Active HCV diagnosis to support prevention of HCC in LMICs
Project Number1U01CA292771-01
Contact PI/Project LeaderMCFALL, SALLY MAUREEN Other PIs
Awardee OrganizationNORTHWESTERN UNIVERSITY
Description
Abstract Text
Project Summary
HCV is a major threat worldwide, infecting over 58 million people and causing 300,000 deaths from HCV-related
cirrhosis or hepatocellular carcinoma (HCC) each year. Nigeria has approximately 2.2 million people living with
HCV with prevalence rates ranging from 0.1-30% depending on the population and region. HCV contributes to
about a quarter of HCC in Nigeria, which is the fifth leading cause of cancer and cancer related mortality in this
country. Approximately 15-45% of persons infected with HCV will spontaneously clear the virus, therefore after
testing positive on a serological test (anti-HCV), confirmation of HCV viremia with laboratory-based molecular
HCV viral load (VL) testing is necessary to identify those who need treatment. In Nigeria and many other LMICs,
access to laboratory-based VL tests remains limited and as a result many people screening positive for anti-
HCV and with active HCV (defined as positive anti-HCV, detectable (>LLD) HCV RNA) are never linked to care
and treatment. Successful treatment of HCV has significantly reduced the risk of HCV-related HCC. The lack of
a single step point-of-care (POC) test for the diagnosis of active HCV infection both high- and low-and-middle
income countries is a significant impediment to swift initiation of treatment impacting the ability to end the HCV
epidemic and prevent long-term complications such as HCC. Here we propose to develop and validate an HCV
test for the DASH™ platform for the diagnosis of active HCV at the point of care, by sensitively detecting HCV
viral RNA, obviating the requirement for two-step serologic and laboratory based molecular testing. The
DASH™HCV test is designed to be easily operated by non-laboratory personnel in settings that lack laboratory
infrastructure. A capillary blood sample is simply collected by fingerstick, added to the test cartridge, and inserted
into the DASH™ analyzer. After 15 minutes, an easy-to-read qualitative positive or negative result appears on
the unit's touch screen. Following development, the diagnostic accuracy of DASH™ HCV will be evaluated on
both stored plasma and prospectively collected whole blood samples from Nigeria. The acceptability and usability
of DASH™ HCV will also be evaluated in real-world settings among at risk adults from three diverse geographic
regions of Nigeria. This study is expected to lead to the approval of a small, portable, cheap POC molecular
device for the rapid, single step, diagnosis of active HCV in a wide range of LMIC settings that will significantly
increase availability and access to HCV testing and thus reduce the incidence of HCV- related HCC.
Public Health Relevance Statement
Project Narrative
Active Viral Hepatitis Diagnostics to Support Prevention/Treatment of HCC
Hepatocellular carcinoma (HCC) is a highly lethal cancer with over 80% of the cases occurring
in low resource settings. Chronic hepatitis C (HCV) infection is major risk factor for HCC
development. The goal of this proposal is to develop and validate a diagnostic test for HCV
infections for use in low-and-middle-income-countries to identify patients for treatment thus
reducing their risk of developing HCC.
NIH Spending Category
No NIH Spending Category available.
Project Terms
AdministratorAdultAgeBiological AssayBlood capillariesBlood specimenCOVID-19 testCancer EtiologyCaringCessation of lifeCharacteristicsChronic Hepatitis CCirrhosisClinical SensitivityCommunicable DiseasesComplexCountryDataDevelopmentDevicesDiagnosisDiagnosticDiagnostic testsEnrollmentEnzyme ImmunoassayEpidemicFDA Emergency Use AuthorizationFingersFutureGenotypeGeographic LocationsGlobal AwarenessGoalsHIVHealth TechnologyHepatitis B VirusHepatitis CHepatitis C IncidenceHepatitis C TherapyHepatitis C ViremiaHuman ResourcesImprove AccessIncidenceInfectionInfrastructureKineticsLaboratoriesLeftLicensingLifeLinkLiverLiver diseasesMalignant NeoplasmsMolecularNigeriaNigerianParticipantPatientsPerformancePersonsPlasmaPolymerase Chain ReactionPopulationPrevalencePreventionPrimary carcinoma of the liver cellsPublic HealthRNAReagentResource-limited settingReverse TranscriptionRiskRisk FactorsSamplingSensitivity and SpecificitySerologySerology testSpecificitySystemTechnologyTestingTimeVenousViral Load resultViral hepatitisVirusVisitWhole Bloodacceptability and feasibilityanti-hepatitis Ccommercializationcostdesigndetection limitdiagnostic accuracyglobal healthhigh riskimprovedinnovationlow and middle-income countriesmortalitynovelpatient populationpoint of carepoint of care testingpoint-of-care diagnosticsportabilitypreferencepreventpreventive interventionprospectivereagent testingrural areascreeningsextouchscreenurban areausabilityviral RNAvirus testing
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