Dried blood spot‐based detection of serological profiles of hepatitis B and C infections and their prevalence in Cambodia

Bunthen, E; Ko, Ko; Nagashima, Shintaro; Ouoba, Serge; Hussain, Razeen Ashraf; Sugiyama, Aya; Akita, Tomoyuki; Ohisa, Masayuki; Chuon, Channarena; Mao, Bunsoth; Hossain, Shafiqul; Ork, Vichit; Tanaka, Junko

doi:10.1002/ygh2.468

Cited by 3 publications

(3 citation statements)

References 17 publications

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“…The potential influence of DBS samples on the accuracy of HBeAg detection may have resulted in the lower sensitivity observed in our study. While our previous study found good sensitivity and specificity for DBS samples to detect HBeAg 12 , literature on this matter has produced contrasting results, with some studies reporting suboptimal accuracy 27,28 . Furthermore, genotype identification by viral sequencing requires recovering a certain amount of HBV DNA from the DBS, which could be a source of spectrum bias.…”

Section: Discussionmentioning

confidence: 55%

“…HBsAg, HBeAg, and HBeAb, were detected using Lumipulse® HBsAg-HQ, Lumipulse® HBeAg, and Lumipulse® HBeAb, respectively. The accuracy of DBS samples to detect HBV seromarkers was evaluated based on our previously published study that compared DBS samples to paired serum samples 12 . The reported sensitivities for HBsAg, HBeAg, and HBeAb were 89.3%, 100%, and 100%, respectively, with a 100% specificity for all seromarkers.…”

Section: Intermediate Hepatitis B Virus Infection Prevalence Among 16...mentioning

confidence: 99%

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Intermediate hepatitis B virus infection prevalence among 1622 pregnant women in rural Burkina Faso and implications for mother-to-child transmission

Ouoba

Lingani

et al. 2023

Sci Rep

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In highly endemic countries for hepatitis B virus (HBV) infection, childhood infection, including mother-to-child transmission (MTCT), represents the primary transmission route. High maternal DNA level (viral load ≥ 200,000 IU/mL) is a significant factor for MTCT. We investigated the prevalence of HBsAg, HBeAg, and high HBV DNA among pregnant women in three hospitals in Burkina Faso and assessed the performance of HBeAg to predict high viral load. Consenting pregnant women were interviewed on their sociodemographic characteristics and tested for HBsAg by a rapid diagnostic test, and dried blood spot (DBS) samples were collected for laboratory analyses. Of the 1622 participants, HBsAg prevalence was 6.5% (95% CI, 5.4–7.8%). Among 102 HBsAg-positive pregnant women in DBS samples, HBeAg was positive in 22.6% (95% CI, 14.9–31.9%), and viral load was quantified in 94 cases, with 19.1% having HBV DNA ≥ 200,000 IU/mL. HBV genotypes were identified in 63 samples and predominant genotypes were E (58.7%) and A (36.5%). The sensitivity of HBeAg by using DBS samples to identify high viral load in the 94 cases was 55.6%, and the specificity was 86.8%. These findings highlight the need to implement routine HBV screening and effective MTCT risk assessment for all pregnant women in Burkina Faso to enable early interventions that can effectively reduce MTCT.

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Section: Discussionmentioning

confidence: 55%

Section: Intermediate Hepatitis B Virus Infection Prevalence Among 16...mentioning

confidence: 99%

Intermediate hepatitis B virus infection prevalence among 1622 pregnant women in rural Burkina Faso and implications for mother-to-child transmission

Ouoba

Lingani

et al. 2023

Sci Rep

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“…There are already documented reports on using DBS tests in hepatitis B infections. A recent study performed by Bunthen et al 11 in Cambodia showed a high diagnostic accuracy of DBS for hepatitis B markers in pregnant women and their babies. This was consistent with other studies that performed large‐scale screenings using DBS samples to detect other serological markers (HBsAg and anti‐HBc) from newborns, 12 illegal miners 13 and at‐risk populations 14 .…”

Section: Introductionmentioning

confidence: 94%

The role of dried blood spot tests in the detection of hepatitis B infection: A systematic review

