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

Xiao, Yinzong; Thompson, Alexander; Howell, Jessica

doi:10.3390/cells9102233

Cited by 42 publications

(34 citation statements)

References 113 publications

(177 reference statements)

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“…The deterring factors for the successful implementation of the guidelines include lack of attention to the prevalence of HBVr, unawareness of the ease of implementation of suitable preventive measures, miscalculations of the total costs to society and potentials for improvement in quality of care taking into consideration of the wide availability of potent generic NUCs at a very low cost and simple virological testing [ 49 , 50 ]. We aim to develop a user-friendly clinical practise guideline for all related medical disciplines which will help to curtail the morbidity and mortality related to HBVr in subjects treated with IST, especially in HBV endemic Asia-Pacific region.…”

Section: Introductionmentioning

confidence: 99%

APASL clinical practice guideline on hepatitis B reactivation related to the use of immunosuppressive therapy

Lau

Wong

et al. 2021

Hepatol Int

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Background & Aim Hepatitis B reactivation related to the use of immunosuppressive therapy remains a major cause of liver-related morbidity and mortality in hepatitis B endemic Asia-Pacific region. This clinical practice guidelines aim to assist clinicians in all disciplines involved in the use of immunosuppressive therapy to effectively prevent and manage hepatitis B reactivation. Methods All publications related to hepatitis B reactivation with the use of immunosuppressive therapy since 1975 were reviewed. Advice from key opinion leaders in member countries/administrative regions of Asian-Pacific Association for the study of the liver was collected and synchronized. Immunosuppressive therapy was risk-stratified according to its reported rate of hepatitis B reactivation. Recommendations We recommend the necessity to screen all patients for hepatitis B prior to the initiation of immunosuppressive therapy and to administer pre-emptive nucleos(t)ide analogues to those patients with a substantial risk of hepatitis and acute-on-chronic liver failure due to hepatitis B reactivation.

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Section: Introductionmentioning

confidence: 99%

APASL clinical practice guideline on hepatitis B reactivation related to the use of immunosuppressive therapy

Lau

Wong

et al. 2021

Hepatol Int

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“…Research literature on HIV self-testing indicates benefits in terms of convenience, privacy and managing stigma, but also highlights possible concerns around feasibility, acceptability and potential for harm [15,19,25,40,61]. Furthermore, interest in remote selftesting for HBV and HCV has been recently emphasized [59,60,62]. Transferability of the evidence and relevance of self-testing for HBV/HCV from the HIV field may contribute to this process.…”

Section: Discussionmentioning

confidence: 99%

Self-testing for HIV, HBV, and HCV using finger-stick whole-blood multiplex immunochromatographic rapid test: A pilot feasibility study in sub-Saharan Africa

et al. 2021

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Background The burden of HIV, HBV, and HCV infections remains disproportionately high in sub-Saharan Africa, with high rates of co-infections. Multiplex rapid diagnostic tests for HIV, HBV and HCV serological testing with high analytical performances may improve the “cascade of screening” and quite possibly the linkage-to-care with reduced cost. Based on our previous field experience of HIV self-testing, we herein aimed at evaluating the practicability and acceptability of a prototype finger-stick whole-blood Triplex HIV/HCV/HBsAg self-test as a simultaneous serological screening tool for HIV, HBV, and HCV in the Democratic Republic of the Congo (DRC). Methods A cross-sectional multicentric study consisting of face-to-face, paper-based, and semi-structured questionnaires with a home-based and facility-based recruitment of untrained adult volunteers at risk of HIV, HBV, and HCV infections recruited from the general public was conducted in 2020 in urban and rural areas in the DRC. The practicability of the Triplex self-test was assessed by 3 substudies on the observation of self-test manipulation including the understanding of the instructions for use (IFU), on the interpretation of Triplex self-test results and on its acceptability. Results A total of 251 volunteers (mean age, 28 years; range, 18–49; 154 males) were included, from urban [160 (63.7%)] and rural [91 (36.3%)] areas. Overall, 242 (96.4%) participants performed the Triplex self-test and succeeded in obtaining a valid test result with an overall usability index of 89.2%. The correct use of the Triplex self-test was higher in urban areas than rural areas (51.2% versus 16.5%; aOR: 6.9). The use of video IFU in addition to paper-based IFU increased the correct manipulation and interpretation of the Triplex self-test. A total of 197 (78.5%) participants correctly interpreted the Triplex self-test results, whereas 54 (21.5%) misinterpreted their results, mainly the positive test results harboring low-intensity band (30/251; 12.0%), and preferentially the HBsAg band (12/44; 27.3%). The rates of acceptability of reuse, distribution of the Triplex self-test to third parties (partner, friend, or family member), linkage to the health care facility for confirmation of results and treatment, and confidence in the self-test results were very high, especially among participants from urban areas. Conclusions This pilot study shows evidence for the first time in sub-Saharan Africa on good practicability and high acceptability of a prototype Triplex HIV/HCV/HBsAg self-test for simultaneous diagnosis of three highly prevalent chronic viral infections, providing the rational basis of using self-test harboring four bands of interest, i.e. the control, HIV, HCV, and HBsAg bands. The relatively frequent misinterpretation of the Triplex self-test points however the necessity to improve the delivery of this prototype Triplex self-test probably in a supervised setting. Finally, these observations lay the foundations for the potential large-scale use of the Triplex self-test in populations living in sub-Saharan Africa at high risk for HIV, HBV, and HCV infections.

