scholarly journals Point-of-Care Tests for Hepatitis B: An Overview

Cells ◽  
2020 ◽  
Vol 9 (10) ◽  
pp. 2233
Author(s):  
Yinzong Xiao ◽  
Alexander J. Thompson ◽  
Jessica Howell
Keyword(s):  
Hepatitis B ◽  
Technology Implementation ◽  
Point Of Care ◽  
Point Of Care Testing ◽  
Future Directions ◽  
Blood Tests ◽  
Laboratory Facilities ◽  
Regulatory Bodies ◽  
Hard To Reach Populations ◽  
Point Of Care Tests

Despite the heavy disease burden posed by hepatitis B, around 90% of people living with hepatitis B are not diagnosed globally. Many of the affected populations still have limited or no access to essential blood tests for hepatitis B. Compared to conventional blood tests which heavily rely on centralised laboratory facilities, point-of-care testing for hepatitis B has the potential to broaden testing access in low-resource settings and to engage hard-to-reach populations. Few hepatitis B point-of-care tests have been ratified for clinical use by international and regional regulatory bodies, and countries have been slow to adopt point-of-care testing into hepatitis B programs. This review presents currently available point-of-care tests for hepatitis B and their roles in the care cascade, reviewing evidence for testing performance, utility, acceptability, costs and cost-effectiveness when integrated into hepatitis B diagnosis and monitoring programs. We further discuss challenges and future directions in aspects of technology, implementation, and regulation when adopting point-of-care testing in hepatitis B programs.

scholarly journals Comparison of Rapid Point-of-Care Tests for Detection of Antibodies to Hepatitis C Virus

2015 ◽  
Vol 2 (3) ◽  
Author(s):  
Dennis G. Fisher ◽  
Kristen L. Hess ◽  
Erlyana Erlyana ◽  
Grace L. Reynolds ◽  
Catherine A. Cummins ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Hepatitis B ◽  
Whole Blood ◽  
Point Of Care ◽  
Antibody Test ◽  
The United States ◽  
Blood Tests ◽  
Hcv Antibody ◽  
Point Of Care Tests

Abstract Background.  Hepatitis C is one of the most prevalent blood-borne diseases in the United States. Despite the benefits of early screening, among 3.2 million Americans who are infected with hepatitis C virus (HCV), 50%–70% are unaware of their infection status. Methods.  Data were collected between 2011 and 2014, from 1048 clients who were in the following groups: (1) injection drug users, (2) women at sexual risk, (3) gay and bisexual men, and (4) transgender individuals. The sensitivity and specificity of point-of-care tests included (1) the MedMira rapid human immunodeficiency virus (HIV)/HCV antibody test, (2) MedMira hepatitis B (HBV)/HIV/HCV antibody test, (3) Chembio HCV Screen Assay used with both whole blood and (4) oral specimens, (5) Chembio HIV-HCV Assay also used with both whole blood and (6) oral specimens, (7) Chembio HIV-HCV-Syphilis Assay, and (8) OraSure HCV Rapid Antibody Test used with whole blood. The gold standard for the HCV tests were HCV enzyme immunoassay (EIA) 2.0. Results.  OraSure had the highest sensitivity at 92.7% (95% confidence interval [CI] = 88.8%–96.5%) followed closely by Chembio's 3 blood tests at 92.1% (95% CI = 87.7%–96.4%), 91.5% (95% CI = 87.2%–95.7%), and 92.3% (95% CI = 88.4%–96.2%). The sensitivities of MedMira HIV/HCV and MedMira HIV/HCV/HBV tests were the lowest, at 79.1% (95% CI = 72.6%–85.5%), and 81.5% (95% CI = 75.2%–87.8%), respectively. Specificity for the OraSure was 99.8% (95% CI = 99.4%–100%); specificity for the Chembio blood tests was 99.2% (95% CI = 98.6%–99.9%), 99.4% (95% CI = 98.8%–99.9%), and 99.3% (95% CI = 98.8%–99.9%); and specificity for the MedMira was100% and 100%. False-negative results were associated with HIV and hepatitis B core antibody serostatus. Conclusions.  The OraSure and Chembio blood tests (including those multiplexed with HIV and syphilis) appear to good performance characteristics. This study has identified potential limitations of rapid testing in those testing positive for HIV and HBcAb. There should be discussion of updates to the 2013 CDC guidance.

scholarly journals Formulating Design Recommendations for the Acceptance of the Use and Results of Point-of-Care Testing in Low- and Middle-Income Countries: A Literature Review