Virtudazo,

Aquino,

Arellano

et al. 2023

Journal of Viral Hepatitis

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Hepatitis B remains a public health problem worldwide despite vaccine availability. Although the existing diagnostic tools help detect the infection, logistics support and limited resources and technologies affect their usefulness and reliability in developing countries. This systematic review evaluated the performance of dried blood spots (DBS) as a collection and storage tool for diagnosing an hepatitis B virus (HBV) infection. A comprehensive search using OVID, Scopus and CINAHL databases was performed to collate articles published up to April 2023 that detected Hepatitis B infections using DBS. Five reviewers independently performed identification, screening, quality assessment and data extraction. A qualitative synthesis of the included studies was conducted. Of the 402 articles, 78 met the inclusion criteria. The results show that most studies focused on populations with known HBV, HCV and/or HIV status. Approximately half (49%) of the included studies utilized the Whatman Protein Saver Card for DBS collection. The DBS samples were then predominantly stored in room temperature conditions. In line with this, storage conditions influenced the concentration and stability of the analyte from the DBS samples, affecting the accuracy of downstream diagnostic methods. ELISA methods, using hepatitis B surface antigen (HBsAg) as an HBV marker, were the most widely used diagnostic tool for detecting HBV infection in DBS samples. The simplicity and cost‐effectiveness of the ELISA technique highlight its potential to be used in low‐resource settings. In line with this, the detection of HBsAg using an ELISA immunoassay had higher sensitivity (85.6%–100%), and specificity (95%–100%) ranges as compared to other target molecules and methods. Although this review only performed a qualitative analysis, DBS offers a promising method for collecting and storing blood samples; however, the standardization of sampling, storing conditions and diagnostic techniques is required to ensure sustainable application.

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Residual risk of mother-to-child transmission of HBV despite timely Hepatitis B vaccination: a major challenge to eliminate hepatitis B infection in Cambodia

Bunthen

Kim

et al. 2023

BMC Infect Dis

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Background In countries with intermediate or high hepatitis B virus (HBV) endemicity, mother-to-child transmission (MTCT) represents the main route of chronic HBV infection. There is a paucity of information on HBV MTCT in Cambodia. This study aimed to investigate the prevalence of HBV infection among pregnant women and its MTCT rate in Siem Reap, Cambodia. Methods This longitudinal study included two parts, study-1 to screen HBsAg among pregnant women and study-2 to follow up babies of all HBsAg-positive and one-fourth of HBsAg-negative mothers at their delivery and six-month post-partum. Serum or dried blood spot (DBS) samples were collected to examine HBV sero-markers by chemiluminescent enzyme immunoassay (CLEIA), and molecular analyses were performed on HBsAg-positive samples. Structured questionnaires and medical records were used to examine the risk factors for HBV infection. MTCT rate was calculated by HBsAg positivity of 6-month-old babies born to HBsAg-positive mothers and ascertained by the homology of HBV genomes in mother–child pair at 6-month-old. Results A total of 1,565 pregnant women were screened, and HBsAg prevalence was 4.28% (67/1565). HBeAg positivity was 41.8% and was significantly associated with high viral load (p < 0.0001). Excluding subjects who dropped out due to restrictions during COVID-19, one out of 35 babies born to HBsAg-positive mothers tested positive for HBsAg at 6 months of age, despite receiving timely HepB birth dose and HBIG, followed by 3 doses of HepB vaccine. Hence the MTCT rate was 2.86%. The mother of the infected baby was positive for HBeAg and had a high HBV viral load (1.2 × 109 copies/mL). HBV genome analysis showed 100% homology between the mother and the child. Conclusions Our findings illustrate the intermediate endemicity of HBV infection among pregnant women in Siem Reap, Cambodia. Despite full HepB vaccination, a residual risk of HBV MTCT was observed. This finding supports the recently updated guidelines for the prevention of HBV MTCT in 2021, which integrated screening and antiviral prophylaxis for pregnant women at risk of HBV MTCT. Furthermore, we strongly recommend the urgent implementation of these guidelines nationwide to effectively combat HBV in Cambodia.

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Dried blood spot‐based detection of serological profiles of hepatitis B and C infections and their prevalence in Cambodia

Abstract: This is an open access article under the terms of the Creat ive Commo ns Attri butio n-NonCo mmerc ial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Cited by 3 publications

References 17 publications

Intermediate hepatitis B virus infection prevalence among 1622 pregnant women in rural Burkina Faso and implications for mother-to-child transmission

Intermediate hepatitis B virus infection prevalence among 1622 pregnant women in rural Burkina Faso and implications for mother-to-child transmission

The role of dried blood spot tests in the detection of hepatitis B infection: A systematic review

Residual risk of mother-to-child transmission of HBV despite timely Hepatitis B vaccination: a major challenge to eliminate hepatitis B infection in Cambodia

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