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“…Hepatitis B and hepatitis C viral particles are comprised of core-composed capsids and a host lipid envelope studded with viral proteins. Viral particles are secreted from infected cells and can be detected in the blood of patients; thus, these protein components are also a target of the host immune system (32). Infection with HBV produces a host of immune responses in patients with resultant immunological markers detectable in the blood (33,34).…”

Section: Serological and Molecular Markers Of Hbv And Hcv Infectionsmentioning

confidence: 99%

“…Infection with HBV produces a host of immune responses in patients with resultant immunological markers detectable in the blood (33,34). These markers (Table 1), function at different levels of screening, diagnosis, assessment of liver disease stage, eligibility for treatment, treatment management, and monitoring for hepatocellular carcinoma (HCC) (32). Different HBV serological markers of infection include the small surface protein (HBsAg), primarily detected in serum and secreted as subviral particles consisting of host lipid and membrane-bound protein, antibody to the surface protein (anti-HBs), antibody to the viral core protein (anti-HBc) consisting of both immunoglobulin M (IgM) and immunoglobulin G (IgG), the secreted, non-structural HBeAg protein, and antibody to HBeAg (anti-HBe) (35).…”

Section: Serological and Molecular Markers Of Hbv And Hcv Infectionsmentioning

confidence: 99%

“…Self-testing strategies which remove the requirement to undergo POC testing at a healthcare facility have been assessed in LMIC regions and have shown advantages of ease of use, convenience, and privacy; however, provision of testing instructions, at the point of sale (pharmacy or hospital) is likely required to minimize confusion and ensure the procedure is followed correctly (55,56). The major limitations of most POC tests in LMIC involve procurement, distribution and handling of POC tests, training of personnel, and regulatory protocols which may hinder access in certain LMIC (32). LMIC may benefit from reappraisal of the testing algorithm used in high income countries, such that entry into care and treatment is initiated based on a combination of rapid and confirmatory testing to provide the most efficient, costeffective, and accurate diagnoses (57)(58)(59)(60).…”

Section: Rapid Point Of Care Diagnostic Testingmentioning

confidence: 99%

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Rapid Diagnostics for Hepatitis B and C Viruses in Low- and Middle-Income Countries

Shenge¹,

Osiowy

2021

Front.Virol.

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The global health challenge posed by hepatitis B virus (HBV) and hepatitis C virus (HCV) persists, especially in low-and-middle-income countries (LMICs), where underdiagnosis of these viral infections remains a barrier to the elimination target of 2030. HBV and HCV infections are responsible for most liver-related mortality worldwide. Infected individuals are often unaware of their condition and as a result, continue to transmit these viruses. Although conventional diagnostic tests exist, in LMIC they are largely inaccessible due to high costs or a lack of trained personnel, resulting in poor linkage to care and increased infections. Timely and accurate diagnosis is needed to achieve elimination of hepatitis B and C by the year 2030 as set out by the World Health Organization Global Health Sector Strategy. In this review rapid diagnostic tests allowing for quick and cost-effective screening and diagnosis of HBV and HCV, are discussed, as are their features, including suitability, reliability, and applicability in LMIC, particularly those within Africa.

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

Cited by 42 publications

References 113 publications

APASL clinical practice guideline on hepatitis B reactivation related to the use of immunosuppressive therapy

APASL clinical practice guideline on hepatitis B reactivation related to the use of immunosuppressive therapy

Self-testing for HIV, HBV, and HCV using finger-stick whole-blood multiplex immunochromatographic rapid test: A pilot feasibility study in sub-Saharan Africa

Rapid Diagnostics for Hepatitis B and C Viruses in Low- and Middle-Income Countries

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