Hepatitis B surface antigen detection using pooled sera: A cost-benefit analysis

Abstract

Objectives: to examine the feasibility and to perform a cost benefit analysis of a 5-sample pooling strategy using an enzyme immunoassay (EIA) for the screening of hepatitis B surface antigen (HBsAg).Material and methods: to assess the sensitivity and specificity of the pooling method, each of the 40 positive sera (from weak to intensely HBsAg-positive) and 250 negative sera were tested in a pool with 4 HBsAg-negative sera. The limit of detection for HBsAg/ad and HBsAg/ay was evaluated using sera from a panel of purified subtypes. A study under real conditions was conducted using pools from 340 pregnant women.Results: the sensitivity and specificity of this technique were 100%. The correlation coefficient among the sample/cutoff ratios of 40 samples studied in single and in pooled conditions was 0.792 (p < 0.005). The pooling method has lower levels of detection for HBsAg/ad and HBsAg/ay at 0.20 ng/mL and 0.12 ng/mL, and the single method at 0.34 ng/mL and 0.29 ng/mL, respectively. The pooling method loses no sensitivity for values up to 100 IU/L of anti-HBs in the four sera mixed with a positive serum. The cost-benefit analysis showed that the pooling method could save from 30% up to 75% of the cost of HBsAg determination, according to whether seroprevalences were 10% or 1%, respectively.Conclusions: the pooled HBsAg EIA yielded no worse than the single EIA test, and was a cost-effective and valid strategy in areas with a high, medium or low prevalence.

Comparison of human immunodeficiency virus and syphilis results in pooled sera versus individual samples of blood donors attending suez canal university hospital

“…The current study aimed to investigate pooled sera for HIV and syphilis in blood donors compared to their individual sera to reduce the cost taking into account previous studies that demonstrated pooling was feasible and costeffective even in populations with high prevalence of HBV and HCV infection. 8,9 As far as we know, no previous research has investigated pooling method by ELISA on syphilis. However, in the current study, we chose only 2 parameters HIV and syphilis infection.…”

Study of the Association of Mutant HBsAg Gene and Hodgkin and Non-Hodgkin Lymphoma

“…Distribution of HBsAg subtype has been reported in different regions of the world. Fernández et al in Spain reported the ad and ay HBs subtypes amongst 40 chronic HBV patients ( 24 ). De Souza et al from Brazil reported HBsAg subtypes adw2 , adw4 , and ayw amongst patients with mental problems ( 25 ).…”

Sensitivity of pooled serum testing for screening antibody of schistosomiasis japonica by IHA in a mountainous area of Yunnan, China

“…It has been mentioned that in various diseases the presence of antigen without antibody in those who have negative tests may neutralise the positivity in a pool containing positive samples (Raboud et al 1996; Fernández et al 2006). The probability of antibody being neutralised would depend on the strength and concentration of the antigen and the prevalence of antigen in the investigated population.…”