In this study, a modified enzyme immunoassay (EIA) was evaluated for the Hepatitis B surface antigen (HBsAg) among whole saliva and oral fluid samples. Specimens were collected from 115 individuals who gave serum and oral fluid using Salivette (Sarstedt, Nümbrecht, Germany) and whole saliva. Saliva specimens were tested following a modified ELISA, and the results were compared with paired serum specimens that were tested according to the supplier's instructions. Transport buffer for the oral fluids, sample volume for assay, incubation period of sample with conjugate as well as cut-off values were evaluated to optimize the assay. The highest sensitivity and specificity were obtained by increasing the incubation of sample and conjugate to 16  hr and using the area under the receiver operating characteristic curve to calculate cut-off values. HBsAg was detected in 40 oral fluids and 44 whole saliva samples out of 47 paired positive serum specimens and not detected in 64 oral fluids and 63 whole saliva samples out of 68 matched negative sera samples by the ELISA assay. There was excellent agreement between the results for the serum and saliva specimens kappa value (κ): 0.80 for oral fluid and κ: 0.87 for whole saliva and there was excellent reproducibility. Using an optimized protocol, the sensitivities of whole saliva and oral fluid were 93.6 and 85.1%, respectively, whereas specificities of whole saliva and oral fluid were 92.6 and 94.1%, respectively. Our data showed a significant promise for the use of whole saliva and oral fluid together with the modified commercial EIA for Hepatitis B virus infection surveillance.

BackgroundRapid tests (RTs) might have several advantages over standard laboratory procedures, increasing access to diagnosis, especially among vulnerable populations and/or those living in remote areas. The aim of this study was to evaluate the performance of RTs for the detection of hepatitis B virus surface antigen (HBsAg) in samples from different populations/settings.MethodsThree RTs for HBsAg detection (Vikia® HBsAg, HBsAg Teste Rápido®, and Imuno-Rápido HBsAg®) and different biological specimens (serum, whole blood, and saliva) were evaluated. Analyses comprised a reference panel and samples from field studies targeting suspected cases of hepatitis B virus (HBV) (G I), individuals living in deprived areas (G II), and highly vulnerable individuals (G III). Enzyme immunoassay (EIA) was defined as the gold standard in this study. Reproducibility, repeatability, and cross-reactivity with other infectious agents such as dengue, immunodeficiency (HIV), and hepatitis C (HCV) viruses and T. pallidum were determined.ResultsFor the reference panel, the sensitivity and specificity of all HBsAg RTs were higher than 93.00 %. G I presented the highest kappa values for all rapid assays using sera samples. When using serum, the sensitivity values were higher than 93.40 for G I, 60.00 % for G II and 66.77 % for G III, and the specificity values were higher than 99.50 for GI, 97.20 for G II and 99.10 % for G III for all tests. For whole blood samples & the Vikia® HBsAg assay, the best performance was achieved for GIII (k = 79.75 %). For saliva samples, the Imuno-Rápido HBsAg® assay showed the highest concordance values with EIA for G I (40.68 %) and G II (32.20 %). The reproducibility and repeatability of all RTs for serum and saliva were excellent, and the concordance between HBsAg EIAs and RTs using samples reactive with other infectious agents varied from 70.10 % to 100.00 %.ConclusionsThe overall performance of RTs for HBsAg in serum was high/moderately high for all groups, thereby promoting increased access to HBV diagnosis among vulnerable populations as well as samples from individuals in emergency settings or remote areas. Rapid tests for HBsAg using whole blood could be used in prevalence studies, though these assays should not be used for saliva samples.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-015-1249-5) contains supplementary material, which is available to authorized users.

The context of first drug injection and its association with ongoing injecting practices and HCV (hepatitis C virus)

Beauty treatments, such as tattooing, piercing, manicures, pedicures, and barbershop shaving, can pose an important risk of virus transmission. This study was conducted to determine hepatitis A virus (HAV), hepatitis B virus (HBV), and hepatitis C virus (HCV) prevalence in a sample of beauticians from Rio de Janeiro (Southeast Brazil) and to assess the knowledge and attitudes of these professionals regarding viral hepatitis and their practices during their activities. One hundred nineteen beauticians were recruited in September 2010. Serum samples were tested for total anti-HAV, total anti-HBc, HBsAg, anti-HBs, and anti-HCV reactivity. A questionnaire was administered to identify socio-demographic risk factors and to determine knowledge and attitudes regarding viral hepatitis. Prevalence was 73.9% for total anti-HAV, 0% for HBsAg, 5.9% for anti-HBc, 23.6% for anti-HBs, and 0.8% for anti-HCV. Most professionals (81.5%) were well informed (4-7 correct answers) and reported the use of disposable sandpaper and nail sticks and sterilized pliers, but only 40% of them reported adequate processes of disinfection/sterilization. In conclusion, a high prevalence of HAV infection and a low prevalence of HBV and HCV infection were observed among beauticians. In addition, most of these individuals were not immune to HBV, indicating the need for vaccination campaigns targeting these professionals. Most of these professionals were well informed regarding viral hepatitis, although there was a gap in knowledge regarding disinfection and sterilization procedures. Public health prevention strategies should be adopted to improve education about disinfection/sterilization procedures for manicures and pedicures.