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. 2024 Aug 26;11(9):ofae483.
doi: 10.1093/ofid/ofae483. eCollection 2024 Sep.

Impact of Hepatitis B Virus Point-of-care DNA Viral Load Testing Compared With Laboratory-based Standard-of-care Approaches on Uptake of HBV Viral Load Testing, Treatment, and Turnaround Times: A Systematic Review and Meta-analysis

Shuqin Gu  1 , Yusha Tao  2   3 , Chengxin Fan  3   4 , Yifan Dai  2 , Feifei Li  2 , Jamie L Conklin  5 , Joseph D Tucker  3   6   7 , Roger Chou  8 , M Anthony Moody  1   9 , Philippa Easterbrook  10 , Weiming Tang  2   3
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Impact of Hepatitis B Virus Point-of-care DNA Viral Load Testing Compared With Laboratory-based Standard-of-care Approaches on Uptake of HBV Viral Load Testing, Treatment, and Turnaround Times: A Systematic Review and Meta-analysis

Shuqin Gu et al. Open Forum Infect Dis. .

Abstract

Background: Point-of-care (PoC) hepatitis B virus (HBV) DNA viral load (VL) assays represent an alternative to laboratory-based standard-of-care (SoC) VL assays to accelerate diagnosis and treatment. We evaluated the impact of using PoC versus SoC approaches on the uptake of VL testing, treatment, and turnaround times from testing to treatment across the HBV care cascade.

Methods: We searched 5 databases, 6 conference websites, and contacted manufacturers for unpublished reports, for articles with or without a comparator (SoC VL testing), and had data on the uptake of VL testing, treatment, or turnaround times between hepatitis B surface antigen (HBsAg) testing, VL testing, and treatment in the cascade. We performed a random-effects meta-analysis on rates of VL testing and treatment initiation.

Results: Six studies, composing 9 arms, were included. Three PoC arms reported less than 1 day between screening for HBsAg positivity and VL testing, and the other one (2 arms) reported it between 7 and 11 days. Five arms reported the time to available VL test results (<1 day). Three studies reported 1-8 days between VL testing results and treatment initiation. Two studies reported the turnaround times between a positive HBsAg screening and treatment initiation (the same day and 27 days). Overall, 84.1% of those with HBsAg positivity were tested for DNA VL and 88.3% of eligible people initiated treatment.

Conclusions: HBV PoC DNA testing appears to be associated with a turnaround time of <1 day for receipt of VL results and appears associated with high rates of DNA testing and initiation of treatment among those eligible.

Clinical trials registration: PROSPERO CRD42023398440.

Keywords: hepatitis B virus; meta-analysis; point-of-care; systematic review; viral load.

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Conflict of interest statement

Potential conflicts of interest. All authors: no reported conflicts.

Figures

Figure 1.
Figure 1.
Flow diagram of study inclusion. *International Liver Conference 2020–2022, the International Network on Hepatitis in Substance Users symposia 2019, 2021, 2022, and the International Viral Hepatitis Elimination Meeting 2020–2022, American Association for the Study of Liver Diseases The Liver Meeting 2023, American Society for Microbiology 2020–2023.
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