Utility of oral fluid samples for hepatitis B antibody detection in real life conditions

Abstract

Background Hepatitis B virus (HBV) testing in oral fluid samples may provide advantages in diagnosis, screening or prevalence studies, especially among individuals with venous access difficulties. This study aims to optimize one commercially available assay for detecting total anti-HBc marker in oral fluid samples and to evaluate its utility under real life conditions in different settings for the purposes of prevalence and diagnostic studies. Methods Oral fluid was collected using a Salivette device and some parameters were initially evaluated: type of elution buffer and sample volume. Thereafter, the utility of oral fluid samples for detection of anti-HBc was evaluated in real life conditions in which, 1296 individuals gave serum and oral fluid samples. All serum samples were submitted to commercial EIAs to detect total anti-HBc, according to the manufacturer’s instructions and oral fluid samples according to previous optimization. Results In optimization evaluation, PBS/BSA 0.5% and 100 μL of oral fluid (volume was two-fold increased compared to serum in EIA) were chosen as transport buffer and sample volume. In the field study, anti-HBc was detected in 211 out of 1296 serum samples giving overall oral fluid sensitivity of 52.6% and specificity of 96%. Concordance was higher in ambulatory setting (67.7) compared to general population (31.8). Mean ± standard deviation values of optical density/cutoff (OD/CO) in serum samples were higher in false-negative oral fluid samples than those seen in true positive samples. Sensitivity was higher in those presenting active infection compared to anti-HBc isolate and past infection. Sensitivity also increased in the ambulatory group when HCV individuals were excluded. Conclusions It was possible to optimize a commercial EIA for detecting anti-HBc in oral fluid samples and where the highest concordance was found in ambulatory settings and among individuals with active infection.

USEFULNESS OF SALIVA SAMPLES FOR DETECTING SARS-CoV-2 RNA AMONG LIVER DISEASE PATIENTS

“…Saliva samples could be useful specimens since collection is less invasive, safer and allows the option of self-collection. Saliva samples have been evaluated for detecting viral hepatitis markers ( 2 , 3 ), however there is a lack of studies about usefulness of these samples for detecting SARS CoV-2 in hepatitis infected individuals and non-severe cases of COVID-19. The saliva collection can be safer than NPS samples, especially for those patients that presenting decompensated cirrhosis or other severe sequels, like hepatocarcinoma.…”

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“…[19] Regarding SARS-CoV-2, only a study procedure aimed to analyse IgG, IgM and IgA in changed biological fluids including self-collected saliva for rapid SARS-CoV-2 diagnosis has been published [20] . Viral antibodies have been noticed in saliva and the immunisation status of measles, rubella, mumps and hepatitis can be confirmed by analysing IgG, IgM and IgA in oral fluids [18] . Though, there are so far no outcomes describing the presence of antibodies against SARS-CoV-2 in human saliva.…”

“…Viral antibodies have been spotted in saliva and the immunisation status of measles, rubella, mumps and hepatitis can be tested by analysing IgG, IgM and IgA in oral fluids [18] . In addition to RT-PCR-based RNA detection of SARS-CoV-2, initially studies have been reported, capable results for the finding of IgM and IgG against SARS-CoV-2 in serum/plasma samples of patients with SARS-CoV-2.…”

“…Saliva has been studied comprehensively as a possible diagnostic tool and it is likely to become a auxiliary for other biological fluids such as serum or urine in disease analysis [18] . Compared with other investigative fluids, saliva sampling has both advantages and disadvantage in use for the diagnosis of COVID-19.…”

Prevalence of SARS-CoV-2 Infection in Children by Antibody Detection in Saliva: Protocol for a Prospective Longitudinal Study (Coro-Buddy)

“…Saliva sampling as a noninvasive method (ie, it does not cause disturbance) for SARS-CoV-2 antibody measurements and is an elegant approach to rapidly assess the prevalence of SARS-CoV-2 infection in vulnerable cohorts at numbers appropriate for epidemiologic investigations [ 14 ]. Studies have reported the use of saliva not only for detection of respiratory viruses, including coronaviruses and SARS-CoV-2 [ 15 ], but also for detection of antibodies against measles, rubella, mumps, and hepatitis [ 16 - 18 ]. The number of seroprevalence studies benefiting from noninvasive saliva sampling is increasing [ 19 ].…”