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Diagnosing Hepatitis C

Urine Test for Diagnosing Hepatitis C

Diagnosing hepatitis C can be made simpler with an easy urine test instead of the conventional and costlier two-step approach with a blood test that is currently utilized. Scientists at University of California Irvine School of Medicine have developed a test that uses enzyme-linked immunosorbent assay (ELISA)—a common diagnostic tool when using wet lab samples—to detect hepatitis C antigens indicative of a current infection.

With the traditional blood test, the first step involves detecting anti-hepatitis C antibodies. A positive result, however, does not indicate an active infection as these antibodies will be present if a person was exposed to the hepatitis C virus (HCV) in the past and the immune system fought off the pathogen. A positive test is followed by a HCV RNA test to detect viral RNA in the blood to determine an active infection. Genotyping may also be ordered to discern the most effective treatment and predict the expected length of therapy.

Urine from 110 people and blood from 138 people was collected. The results were compared using the two approaches, in which the urine test matched the blood test results completely. The new method not only increases sensitivity and specificity, it is also less expensive as the HCV RNA test can cost up to $200. In less developed nations where skilled phlebotomists and blood-processing equipment are not readily available, a simple urine test for diagnosing hepatitis C may be a lifesaver.

Hepatitis C is a blood-borne pathogen and is acquired through blood and bodily fluids, i.e. passed from infected mother to child, sharing of needles, engaged in unprotected sex, received organ transplants before 1992 and blood transfusions before 1987. According to the World Health Organization (WHO), 130-150 million people suffer from chronic hepatitis C, of which 2.7 million are Americans. During the early stages, a person infected with HCV is asymptomatic and usually goes undetected until complications develop later, which includes cirrhosis and liver failure. Diagnosing hepatitis C effectively and efficiently can staunch transmission rates and prevent future generations from unknowingly acquiring the disease.

Nose in a Bottle Can Aid in Expediting Sepsis Diagnosis

Based on the premise that pathogens give off a distinct malodorous scent, scientists at the Oklahoma City University and the National University of Kaohsiung in Taiwan of the Republic of China developed a sepsis-testing device with an “artificial nose” that procures 99% clinically relevant results in 24 hours compared to the traditional 72 hours in a hospital setting using far more expensive equipment.

The sepsis-detecting contraption comprises of a plastic bottle, which fits into the palm of the hand, with a liquid nutrient medium to culture the bacteria, and a chemical sensing array (CSA) within the bottle. The CSA comes in the form of 36 clear dots that function as the “nose” and change color as it reacts to the unique odor given off by microbes.

Using the device is simple: a potentially infected blood sample is injected into the bottle and then shaken by a simple agitation machine to induce bacterial growth. As the pathogens give off their signature scent, the dots change color according to the pigments in the dots in a designated pattern to identify the specific bacteria strain. The test is complete within 24 hours. The current model can classify only eight of the most common bloodborne pathogens and scientists are working on expanding the test’s range to detect other sepsis-causing bacteria.

Sepsis, or “blood poisoning,” kills 250,000 people each year in the United States alone, with costs to treat sepsis averaging more than $20 billion. Sepsis causes a cascade of reactions in the body in response to bloodborne pathogens. When caught late, it causes multi-organ failure and ultimately death. Thus, determining the specific bacteria strain, and hence the correct antibiotic to treat the disease, within a short amount of time is crucial.

Due to the portable, relatively inexpensive, and time-saving nature of the test, scientists are hoping the device can be utilized to decrease the death rate of sepsis, particularly in developing nations where access to a laboratory is impossible and the 72 hours it takes to culture the bacteria and test the strain for antibiotic sensitivity might mean certain death to countless people.