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Diagnostic Accuracy of Point-of-Care Tests for Hepatitis C Virus Infection: A Systematic Review and Meta-Analysis

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  • Mehnaaz Sultan Khuroo
  • Naira Sultan Khuroo
  • Mohammad Sultan Khuroo

Abstract

Background: Point-of-care tests provide a plausible diagnostic strategy for hepatitis C infection in economically impoverished areas. However, their utility depends upon the overall performance of individual tests. Methods: A literature search was conducted using the metasearch engine Mettā, a query interface for retrieving articles from five leading medical databases. Studies were included if they employed point-of-care tests to detect antibodies of hepatitis C virus and compared the results with reference tests. Two reviewers performed a quality assessment of the studies and extracted data for estimating test accuracy. Findings: Thirty studies that had evaluated 30 tests fulfilled the inclusion criteria. The overall pooled sensitivity, specificity, positive likelihood-ratio, negative likelihood-ratio and diagnostic odds ratio for all tests were 97.4% (95% CI: 95.9–98.4), 99.5% (99.2–99.7), 80.17 (55.35–116.14), 0.03 (0.02–0.04), and 3032.85 (1595.86–5763.78), respectively. This suggested a high pooled accuracy for all studies. We found substantial heterogeneity between studies, but none of the subgroups investigated could account for the heterogeneity. Genotype diversity of HCV had no or minimal influence on test performance. Of the seven tests evaluated in the meta-regression model, OraQuick had the highest test sensitivity and specificity and showed better performance than a third generation enzyme immunoassay in seroconversion panels. The next highest test sensitivities and specificities were from TriDot and SDBioline, followed by Genedia and Chembio. The Spot and Multiplo tests produced poor test sensitivities but high test specificities. Nine of the remaining 23 tests produced poor test sensitivities and specificities and/or showed poor performances in seroconversion panels, while 14 tests had high test performances with diagnostic odds ratios ranging from 590.70 to 28822.20. Conclusions: Performances varied widely among individual point-of-care tests for diagnosis of hepatitis C virus infection. Physicians should consider this while using specific tests in clinical practice.

Suggested Citation

  • Mehnaaz Sultan Khuroo & Naira Sultan Khuroo & Mohammad Sultan Khuroo, 2015. "Diagnostic Accuracy of Point-of-Care Tests for Hepatitis C Virus Infection: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 10(3), pages 1-22, March.
    • Handle: RePEc:plo:pone00:0121450
    DOI: 10.1371/journal.pone.0121450
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    References listed on IDEAS

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    1. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
    2. Drobnik, A. & Judd, C. & Banach, D. & Egger, J. & Konty, K. & Rude, E., 2011. "Public health implications of rapid hepatitis C screening with an oral swab for community-based organizations serving high-risk populations," American Journal of Public Health, American Public Health Association, vol. 101(11), pages 2151-2155.
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    1. Paul Jülicher & Vladimir P Chulanov & Nikolay N Pimenov & Ekaterina Chirkova & Anna Yankina & Claudio Galli, 2019. "Streamlining the screening cascade for active Hepatitis C in Russia: A cost-effectiveness analysis," PLOS ONE, Public Library of Science, vol. 14(7), pages 1-22, July.
    2. Léa Duchesne & Gilles Hejblum & Richard Njouom & Coumba Touré Kane & Thomas d’Aquin Toni & Raoul Moh & Babacar Sylla & Nicolas Rouveau & Alain Attia & Karine Lacombe, 2020. "Model-based cost-effectiveness estimates of testing strategies for diagnosing hepatitis C virus infection in Central and Western Africa," PLOS ONE, Public Library of Science, vol. 15(8), pages 1-18, August.
    3. Christina Greenaway & Iuliia Makarenko & Claire Nour Abou Chakra & Balqis Alabdulkarim & Robin Christensen & Adam Palayew & Anh Tran & Lukas Staub & Manish Pareek & Joerg J. Meerpohl & Teymur Noori & , 2018. "The Effectiveness and Cost-Effectiveness of Hepatitis C Screening for Migrants in the EU/EEA: A Systematic Review," IJERPH, MDPI, vol. 15(9), pages 1-24, September.

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