Victorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital and WHO Regional Reference Laboratory for Hepatitis B/D, at The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia.
Tungaru Central Hospital, Ministry of Health and Medical Services, Tarawa, Republic of Kiribati.
J Med Virol. 2022 Feb;94(2):642-648. doi: 10.1002/jmv.25485. Epub 2019 Apr 24.
Areas with the highest burden of hepatitis B virus (HBV) infection are often low-middle-income countries with limited access to diagnosis due to isolation, affordability, and/or feasibility. Dried blood spots (DBSs) provide an alternative for remote areas where collection and transportation of serum is impractical. In this study, the application of DBS for serological and molecular detection of HBV and hepatitis D virus (HDV) was evaluated. Hepatitis B surface antigen was detected in 87 of 91 (95.6%) DBS. Seventeen of 21 (81%) had detectable HBeAg and 52 of 71 (73.2%) were anti-HBe positive. Anti-HD was detectable in 11 of 12 (91.6%) spiked control DBS after an initial failure to detect in patient DBS. HBV DNA was detected from 50 of 70 (71.4%) DBS with serum loads greater than 200 IU/mL in an in-house assay and 18 of 24 (75%) DBS with loads exceeding 389 IU/mL in a commercial assay. Using linear regression, HBV DNA loads from DBS were able to predict serum loads in 46 of 50 (92%) samples to within 1 log of actual serum load. HDV RNA was detected in 42 of 47 (89%) DBS with serum levels greater than 7200 IU/mL. DBSs are recommended for diagnosis of HBV, monitoring, and detection of high loads in pregnant women where peripheral blood testing remains unfeasible. Detection of HDV RNA from DBS may prove useful in endemic areas.
在乙型肝炎病毒 (HBV) 感染负担最重的地区，往往是中低收入国家，由于隔离、经济承受能力和/或可行性等原因，诊断手段有限。干血斑 (DBS) 为无法采集和运输血清的偏远地区提供了一种替代方法。本研究评估了 DBS 用于 HBV 和丁型肝炎病毒 (HDV) 血清学和分子检测的应用。在 91 份 DBS 中有 87 份 (95.6%) 检测到乙型肝炎表面抗原。21 份中有 17 份 (81%) 可检测到 HBeAg，71 份中有 52 份 (73.2%) 抗-HBe 阳性。在最初未能在患者 DBS 中检测到抗-HD 的情况下，12 份加标对照 DBS 中有 11 份 (91.6%) 可检测到抗-HD。在内部检测中，从 70 份 DBS 中有 50 份 (71.4%) 检测到 HBV DNA，血清载量大于 200IU/mL，在商业检测中，从 24 份 DBS 中有 18 份 (75%) 载量超过 389IU/mL。使用线性回归，46 份 DBS 中的 HBV DNA 载量能够预测 50 份 (92%) 样本的血清载量，与实际血清载量相差 1 个对数。在 47 份 DBS 中有 42 份 (89%) 检测到 HDV RNA，血清水平大于 7200IU/mL。DBS 推荐用于诊断 HBV、监测和检测孕妇中的高载量，因为外周血检测仍不可行。从 DBS 中检测 HDV RNA 可能在流行地区证明有用。
