Enhanced detection of occult and active infections using multiplex HIV/HBV/HCV nucleic acid testing in high-risk populations: a cross-sectional study
7 affiliations
- 1National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention & Chinese Academy of Preventive Medicine , ,
- 2Kunming Medical University , ,
- 3Department of Epidemiology, School of Public Health, China Medical University , ,
- 4Yunnan Center for Disease Control and Prevention, Yunnan Academy of Preventive Medicine , ,
- 5Beijing Youan Hospital, Capital Medical University , ,
- 6Center for Disease Control and Prevention, Health Supervision Institute, Honghe Hani and Yi Autonomous Prefecture , ,
- 7Center for Disease Control and Prevention , , ,
Abstract
Introduction: Given the shared modes of transmission, HIV, HBV, and HCV confer a high risk of co-infection, particularly among key populations. Currently, clinical screening for these viruses still relies predominantly on serological assays, which fail to detect a substantial proportion of infections, including occult HBV infection (OBI, defined as HBsAg-negative but HBV DNA-positive) and current HCV infection. HIV/HBV/HCV multiplex nucleic acid testing (NAT) has been widely adopted in blood screening due to its superior sensitivity, specificity, and shorter window period. However, this highly effective screening assay has not yet been translated into routine clinical screening for high-risk populations.
Methods: To evaluate its clinical performance and feasibility, we conducted a cross-sectional study enrolling 802 people who use drugs (PWUD) and 400 men who have sex with men (MSM) in China. All participants underwent parallel serological screening and HIV/HBV/HCV multiplex NAT, with final infection status confirmed by supplementary testing, epidemiological history, and clinical symptoms.
Results: Upfront HIV/HBV/HCV multiplex NAT identified 12 additional OBI cases (incremental yield 12/1,202) that were missed by HBsAg-only screening and HBsAg-triggered reflex testing. HCV RNA testing distinguished current from non-current HCV infection, but this benefit was not specific to the multiplex strategy. Acceptance of multiplex NAT and post-diagnosis treatment was high among participants.
Conclusion: Our findings suggest that HIV/HBV/HCV multiplex NAT could detect clinically relevant infections undetectable by serology in key populations, suggesting potential clinical benefits. However, further prospective implementation studies and cost-effectiveness analyses are warranted before routine integration into clinical practice.
Related
- Viral Respiratory Infections Diagnosed by Multiplex PCR after Allogeneic Hematopoietic Stem Cell Transplantation: Long-Term Incidence and Outcome
- Cross-kingdom antimicrobial resistance profiling: A unified multiplex PCR assay for simultaneous bacterial and fungal detection
- Development of a Single Thermal Cycling Multiplex RT-qPCR Assay for Rapid Arbovirus Detection
- Evaluation of the One-Step Multiplex Real-Time Reverse Transcription-PCR ProFlu-1 Assay for Detection of Influenza A and Influenza B Viruses and Respiratory Syncytial Viruses in Children
- Respiratory viral and bacterial co-infections in adults in acute care: A multiplex PCR-based study
BibTeX
@article{jin2026enhanced,
title = {{Enhanced detection of occult and active infections using multiplex HIV/HBV/HCV nucleic acid testing in high-risk populations: a cross-sectional study}},
author = {Cong Jin and Yu Wang and Zuyang Zhang and Mingzhu Niu and Jingyi Wang and Huichao Chen and Hongxiang Yuan and Ning Liu and Enlong Yao and Man Li and Yuehui Zhang and Xia Feng and Yuhua Shi and Kai Lu},
journal = {Frontiers in cellular and infection microbiology},
year = {2026},
month = oct,
doi = {10.3389/fcimb.2026.1870687},
url = {https://europepmc.org/article/PMC/PMC13719367},
note = {CC BY},
}
RIS
TY - JOUR
TI - Enhanced detection of occult and active infections using multiplex HIV/HBV/HCV nucleic acid testing in high-risk populations: a cross-sectional study
AU - Cong Jin
AU - Yu Wang
AU - Zuyang Zhang
AU - Mingzhu Niu
AU - Jingyi Wang
AU - Huichao Chen
AU - Hongxiang Yuan
AU - Ning Liu
AU - Enlong Yao
AU - Man Li
AU - Yuehui Zhang
AU - Xia Feng
AU - Yuhua Shi
AU - Kai Lu
PY - 2026
DA - 2026/10/16
JO - Frontiers in cellular and infection microbiology
DO - 10.3389/fcimb.2026.1870687
UR - https://europepmc.org/article/PMC/PMC13719367
AB - Introduction: Given the shared modes of transmission, HIV, HBV, and HCV confer a high risk of co-infection, particularly among key populations. Currently, clinical screening for these viruses still relies predominantly on serological assays, which fail to detect a substantial proportion of infections, including occult HBV infection (OBI, defined as HBsAg-negative but HBV DNA-positive) and current HCV infection. HIV/HBV/HCV multiplex nucleic acid testing (NAT) has been widely adopted in blood screening due to its superior sensitivity, specificity, and shorter window period. However, this highly effective screening assay has not yet been translated into routine clinical screening for high-risk populations. Methods: To evaluate its clinical performance and feasibility, we conducted a cross-sectional study enrolling 802 people who use drugs (PWUD) and 400 men who have sex with men (MSM) in China. All participants underwent parallel serological screening and HIV/HBV/HCV multiplex NAT, with final infection status confirmed by supplementary testing, epidemiological history, and clinical symptoms. Results: Upfront HIV/HBV/HCV multiplex NAT identified 12 additional OBI cases (incremental yield 12/1,202) that were missed by HBsAg-only screening and HBsAg-triggered reflex testing. HCV RNA testing distinguished current from non-current HCV infection, but this benefit was not specific to the multiplex strategy. Acceptance of multiplex NAT and post-diagnosis treatment was high among participants. Conclusion: Our findings suggest that HIV/HBV/HCV multiplex NAT could detect clinically relevant infections undetectable by serology in key populations, suggesting potential clinical benefits. However, further prospective implementation studies and cost-effectiveness analyses are warranted before routine integration into clinical practice.
SN - 2235-2988
ER -