Routine practice HCV infection screening with saliva samples: multicentric study in an intravenous drug user population.
OBJECTIVE
The purpose of this randomized multicentric study was to evaluate the diagnostic contribution of screening for HCV infection on saliva samples in day-to-day practice in the intravenous drug-user (IVDU) population.


METHODS
Between January and May 2004, 274 presumably HCV-negative IVDU were screened for HCV infection in 15 centers in France (median age 29 years). After centralized randomization, screening tests were performed on blood samples (arm A) or saliva samples (arm B). Screening tests were performed in 78 subjects (28%) had never been screened before and in 196 subjects (72%) who had had a negative HCV screening test on average 12 months prior to the beginning of the study. In the event of a positive saliva test for anti-HCV Ab, a serum test for anti-HCV Ab was performed. In the event of a positive serum test for anti-HCV Ab, PCR was performed on serum to measure HCV-RNA.


RESULTS
Fourteen individuals were positive for HCV RNA (7 in each arm). Six of these cases had not been detected before. In eight cases, the median time between the last negative screening test and study inclusion was 11 months (range 6-94 months).


CONCLUSIONS
Viremia tests were positive in 5% percent of the target population, although one-third of the individuals in arm A (blood samples) were not tested. The saliva test may be a useful alternative in the event of refusal of a blood test or when poor venous conditions compromise venous puncture. A confirmatory blood test still remains difficult to obtain in nearly half of patients.
Lucidarme
Damien
D
Groupe Hospitalier de l'Institut Catholique de Lille, Hôpital Saint-Philibert, Lomme. lucidarme.damien@ghicl.net
Decoster
Anne
A
Fremaux
Didier
D
Harbonnier
Jean
J
Jacob
Claude
C
Vosgien
Véronique
V
Josse
Pascal
P
Villeger
Pierre
P
Henrio
Cécile
C
Prouvost-Keller
Bernard
B
Saccardy
Claire
C
Lemaire
Muriel
M
Vazeille
Gérard
G
Duchene
Claude
C
Thuillier
Michel
M
Colbeaux
Christian
C
Lefebvre
Anne-Marie
AM
Forzy
Gérard
G
Filoche
Bernard
B
D000328:Adult; D015331:Cohort Studies; D005260:Female; D016174:Hepacivirus / Q000235:genetics / Q000276:immunology; D006526:Hepatitis C / Q000097:blood / Q000175:diagnosis*; D018937:Hepatitis C Antibodies / Q000032:analysis / Q000097:blood; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000032:analysis; D012463:Saliva / Q000821:virology*; D015819:Substance Abuse, Intravenous / Q000097:blood / Q000821:virology*; D013997:Time Factors; D014766:Viremia / Q000821:virology
D018937:Hepatitis C Antibodies; D012367:RNA, Viral