2024 · JHEP reports : innovation in hepatology · open access
Implementing a new HCV model of care for people who use drugs
Herranz Mochales et al.
The finding, in our words
Among 1,423 people who use drugs across 21 community centres, a decentralised care programme using dried blood spot testing achieved a 93% cure rate in those who completed hepatitis C therapy and were monitored. Over 90% of participants accepted the decentralised screening and treatment approach, showing patient-centric microsampling can improve healthcare access for stigmatised populations.
A paraphrase to the Library’s standard, never the abstract. The source is one link away and is always the authority.
In a pilot mixed-methods study of youth with HIV, mailed HemaSpot-HF kits enabled home-based dried blood spot collection that participants found feasible and acceptable, supporting remote viral load monitoring and a self-management model for decentralised care.
A study of older rural US patients found that 96 to 98 per cent of self-collected dried blood spot specimens were successfully analysed for HIV viral load, with high acceptability. However, concordance between self-reported and measured viral load was only 69 to 82 per cent, highlighting the value of objective decentralised microsampling over self-reporting.
The study found that although participants preferred patient-centric microsampling devices for home use, the agreement with venous plasma for measuring CRP and cytokines was inconsistent, indicating that further validation is required before these methods replace standard venipuncture.
Task sharing dried blood spot collection for HIV viral load testing with community lay cadres achieved high diagnostic agreement with healthcare worker collections and was highly acceptable to patients. This approach offers a viable strategy to overcome healthcare worker shortages and support decentralised viral load monitoring in resource-limited settings.
This review establishes that microsampling across blood, saliva, urine and stool matrices offers validated workflows and regulatory recognition for human biomonitoring comparable to conventional methods. It finds that these decentralised approaches enhance participant acceptability and enable screening in remote or low-resource settings.