2019 ◽  
Vol 1 (1) ◽  
pp. 2795-2804
Author(s):  
Yvonne Jolanda Melanie Licher ◽  
Jan Simon Visser ◽  
G-Young Van ◽  
Jan Carel Diehl
Keyword(s):  
Healthcare Workers ◽  
Point Of Care ◽  
Waiting Times ◽  
Point Of Care Testing ◽  
Middle Income ◽  
Future Design ◽  
Middle Income Countries ◽  
Barriers And Opportunities ◽  
Point Of Care Tests ◽  
Low And Middle Income

AbstractIn low- and middle-income countries (LMIC), diagnostics are not always available in remote areas. Hospitals and healthcare centres are often too far from the community, and waiting times are up to a few hours even for relatively simple procedures. Moreover, travelling to the healthcare centre and taking the diagnostic test is frequently unaffordable. Point of Care Tests (POCTs) can improve the availability, accessibility and affordability of the diagnostics by providing the test at the time and place of patient care. Although many POCTs have been developed already, there remain challenges to enable the healthcare workers (HCW) and the patients to use the device in practice. In this paper, we aim to provide a systemic overview of the barriers and opportunities for the adoption of use and acceptance of the results of POCTs based on the literature. The barriers and opportunities were clustered into six themes and used to draw out recommendations for the future design.

Point-of-Care Testing in Liver Disease and Liver Surgery

2017 ◽  
Vol 43 (04) ◽  
pp. 407-415 ◽  
Author(s):  
Lasitha Abeysundara ◽  
Susan Mallett ◽  
Ben Clevenger
Keyword(s):  
Liver Disease ◽  
Blood Product ◽  
Point Of Care ◽  
Massive Bleeding ◽  
Point Of Care Testing ◽  
Hemostatic System ◽  
Coagulation Tests ◽  
Postoperative Thrombosis ◽  
Coagulation Status ◽  
Point Of Care Tests

AbstractThe alterations in coagulation and hemostasis that accompany liver disease are complex, and while patients with this disease have traditionally been perceived as having a bleeding diathesis, it is now understood that in stable patients hemostasis is “re-balanced.” Hepatic surgery, and particularly liver transplantation, can be associated with large fluid shifts, massive bleeding, and coagulopathy, as well as postoperative thrombosis. Point-of-care tests (POCTs) of coagulation facilitate goal-directed treatments and hemostatic monitoring in dynamic environments where the coagulation status can alter rapidly and often unpredictably. POCTs reflect more accurately the re-balanced hemostatic system than do conventional coagulation tests (CCTs). Viscoelastic POCT-guided transfusion algorithms permit a reduction in blood product administration and are a key component of patient blood management programs. Moreover, viscoelastic POCTs are better able to identify patients with hypercoagulability than CCTs. With thrombosis increasingly recognized to be a problem in patients with liver disease, POCTs hold promise for both individualized bleeding and thrombosis management.

Basis of Image Analysis for Evaluating Cell Biomaterial Interaction Using Brightfield Microscopy

2021 ◽  
pp. 1-28
Author(s):  
Arban Uka ◽  
Albana Ndreu Halili ◽  
Xhoena Polisi ◽  
Ali O. Topal ◽  
Gent Imeraj ◽  
...  
Keyword(s):  
Image Analysis ◽  
Point Of Care ◽  
Cell Interaction ◽  
Specific Pattern ◽  
Point Of Care Testing ◽  
New Techniques ◽  
Future Directions ◽  
Sensing Platforms ◽  
Brightfield Microscopy ◽  
Characteristics Of Image

Medical imaging is a growing field that has stemmed from the need to conduct noninvasive diagnosis, monitoring, and analysis of biological systems. With the developments and advances in the medical field and the new techniques that are used in the intervention of diseases, very soon the prevalence of implanted biomedical devices will be even more significant. The implanted materials in a biological system are used in diverse fields, which require lengthy evaluation and validation processes. However, currently the evaluation of the toxicity of biomaterials has not been fully automated yet. Moreover, image analysis is an integral part of biomaterial research, but it is not within the core capacities of a significant portion of biomaterial scientists, which results in the use of predominantly ready-made tools. The detailed image analysis can be conducted once all the relevant parameters including the inherent characteristics of image acquisition techniques are considered. Herein, we cover the currently used image analysis-based techniques for assessment of biomaterial/cell interaction with a specific focus on unstained brightfield microscopy acquired mostly in but not limited to microfluidic systems, which serve as multiparametric sensing platforms for noninvasive experimental measurements. We present the major imaging acquisition techniques that enable point-of-care testing when incorporated with microfluidic cells, discuss the constraints enforced by the geometry of the system and the material that is analyzed, and the challenges that rise in the image analysis when unstained cell imaging is employed. Emerging techniques such as utilization of machine learning and cell-specific pattern recognition algorithms and potential future directions are discussed. Automation and optimization of biomaterial assessment can facilitate the discovery of novel biomaterials together with making the validation of biomedical innovations cheaper and faster.

