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优化Elecsys®的HCV测定值,以改善型肝炎的诊断算法,并通过尽量减少补充测试来降低医疗保健成本

Beverly Buffart¹, Sara Cherkaoui², Hafid Dahma²

¹Department of Microbiology, Laboratoire Hospitalier Universitaire de Bruxelles - Universitair Laboratorium Brussel (LHUB-ULB), Université Libre de Bruxelles (ULB, Bruxelles, Rue Haute, 322 - 1000, Belgium. beverly.buffart@lhub-ulb.be.

European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology

|April 10, 2025

概括

优化C型肝炎病毒 (HCV) 查的测试值可以准确地识别真实阳性. 这减少了不必要的确认测试,提高了诊断效率,降低了医疗保健成本.

科学领域:

临床化学临床化学
病毒学病毒学
公共卫生公共卫生

背景情况:

病毒性肝炎,特别是型肝炎病毒 (HCV),是全球传染病死亡的一个重要原因.
目前的血清学查方法可能会导致不必要的测试和相关的医疗保健费用.

研究的目的:

为了优化HCV血清查的测试值.
通过提高初始查的准确性来减少不必要的测试和医疗保健成本.

主要方法:

通过使用260个样本,将三种HCV查试验 (Elecsys® Anti-HCV II,Alinity's Anti-HCV,Ortho® HCV 3.0) 与黄金标准进行了比较.
通过使用表现最佳的方法,为Elecsys® Anti-HCV II试验确定了最佳的信号至切断 (S/CO) 值.
在667名患者的回顾性队列中验证了值的有效性,评估了诊断影响和成本节省.

主要成果:

阿林蒂的抗HCV测定显示出高灵敏度 (100%) 和特异性 (98.2%).
对于Elecsys® Anti-HCV II试验的S/CO切线为17.8,获得了95.6%的灵敏度和96.4%的特异性 (尤登指数).
应用这一截止值发现了105个错误阳性结果 (15.74%的初始阳性),避免了不必要的PCR测试,并估计在7个月内可能节省7186.2欧元.

结论:

在 Elecsys® Anti-HCV II 试验中,S/CO 切线为 17.8,可准确预测大约 97% 的病例的真实HCV阳性.
这一优化值显著降低了确认性PCR测试的需要.
实施这种优化的切断线可以在HCV查计划中大幅节省成本.

关键词:

诊断诊断诊断诊断诊断医疗保健成本医疗保健成本肝炎是一种肝炎.这是一个PCRPCR.血清学血清学是一门学科.这是一种抗HCVV的药物.

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