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Analytical validation of hepatitis B core‐related antigen (HBcrAg) using dried blood spots (DBS)

Abstract : Limited access to nucleic acid testing (NAT) to quantify HBV DNA levels, an essential tool to determine anti-HBV treatment eligibility, represents a significant barrier to scale up HBV diagnostic services in resource-limited countries. Hepatitis B core-related antigen (HBcrAg) has the potential to become an affordable alternative because of its low cost (US$ <15/assay) and strong correlation with HBV DNA levels in treatment-naïve patients. However, the current assay requires plasma or serum. To further facilitate its application to decentralized settings, we developed and evaluated a standardized procedure to quantify HBcrAg using dried blood spots as a tool to diagnose HBV-infected people with high viraemia. We evaluated the following elution method optimized to quantify HBcrAg: suspension of a punched blood-soaked disc (11 mm) of Whatman 903 Protein Saver Card in 450 µL of PBS 0.05% Tween 20, followed by an incubation for 4 h at room temperature and a centrifugation at 10,000 g for 10 minutes. 150 µL of DBS eluate was used to quantify HBcrAg using chemiluminescent enzyme immunoassay (LUMIPULSE® G600II, Fujirebio). The limit of detection of dried blood spot HBcrAg in relation with HBV DNA levels was 19,115 IU/mL across the five major HBV genotypes (A/B/C/D/E). A strong linear correlation was confirmed between dried blood spot HBcrAg and HBV DNA levels (r = 0.94, p < 0.0001) in samples with high viral loads (range: 3.7–7.0 log IU/mL). The coefficient of variation ranged between 4.0–11.2% for repeatability and 3.9–12.2% for reproducibility. Analytical specificity was 100% (95% CI: 83.9–100%) in HBV-negative samples. Using our elution method, it may be possible to identify HBV-infected patients with high viraemia who need antiviral therapy using dried blood spot and HBcrAg. A large-scale clinical validation is warranted in resource-limited countries.
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https://hal-pasteur.archives-ouvertes.fr/pasteur-03697743
Contributor : Yusuke Shimakawa Connect in order to contact the contributor
Submitted on : Friday, June 17, 2022 - 11:27:30 AM
Last modification on : Friday, August 5, 2022 - 2:54:00 PM

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Journal of Viral Hepatitis - 2...
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Yusuke Shimakawa, Laura Vernoux, Audrey Gabassi, Séverine Mercier-Delarue, Jeanne Perpétue Vincent, et al.. Analytical validation of hepatitis B core‐related antigen (HBcrAg) using dried blood spots (DBS). Journal of Viral Hepatitis, 2021, 28 (5), pp.837-843. ⟨10.1111/jvh.13489⟩. ⟨pasteur-03697743⟩

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