Evaluation of the efficiency of dried blood spot-based measurement of hepatitis B and hepatitis C virus seromarkers

Abstract

Although hepatitis B (HBV) and C (HCV) virus infections are still global health issues, measuring sero-markers by standard venipuncture is challenging in areas limited with the adequate human resources and basic infrastructure. This study aimed to inform the usefulness of dried blood spot (DBS) sampling technique for epidemiological study of HBV and HCV in the resources limited areas. We compared specimen recovery rate expressed as analytical sensitivity ratio of HBsAg, HBcAb and anti-HCV between serum specimens and DBS samples (HemaSpot vs Whatman903). Sensitivity ratio was calculated as the ratio of the measured value from DBS to the measured value from serum. Then both the qualitative and quantitative comparisons of HBsAg detection by DBS were done using Cambodian samples. HBsAg, HBcAb and anti-HCV sensitivity ratios for the highest sample dilution (8fold) were 31.2:1, 38.9:1 and 32.0:1 for Whatman903 card and 17.6:1, 23.5:1 and 26.3:1 for HemaSpot respectively. Detection efficacy of HemaSpot (80%) was not inferior to Whatman903 (60%) after 1 month storage, and no significant difference in any hepatitis virus sero-markers was observed in HemaSpot-spotted patient samples stored for 2 weeks at −25 °C and 29 °C. All reference HemaSpot-spotted 400 HBsAg sero-negative samples showed negative. Sensitivity and specificity of HBsAg in HemaSpot were 92.3% and 100%. The recovery expressed as analytical sensitivity ratio of HBsAg, HBcAb and anti-HCV of HemaSpot specimen were not inferior to Whatman903. Therefore, DBS with its usefulness proved as an acceptable tool for large epidemiological study of HBV and HCV in resources limited remote area. Hepatitis B virus (HBV) and hepatitis C virus (HCV) constitute a global health issue. Although there are the effective hepatitis B vaccine since 1982 1 and anti-viral drugs such as interferon alpha, lamivudine and others (tenofovir, adefovir, etc) 2,3 , WHO reported that approximately 257 million people have been infected with HBV and only 16.7% of the people diagnosed with hepatitis B were on anti-viral treatment as of 2016 4. Similarly, even there is no vaccine for HCV till now, the direct-acting antiviral drugs (DAAs) for the treatment of HCV were initially developed in 2011 5 and have since yielded high sustained virologic responses (SVRs) 6. But, WHO reported that 71 million people have been chronically infected with HCV and approximately 19% of global population (13.1 millions) knew their diagnosis and around 5 million only had treated with DAA at the end of 2017 7. Therefore, the World Health Organization (WHO) announced in 2016 a target to eliminate HBV as public health threats by 2030 by reducing the hepatitis B surface antigen (HBsAg) prevalence among children to ≤0.1% 8 and to eliminate HCV by 90% reduction in new diagnosis and 65% reduction in HCV related mortality by 2030 9. However, both

The use of dried blood spots for the serological evaluation of SARS-CoV-2 antibodies

“…While our study did not assess the feasibility of sample collection using finger-prick, we believe that this is unlikely to affect our results given the utility of finger-prick sampling for other studies. 5–8 Therefore, our data suggest that the combination of finger-prick sampling and DBS collection could be used to facilitate serosurveillance efforts for SARS-CoV-2 in a similar way that they have been for monitoring infectious disease control of measles, hepatitis B and hepatitis C. 6 , 7 Such an approach would be valuable for SARS-CoV-2 serosurveys particularly in hard-to-reach populations.…”

Point-of-Care Tests for Hepatitis B: An Overview

“…This method is now recommended by the 2017 WHO hepatitis B testing guidelines [ 83 ] in settings where no access to venous blood sampling or quality-assured testing assays is available. DBS testing has been used to detect HBsAg, HBeAg, anti-HBc, HBV DNA and even for viral genotyping [ 99 , 100 ]. A meta-analysis [ 101 ] evaluating DBS for HBV DNA quantification showed pooled sensitivity of 95% (83–99%) and specificity of 99% (53–100%); however, most of the included studies used cold chain to store samples, which might limit the generalisation of the accuracy estimates in field conditions.…”

Prevalence of total hepatitis A antibody among 5 to 7 years old children and their mothers in Cambodia

“…Another noteworthy finding of this study was that we used the DBS as the new sampling strategy instead of collecting whole blood samples from all participants. The validity and efficacy of DBS for detection of HBV sero-markers 14 and also the usefulness of DBS for molecular analysis of HBV 15 had been reported previously. This study examined the sensitivity and specificity of total anti-HAV detection using DBS-driven samples against gold standard serum samples and set the cutoff value for the DBS-driven samples.…”