Rapid Versus Laboratory-Based Testing for HIV and Hepatitis C at a Drug Detoxification Treatment Center: A Randomized Trial.
Adult
Clinical Laboratory Services
/ statistics & numerical data
Female
HIV Infections
/ diagnosis
HIV Testing
/ statistics & numerical data
Hepatitis C
/ diagnosis
Humans
Male
Mass Screening
/ instrumentation
Middle Aged
Point-of-Care Testing
/ statistics & numerical data
Substance Abuse Treatment Centers
/ statistics & numerical data
Substance-Related Disorders
/ complications
HIV
drug treatment
hepatitis C
injection drug use
linkage to care
testing
Journal
The Journal of infectious diseases
ISSN: 1537-6613
Titre abrégé: J Infect Dis
Pays: United States
ID NLM: 0413675
Informations de publication
Date de publication:
02 09 2020
02 09 2020
Historique:
entrez:
3
9
2020
pubmed:
3
9
2020
medline:
19
3
2021
Statut:
ppublish
Résumé
A health department survey revealed nearly half employ laboratory-based HIV and HCV testing (LBT) over rapid testing (RT) in nonhospital settings such as drug detoxification centers. LBT has higher sensitivity for acute HIV infection compared to RT but LBT is not point of care and may result in fewer diagnoses due to loss to follow-up before result delivery. We conducted a randomized trial comparing real-world case notification of RT (Orasure) vs LBT (HIV Combo Ag/Ab EIA, HCV EIA) for HIV and HCV at a drug detoxification center. Primary outcome was receipt of test results within 2 weeks. Among 341 individuals screened (11/2016-7/2017), 200 met inclusion criteria; 58% injected drugs and 31% shared needles in the previous 6 months. Of the 200 randomized, 98 received RT and 102 LBT. Among all participants, 0.5% were positive for HIV and 48% for HCV; 96% received test results in the RT arm and 42% in the LBT arm (odds ratio, 28.72; 95% confidence interval, 10.27-80.31). Real-world case notification was 95% and 93% for HIV and HCV RT, respectively, compared to 42% for HIV and HCV LBT. RT has higher real-world case notification than LBT at drug detoxification centers.Clinical trials registration: NCT02869776.
Sections du résumé
BACKGROUND
A health department survey revealed nearly half employ laboratory-based HIV and HCV testing (LBT) over rapid testing (RT) in nonhospital settings such as drug detoxification centers. LBT has higher sensitivity for acute HIV infection compared to RT but LBT is not point of care and may result in fewer diagnoses due to loss to follow-up before result delivery.
METHODS
We conducted a randomized trial comparing real-world case notification of RT (Orasure) vs LBT (HIV Combo Ag/Ab EIA, HCV EIA) for HIV and HCV at a drug detoxification center. Primary outcome was receipt of test results within 2 weeks.
RESULTS
Among 341 individuals screened (11/2016-7/2017), 200 met inclusion criteria; 58% injected drugs and 31% shared needles in the previous 6 months. Of the 200 randomized, 98 received RT and 102 LBT. Among all participants, 0.5% were positive for HIV and 48% for HCV; 96% received test results in the RT arm and 42% in the LBT arm (odds ratio, 28.72; 95% confidence interval, 10.27-80.31). Real-world case notification was 95% and 93% for HIV and HCV RT, respectively, compared to 42% for HIV and HCV LBT.
CONCLUSIONS
RT has higher real-world case notification than LBT at drug detoxification centers.Clinical trials registration: NCT02869776.
Identifiants
pubmed: 32877557
pii: 5900604
doi: 10.1093/infdis/jiaa162
pmc: PMC7566618
doi:
Banques de données
ClinicalTrials.gov
['NCT02869776']
Types de publication
Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
S376-S383Subventions
Organisme : NIDA NIH HHS
ID : P30 DA040500
Pays : United States
Organisme : NIDA NIH HHS
ID : K23 DA044085
Pays : United States
Organisme : NIDA NIH HHS
ID : R01 DA046527
Pays : United States
Organisme : NIDA NIH HHS
ID : R25 DA035163
Pays : United States
Organisme : NIAID NIH HHS
ID : P30 AI042853
Pays : United States
Informations de copyright
© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.
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