green light for antigen test, but RT-PCR remains the “reference”

After the saliva tests, validated last week by the High Authority of Health (HAS) for the screening of symptomatic people, it is the turn of the antigenic tests to obtain the green light from the experts. Unlike the RT-PCR test, this type of test does not look for the genome, but for proteins of the virus. However, the sampling method remains the same and consists of introducing a swab along the patient’s nasal passage. With a significant advantage: the answer falls in twenty to thirty minutes.

→ READ. Coronavirus: antigenic tests, faster but less reliable than PCR

An asset which largely explains the favorable opinion rendered this Friday, September 25 by the HAS, paving the way for the use and reimbursement by Health Insurance of these tests. “They are certainly a little less sensitive than the RT-PCR test (…) but their speed can have an impact on the circulation of the virus within the population, because a case detected faster will make it possible to take ad hoc measures faster. to limit the risk of infecting other people ”, explains Dominique Le Guludec, the president of the HAS college, whose opinion is based on a corpus of 14 studies. For the moment, the latter only concerns the performances observed on symptomatic individuals, for lack of sufficient data for asymptomatic individuals.

A solution to relieve laboratory congestion

In addition to its speed, the antigen test has another advantage, and not the least: that of being able to be carried out outside laboratories, in particular in pharmacies. An advantage over saliva tests, which are certainly easier to do – a simple sputum in a tube – but still requiring a passage in the laboratory.

→ DEBATE. Should I get tested for Covid-19?

The deployment of antigenic tests could thus help to unclog laboratories, argues the HAS. Not to mention that they could eventually do without the swab to be made in the form of a simple prick on the fingertip. However, in the event of a positive result, the diagnosis must be confirmed … in the laboratory.

Other types of tests under study

According to the HAS, other types of tests could complement the arsenal available to France. This is the case with the oropharyngeal test, carried out by inserting a cotton swab at the back of the throat in order to remove the secretions. “In principle, this test is more bearable than the nasopharyngeal test, however it can cause a cough or vomiting reflex”, warns the head of the evaluation service for professional acts at HAS, Cédric Carbonneil, who recommends it to asymptomatic people who are not able, for one reason or another, to perform an RT-PCR test.

For symptomatic people, on the other hand – in particular those who do not tolerate the nasopharyngeal test, in particular young children and the elderly or with mental disorders – the HAS recommends instead saliva tests, for which the Health Insurance should validate the reimbursement of one day to another. But these alternatives are not worth the RT-PCR test, experts insist. Whether we are symptomatic or not, there remains the “Reference method”. Certainly not very pleasant according to those who have undergone it, but for the time being an unequaled performance.


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