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Evaluation of Simplified HCV Diagnostics in HIV/HCV Co-Infected Patients in Myanmar

To evaluate a decentralised testing model and simplified treatment protocol of hepatitis C virus (HCV) infection to facilitate treatment scale-up in Myanmar, this prospective, observational study recruited HIV–HCV co-infected outpatients receiving sofosbuvir/daclatasvir in Yangon, Myanmar. The study...

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Autores principales: Nyein, Phyo Pyae, Tillakeratne, Shane, Phyu, Sabai, Yee, Myint Myint, Lwin, Mya Mya, Htike, Kyaw Linn, Aung, May Thu, Grebely, Jason, Applegate, Tanya, Hanson, Josh, Matthews, Gail, Lin, Kyaw Swar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9967037/
https://www.ncbi.nlm.nih.gov/pubmed/36851736
http://dx.doi.org/10.3390/v15020521
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author Nyein, Phyo Pyae
Tillakeratne, Shane
Phyu, Sabai
Yee, Myint Myint
Lwin, Mya Mya
Htike, Kyaw Linn
Aung, May Thu
Grebely, Jason
Applegate, Tanya
Hanson, Josh
Matthews, Gail
Lin, Kyaw Swar
author_facet Nyein, Phyo Pyae
Tillakeratne, Shane
Phyu, Sabai
Yee, Myint Myint
Lwin, Mya Mya
Htike, Kyaw Linn
Aung, May Thu
Grebely, Jason
Applegate, Tanya
Hanson, Josh
Matthews, Gail
Lin, Kyaw Swar
author_sort Nyein, Phyo Pyae
collection PubMed
description To evaluate a decentralised testing model and simplified treatment protocol of hepatitis C virus (HCV) infection to facilitate treatment scale-up in Myanmar, this prospective, observational study recruited HIV–HCV co-infected outpatients receiving sofosbuvir/daclatasvir in Yangon, Myanmar. The study examined the outcomes and factors associated with a sustained virological response (SVR). A decentralised “hub-and-spoke” testing model was evaluated where fingerstick capillary specimens were transported by taxi and processed centrally. The performance of the Xpert HCV VL Fingerstick Assay in detecting HCV RNA was compared to the local standard of care ( plasma HCV RNA collected by venepuncture). Between January 2019 and February 2020, 162 HCV RNA-positive individuals were identified; 154/162 (95%) initiated treatment, and 128/154 (84%) returned for their SVR12 visit. A SVR was achieved in 119/154 (77%) participants in the intent-to-treat population and 119/128 (93%) participants in the modified-intent-to-treat population. Individuals receiving an antiretroviral therapy were more likely to achieve a SVR (with an odds ratio (OR) of 7.16, 95% CI 1.03–49.50), while those with cirrhosis were less likely (OR: 0.26, 95% CI 0.07–0.88). The sensitivity of the Xpert HCV VL Fingerstick Assay was 99.4% (95% CI 96.7–100.0), and the specificity was 99.2% (95% CI 95.9–99.9). A simplified treatment protocol using a hub-and-spoke testing model of fingerstick capillary specimens can achieve an SVR rate in LMIC comparable to well-resourced high-income settings.
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spelling pubmed-99670372023-02-26 Evaluation of Simplified HCV Diagnostics in HIV/HCV Co-Infected Patients in Myanmar Nyein, Phyo Pyae Tillakeratne, Shane Phyu, Sabai Yee, Myint Myint Lwin, Mya Mya Htike, Kyaw Linn Aung, May Thu Grebely, Jason Applegate, Tanya Hanson, Josh Matthews, Gail Lin, Kyaw Swar Viruses Article To evaluate a decentralised testing model and simplified treatment protocol of hepatitis C virus (HCV) infection to facilitate treatment scale-up in Myanmar, this prospective, observational study recruited HIV–HCV co-infected outpatients receiving sofosbuvir/daclatasvir in Yangon, Myanmar. The study examined the outcomes and factors associated with a sustained virological response (SVR). A decentralised “hub-and-spoke” testing model was evaluated where fingerstick capillary specimens were transported by taxi and processed centrally. The performance of the Xpert HCV VL Fingerstick Assay in detecting HCV RNA was compared to the local standard of care ( plasma HCV RNA collected by venepuncture). Between January 2019 and February 2020, 162 HCV RNA-positive individuals were identified; 154/162 (95%) initiated treatment, and 128/154 (84%) returned for their SVR12 visit. A SVR was achieved in 119/154 (77%) participants in the intent-to-treat population and 119/128 (93%) participants in the modified-intent-to-treat population. Individuals receiving an antiretroviral therapy were more likely to achieve a SVR (with an odds ratio (OR) of 7.16, 95% CI 1.03–49.50), while those with cirrhosis were less likely (OR: 0.26, 95% CI 0.07–0.88). The sensitivity of the Xpert HCV VL Fingerstick Assay was 99.4% (95% CI 96.7–100.0), and the specificity was 99.2% (95% CI 95.9–99.9). A simplified treatment protocol using a hub-and-spoke testing model of fingerstick capillary specimens can achieve an SVR rate in LMIC comparable to well-resourced high-income settings. MDPI 2023-02-13 /pmc/articles/PMC9967037/ /pubmed/36851736 http://dx.doi.org/10.3390/v15020521 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Nyein, Phyo Pyae
Tillakeratne, Shane
Phyu, Sabai
Yee, Myint Myint
Lwin, Mya Mya
Htike, Kyaw Linn
Aung, May Thu
Grebely, Jason
Applegate, Tanya
Hanson, Josh
Matthews, Gail
Lin, Kyaw Swar
Evaluation of Simplified HCV Diagnostics in HIV/HCV Co-Infected Patients in Myanmar
title Evaluation of Simplified HCV Diagnostics in HIV/HCV Co-Infected Patients in Myanmar
title_full Evaluation of Simplified HCV Diagnostics in HIV/HCV Co-Infected Patients in Myanmar
title_fullStr Evaluation of Simplified HCV Diagnostics in HIV/HCV Co-Infected Patients in Myanmar
title_full_unstemmed Evaluation of Simplified HCV Diagnostics in HIV/HCV Co-Infected Patients in Myanmar
title_short Evaluation of Simplified HCV Diagnostics in HIV/HCV Co-Infected Patients in Myanmar
title_sort evaluation of simplified hcv diagnostics in hiv/hcv co-infected patients in myanmar
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9967037/
https://www.ncbi.nlm.nih.gov/pubmed/36851736
http://dx.doi.org/10.3390/v15020521
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