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HCV Testing trends

Explore the data trends in HCV testing in Northern Ireland over an 11-year dataset from the RAGS Blood Lab Initiative (2011-2012). Learn about chronic and cleared infections, antibody and PCR testing, and the challenges in accurate diagnosis. Discover the impact of HCV testing on different sectors like healthcare, fertility clinics, and occupational health. Gain insights into diagnostic protocols and the importance of second specimen testing for accurate results. Uncover the hidden prevalence of undiagnosed HCV infections and the varying positivity rates across different settings. Dive into the advancements in virology testing through the Blood Lab Initiative, enhancing molecular diagnostics and improving turnaround times for efficient screening.

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HCV Testing trends

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  1. HCVTesting trends

  2. General remarks on HCV testing • Trends in HCV testing in NI • An 11 year dataset • RAGS- blood lab initiative- 2011-2012

  3. 80% develop chronic infection HCV infections 20% clear infection `

  4. Antibody positive PCR positive Current infection Past infection Antibody positive high level PCR negative ` ? Past infection OR Spurious antibody Antibody positive low level PCR negative `

  5. HCV Antibody tests are less perfect than HIV tests • Low antibody positive PCR negative • ?past infection • Or • ?Spurious • E.g fertility occ health etc

  6. Screening EIA (Abbott Architect) Negative Reactive <3 Reactive >3 Monolisa Ag/Ab Monolisa Ag/Ab Negative Positive See next slide HCV Antigen Negative Positive Report: No current infection. Either past infection or false positive antibody. Report: Current infection. Ask for second specimenfor PCR & genotype. Suggest referral. Report: Negative Report: Negative

  7. Screening EIA (Abbott Architect) Reactive >3 Monolisa Ag/Ab Negative Positive PCR Negative Positive Report:No current infection. Indicates past infection. Ask for second specimen Report: Current infection. Ask for second specimenfor PCR & genotype. Suggest referral. Report: Negative

  8. An estimated five out of every six UK people with chronic HCV are unaware of their infection. (2004) Diagnosed Undiagnosed

  9. 9.6% of HCV tests

  10. 15.4% Of HCV tests

  11. 5.2% of HCV tests

  12. 25.6 % of HCV tests

  13. 0.49 % of HCV tests

  14. 0.39 % of HCV tests

  15. 2010 Positive results Trust/GP

  16. 2010 Positive results -Specialty

  17. Trust positivity rate • 0.21% • GP positivity rate • 0.77% • Addiction positivity rate • 2.4% • Prison positivity rate • 2.0%

  18. Virology testing in NI • Blood lab initiative (2011 2012) Biochemistry Haematology Immunology Microbiology serology (including Virology) Molecular

  19. The blood lab:RAGS • Short term • Uncertainty • Diffs • Longer term • Sustains virology molecular • Better TAT • Scaleable

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