who obtained their results and linkage-to-care among those infected, respectively.
Nearly two-thirds of participants were male (mean age, 37.6 years). No participants were registered under a health insurance plan, 75.3% were from sub-Saharan Africa, and 20.1% reported ever being screened for HIV, HBV and HCV.
A greater proportion of participants in the rapid POC arm received test results compared with those in the standard serology arm (98.2% vs. 64.2%; P < .001). More participants from the rapid POC arm with positive results were linked to care, but this increase was not significant. However, a post-hoc analysis assuming similar infection prevalence among participants who did not receive results estimated that increased linkage resulting from the rapid testing (P = .04). More than three-quarters of participants said they would prefer rapid testing, and cited reduced stress and practicality as the leading reasons for this preference.
“A combined approach to HIV and viral hepatitis screening seems to improve the overall cascade of screening and consequently linkage-to-care in a population with high-risk of chronic viral infection,” the researchers wrote. “In the future, the development of a single rapid test for the detection of all three chronic viral diseases could ease the burden of multiple testing, allowing a simplified way of identifying infected HIV/HBV/HCV individuals and increasing awareness of disease status.” – by Dave Muoio
Disclosure: The researchers report no relevant financial disclosures.