scholarly journals Point-of-care testing as the future of pre-hospital emergency medicine: an overview

2021 ◽  
Keyword(s):  
Emergency Medicine ◽  
Point Of Care ◽  
Cost Effective ◽  
Point Of Care Testing ◽  
Hospital Emergency ◽  
Management Guidelines ◽  
Inspection Errors ◽  
Advantages And Disadvantages ◽  
Point Of Care Tests ◽  
Total Compliance

Point-of-care testing (POCT) plays an increasingly important role in pre-emergency medicine by ensuring that patient’s continuum of care is commenced before arrival at health facilities. Given the benefits of POCT during the COVID-19 pandemic, this commentary described the advantages and disadvantages of POCT, and its current practices in pre-hospital emergency medicine. Point-of-care tests are easy to operate, cost-effective, and yield quick and accurate response, but are posed with challenges such as safety errors, poor adherence to quality control standards, and inspection errors. To optimize the benefits of POCT in pre-emergency medicine, it is required that regular trainings are conducted for POCT operators, and total compliance to POCT handling and management guidelines should be considered by each POCT operator.

scholarly journals Evaluation of Serological SARS-CoV-2 Lateral Flow Assays for Rapid Point of Care Testing

2020 ◽  
Author(s):  
Steven E Conklin ◽  
Kathryn Martin ◽  
Yukari C Manabe ◽  
Haley A Schmidt ◽  
Morgan Keruly ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Symptom Onset ◽  
Point Of Care ◽  
Negative Control ◽  
Lateral Flow ◽  
Point Of Care Testing ◽  
Specific Antibodies ◽  
Testing Performance ◽  
Lateral Flow Assays ◽  
Point Of Care Tests

Background. Rapid point-of-care tests (POCTs) for SARS-CoV-2-specific antibodies vary in performance. A critical need exists to perform head-to-head comparison of these assays. Methods. Performance of fifteen different lateral flow POCTs for the detection of SARS-CoV-2-specific antibodies was performed on a well characterized set of 100 samples. Of these, 40 samples from known SARS-CoV-2-infected, convalescent individuals (average of 45 days post symptom onset) were used to assess sensitivity. Sixty samples from the pre-pandemic era (negative control), that were known to have been infected with other respiratory viruses (rhinoviruses A, B, C and/or coronavirus 229E, HKU1, NL63 OC43) were used to assess specificity. The timing of seroconversion was assessed on five POCTs on a panel of 272 longitudinal samples from 47 patients of known time since symptom onset. Results. For the assays that were evaluated, the sensitivity and specificity for any reactive band ranged from 55%-97% and 78%-100%, respectively. When assessing the performance of the IgM and the IgG bands alone, sensitivity and specificity ranged from 0%-88% and 80%-100% for IgM and 25%-95% and 90%-100% for IgG. Longitudinal testing revealed that median time post symptom onset to a positive result was 7 days (IQR 5.4, 9.8) for IgM and 8.2 days (IQR 6.3 to 11.3). Conclusion. The testing performance varied widely among POCTs with most variation related to the sensitivity of the assays. The IgM band was most likely to misclassify pre-pandemic samples. The appearance of IgM and IgG bands occurred almost simultaneously.

2017 European guideline for the screening, prevention and initial management of hepatitis B and C infections in sexual health settings

2018 ◽  
Vol 29 (10) ◽  
pp. 949-967 ◽  
Author(s):  
Gary Brook ◽  
Norbert Brockmeyer ◽  
Thijs van de Laar ◽  
Sven Schellberg ◽  
Andrew J Winter
Keyword(s):  
Hepatitis B ◽  
Sexual Health ◽  
Point Of Care ◽  
Sexual Transmission ◽  
Hepatitis E ◽  
European Guideline ◽  
Virus Infections ◽  
Initial Management ◽  
Exposure Prophylaxis ◽  
Point Of Care Tests

This guideline updates the 2010 European guideline for the management of hepatitis B and C virus infections. It is primarily intended to provide advice on testing, prevention and initial management of viral hepatitis B and C for clinicians working in sexual health clinical settings in European countries. The guideline is in a new question and answer format based on clinical situations, from which population/intervention/comparison/outcome questions were formulated. Updates cover areas such as epidemiology, point-of-care tests for hepatitis B, hepatitis C risk and ‘chemsex’, and HIV pre-exposure prophylaxis and hepatitis B. We have also included a short paragraph on hepatitis E noting there is no evidence for sexual transmission. The guideline has been prepared in accordance with the Europe protocol for production available at http://www.iusti.org/regions/europe/pdf/2017/ProtocolForProduction2017.pdf

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