Hepatitis C Virus Infection Clinical Trial
Official title:
Prospective Diagnostic Accuracy Study of Rapid Diagnostic Tests (RDTs) Detecting Antibodies Against Hepatitis C Virus (HCV) in Freshly Collected Whole Blood, Plasma and Serum
This study evaluates the sensitivity and specificity performance of three Hepatitis C Virus (HCV) rapid diagnostic tests (RDTs) in freshly collected fingerstick whole blood, as well as serum and plasma (Premier Medical Corporation First Response HCV RDT; Beijing Wantai HCV RDT; AccessBio Care Start HCV under development). Performance is compared to the SD Bioline HCV RDT, as well as a composite reference standard, consisting of two enzyme Immunoassay and a line immunoassay.
Hepatitis C virus (HCV) infection is a major public health burden, with an estimated 71
million patients being infected globally. If undiagnosed, HCV infection can lead to severe
liver damage, including hepatocellular carcinoma (HCC). The World Health Organization (WHO)
recently set a target to eliminate HCV by 2030. The first critical step in reaching this
target is to accurately identify people infected with HCV. Globally, significant gaps remain
in diagnosis of HCV, with four out of five people infected still unaware of their status,
largely due to lack of access to testing services.
In resource-limited settings (RLS), laboratory-based testing remains a mainstay for HCV
screening and confirmatory testing. Such laboratory-based assays rely on transportation of
temperature-sensitive samples from clinic sites to centralized laboratories, high-tech
equipment and highly skilled laboratory technicians, limiting the scope of access to testing
and resulting in long turn-around times for results. In recent years, new technologies have
been developed to decentralize HCV screening and confirmatory testing using point-of-care
(POC) assays to overcome these barriers and improve patient outcomes.
Rapid diagnostic tests (RDT) for screening for HCV are affordable, accurate, easy to use by
healthcare workers, and robust in field settings. Although a number of HCV RDTs are on the
market, currently only two have received WHO pre-qualification (PQ) status, demonstrating
their accuracy and reliability for use in the field in RLS. Data on a number of other RDTs
indicate their suitability for use. More data is needed, however, in field settings for these
HCV RDTs, to demonstrate their accuracy and quality in end-user studies and to provide
evidence for WHO PQ approval.
Based on the results of a recent FIND laboratory evaluation assessing the performance of 13
HCV RDTs using archived plasma samples, we have selected three candidate HCV RDTs ("study
RDTs") for further evaluation in field settings (e.g. primary healthcare facilities). The
performance of these RDTs measured in frozen plasma specimens indicated that they have a high
potential to meet WHO PQ performance criteria in freshly collected samples. In addition, the
manufacturers each demonstrate evidence of engagement to pursue both CE-mark status and the
WHO PQ process, showing commitment to delivering quality-assured tests to the market.
The data generated during this study will be used to inform national and international
stakeholders on HCV RDT performance in field settings and shared with manufacturers to
support the evidence package for WHO PQ and/or CE-marking.
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