Assessing Molecular Point-of-Care Testing and Dried Blood Spot for Hepatitis C Virus Screening in People Who Inject Drugs
Background: Injecting drug use is the primary driver of the hepatitis C virus (HCV) is spread throughout the world, and the World Health Organization (WHO) has identified people who inject drugs (PWID) as a key population for targeted for HCV screening and treatment. Point-of-care (POC) tests for hepatitis C and dried blood spot (DBS) samples offer benefits for the management of patients with HCV infection by enhancing HCV testing and linkage to care in different nonclinical settings. The aim of this prospective study was to evaluate the feasibility and acceptance of the use of HCV ribonucleic acid (RNA) and fingerstick DBS POC testing in the centers of socio-medical risk reduction and to describe the treatment cascade among PWID in France.
Methods: Between June 2018 and February 2019, 89 consecutive PWID HCV-seropositive attend two services drug therapy and 1 consumption supervised in Paris were invited to participate in the further evaluation, undergo a review of clinical assessment the liver and blood tests including capillary fingerstick HCV RNA POC whole blood tests and fingerstick DBS sampling.
Results: Of the 89 participants enrolled, HCV RNA was detected in 34 (38.6%) participants. Fingerstick whole blood RNA POC testing and detection of HCV RNA from DBS samples are feasible and acceptable among PWID with no major difference in the detection rate of HCV RNA. Overall, 16 subjects received a pan-genotypic antiviral treatment. The proportion PWID with SVR at 12 weeks was 81.2%, with data for 3 patients were still pending.
Conclusion: One-step screening strategy based on the detection of HCV RNA will engage people in treatment for scale-up of treatment and elimination of HCV. Keywords: HCV RNA screening; dried blood spot; hepatitis C; people who inject drugs; point of care testing.
Assessing Molecular Point-of-Care Testing and Dried Blood Spot for Hepatitis C Virus Screening in People Who Inject Drugs
clinical risk factors and inflammatory biomarkers of acute kidney injury in patients with post-traumatic combat
Background: Post-traumatic acute kidney injury has occurred in every major military conflict since the initial description during World War II. To ensure the proper treatment of victims of war, early detection is critical. This research therefore aims to determine post-traumatic acute injury-related kidney combat-military conflict recently, the former machine learning algorithms to identify clinical variables and biomarkers associated with the development of acute kidney injury post-trauma, and evaluate the effects of post-traumatic kidney injury acute wound healing and nosocomial infections.
Methods: We conducted a retrospective review of clinical cohort of 73 members of the US military service seriously injured were wounded limb-combat related major injury and has amassed characteristics, tested serum and tissue biopsy samples for protein expression and biomarker messenger ribonucleic acid. Bivariate analysis and classification algorithms recursive feature elimination of random forests are used to identify associated characteristics and variables injury biomarker.
Results: The incidence of acute kidney injury posttraumatic is 20.5%. That is, 86% recovery of renal function is basic and only 2 (15%) of acute kidney injury group required renal replacement therapy. Features recursive algorithm can estimate the random forest abolition of post-traumatic acute kidney injury with the area under the curve of 0.93, sensitivity of 0.91 and specificity of 0.91. Acute kidney injury is associated with post-traumatic injury severity scores, epidermal growth factor serum, and tissue activin A receptor type 1, matrix metallopeptidase 10, and X-C motif chemokine ligand 1 expression. Patients with acute post-traumatic injury to the kidneys exhibited poor wound healing and increased incidence of nosocomial infections.
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