presentation about Rapid detection of HCV by Oraquick methods

1. Rapid
detection of
hepatitis C
(OraQuick)
SAID AL JAAFARI
20091117

2. Content
▪ Hepatitis.
▪ Hepatitis C (HCV).
▪ Transmission.
▪ Signs and Symptoms.
▪ Screening and diagnosis.
▪ OraQuick Rapid HCV Antibody Test.
▪ Test Accuracy.
▪ Costs.
▪ Rapid HCV Antibody Test Kit (OraQuick).
▪ Results Interpretation.
▪ Conclusion.

3. Hepatitis
▪ Hepatitis” is an inflammation of the liver, most commonly caused
by a viral infection and can be caused by several mechanisms.
▪ There are five main hepatitis viruses
oHepatitis A virus (HAV)
oHepatitis B virus (HBV)
oHepatitis C virus (HCV)
oHepatitis D virus (HDV)
oHepatitis E virus (HEV)

4. Hepatitis C (HCV)
▪ What it is?
▪ Types of illness?
Acute illness is a presence of hepatitis for less than 6 months.
Chronic illness is a presence of hepatitis for more than 6
months. About 130–150 m people worldwide have chronic HCV
infection.
 A significant number of those who are chronically infected will
develop liver cirrhosis or liver cancer.
 About 500 000 people expire each year from hepatitis C because of liver
diseases.

5. Transmission
It is most commonly transmitted through:
• Blood Transfusion/Receipt of Blood Products
• Unsafe injection of drug practices.
• Sexual Transmission and can be passed from an infected mother to her baby.
• Needle stick injury and inadequate sterilization of medical equipment.

6. Symptoms
 The incubation time for HCV is 14 days to 6 months.
 Signs and symptoms
• Fatigue
• Joint and muscle pain
• decreased appetite
• Nausea
• dark urine
• Diarrhea
• Constipation
• Fever
• Jaundice

7. Diagnosis
1. Screening for anti-HCV antibodies with a serological test identifies
people who have been infected with the virus.
2. Nucleic acid testing (NAT) measures the amount of HCV RNA
present in serum by PCR (Polymerase chain reaction) test.
1. Antibody
Screening test
If Ab test
Reactive
2. Client referred
to follow-up
HCV nucleic acid
testing

8. OraQuick Rapid
HCV Antibody Test
• One-step test
• Uses oral fluid, fingerstick whole blood,
venepuncture whole blood, plasma or
serum.
• Results in just 20 minutes .
• Visual interpretation
• Looks for HCV antibodies

9. Test Accuracy
• Sensitivity is the ability of a test to find what it’s looking for and not miss anything.
• OraQuick has high sensitivity (97.8 to 100%)
• Specificity is when a test finds something, it should be the right thing
• OraQuick has also high specificity (99.5 to 100%).

10. Costs
Item Cost Sources/notes
Cost of EIA (enzyme immunoassay) test £6.36 Example cost from Worcester Royal
Hospital (provided by specialist
commentator).
Cost of communicating results if EIA
negative
£2.83 Assuming 1 letter to patient and 5 minutes
of nurse time (nurse at GP practice, PSSRU
2013) to organise.
Cost of counselling, communicating results
and offering referral if EIA positive
£40.83 One letter to patient (£2.83, as above),
1 GP visit to discuss results (10 minute
consultation, at £3.80 per minute of
patient contact, PSSRU 2013).
Cost of PCR (polymerase chain reaction) £113.00 £56.00 for PCR test, £57.00 for 1 specialist
consultation (Castelnuovo et al. 2006).
OraQuick HCV cost is £12–15.

11. Rapid HCV Antibody Test Kit (OraQuick)
• One-use testing equipment with built-in procedural control
• Single-use test developer solution vial
• Reusable test stand
• Disposable single-use specimen collection loop

12. Results Interpretation
Reactive Non Reactive Invalid

13. Conclusion
• The OraQuick HCV have a high sensitivity and specificity comparable to laboratory-based tests,
even when antibody levels are low.
• It is suitable as an aid in the diagnosis of HCV infection.

14. References
Gao, F., Talbot, E., Loring, C., Power, J., Dionne-Odom, J., Alroy-Preis, S., Jackson, P. and Bean,
C. (2014). Performance of the OraQuick HCV Rapid Antibody Test for Screening Exposed
Patients in a Hepatitis C Outbreak Investigation. Journal of Clinical Microbiology, 52(7),
pp.2650-2652.
Nice.org.uk, (2015). The OraQuick HCV point-of -care test for rapid detection of hepatitis C
virus antibodies | Evidence-review | Advice | NICE. [online] Available at:
https://www.nice.org.uk/advice/mib24/chapter/Evidence-review [Accessed 10 Jan. 2016].
Nice.org.uk, (2016). [online] Available at: http://www.nice.org.uk/advice/mib24/resources/the-
oraquick-hcv-pointofcare-test-for-rapid-detection-of-hepatitisc-virus-antibodies-
63499045128901 [Accessed 11 Jan. 2016].

15. Con..
Normington, J. (2016). âš¡Presentation "OraQuick HCV Rapid Test How to Run the
Test. Overview Background Presentation Demo of the test You will practice
running 2 tests We will not be testing.". [online] Slideplayer.com. Available at:
http://slideplayer.com/slide/1597947/# [Accessed 8 Jan. 2016].
Technologies, O. (2016). OraSure Technologies - OraQuick® HCV Rapid Antibody
Test. [online] Orasure.com. Available at: http://www.orasure.com/products-
infectious/products-infectious-oraquick-hcv.asp [Accessed 11 Jan. 2016].
Who.int, (2016). WHO | Hepatitis C. [online] Available at:
http://www.who.int/mediacentre/factsheets/fs164/en/ [Accessed 9 Jan. 2016].

16. Thank You
ANY QUESTION?