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Abu N, Mohd Bakhori N, Shueb RH. Lateral Flow Assay for Hepatitis B Detection: A Review of Current and New Assays. MICROMACHINES 2023; 14:1239. [PMID: 37374824 DOI: 10.3390/mi14061239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 06/03/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023]
Abstract
From acute to chronic hepatitis, cirrhosis, and hepatocellular cancer, hepatitis B infection causes a broad spectrum of liver diseases. Molecular and serological tests have been used to diagnose hepatitis B-related illnesses. Due to technology limitations, it is challenging to identify hepatitis B infection cases at an early stage, particularly in a low- and middle-income country with constrained resources. Generally, the gold-standard methods to detect hepatitis B virus (HBV) infection requires dedicated personnel, bulky, expensive equipment and reagents, and long processing times which delay the diagnosis of HBV. Thus, lateral flow assay (LFA), which is inexpensive, straightforward, portable, and operates reliably, has dominated point-of-care diagnostics. LFA consists of four parts: a sample pad where samples are dropped; a conjugate pad where labeled tags and biomarker components are combined; a nitrocellulose membrane with test and control lines for target DNA-probe DNA hybridization or antigen-antibody interaction; and a wicking pad where waste is stored. By modifying the pre-treatment during the sample preparation process or enhancing the signal of the biomarker probes on the membrane pad, the accuracy of the LFA for qualitative and quantitative analysis can be improved. In this review, we assembled the most recent developments in LFA technologies for the progress of hepatitis B infection detection. Prospects for ongoing development in this area are also covered.
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Affiliation(s)
- Norhidayah Abu
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
- Advanced Materials Research Centre (AMREC), SIRIM Berhad, Lot 34, Jalan Hi-Tech 2/3, Kulim Hi-Tech Park, Kulim 09000, Kedah, Malaysia
| | - Noremylia Mohd Bakhori
- Advanced Materials Research Centre (AMREC), SIRIM Berhad, Lot 34, Jalan Hi-Tech 2/3, Kulim Hi-Tech Park, Kulim 09000, Kedah, Malaysia
| | - Rafidah Hanim Shueb
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
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The development of a machine learning algorithm for early detection of viral hepatitis B infection in Nigerian patients. Sci Rep 2023; 13:3244. [PMID: 36829040 PMCID: PMC9958122 DOI: 10.1038/s41598-023-30440-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 02/23/2023] [Indexed: 02/26/2023] Open
Abstract
Access to Hepatitis B Virus (HBV) testing for people in low-resource settings has long been challenging due to the gold standard, enzyme immunoassay, being prohibitively expensive, and requiring specialised skills and facilities that are not readily available, particularly in remote and isolated laboratories. Routine pathology data in tandem with cutting-edge machine learning shows promising diagnostic potential. In this study, recursive partitioning ("trees") and Support Vector Machines (SVMs) were applied to interrogate patient dataset (n = 916) that comprised results for Hepatitis B Surface Antigen (HBsAg) and routine clinical chemistry and haematology blood tests. These algorithms were used to develop a predictive diagnostic model of HBV infection. Our SVM-based diagnostic model of infection (accuracy = 85.4%, sensitivity = 91%, specificity = 72.6%, precision = 88.2%, F1-score = 0.89, Area Under the Receiver Operating Curve, AUC = 0.90) proved to be highly accurate for discriminating HBsAg positive from negative patients, and thus rivals with immunoassay. Therefore, we propose a predictive model based on routine blood tests as a novel diagnostic for early detection of HBV infection. Early prediction of HBV infection via routine pathology markers and pattern recognition algorithms will offer decision-support to clinicians and enhance early diagnosis, which is critical for optimal clinical management and improved patient outcomes.
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Ye X, Li T, Li Y, Zeng J, Li R, Xu X, Guan X, Li L. Comparative analysis of hepatitis B virus infections in blood donors born before and after the implementation of universal HBV vaccination in southern China. Transfus Med 2023; 33:81-89. [PMID: 36815535 DOI: 10.1111/tme.12903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 07/09/2022] [Accepted: 07/26/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND In China, the vaccinated blood donors have rapidly increased by recent years, which may impact blood safety. The true prevalence of HBV between vaccinated blood donors and non-vaccinated blood donors should be explored. STUDY DESIGN AND METHODS The samples of blood donors were collected and detected for serologic markers of HBV in the Shenzhen Blood Centre (SZBC). The discrepant results were tested with commercial electrochemiluminescence immunoassay (ELCI) for HBsAg, anti-HBs, HBeAg, Anti-HBe and Anti-HBc, alternative MPX ID NAT, nested PCR, and a quantitative real-time polymerase chain reaction (qPCR) assay for HBV DNA. The serological and molecular characteristics of HBV infected blood donors were analysed, and the effects on blood safety for donors born before and after the implementation of universal HBV vaccination were compared. RESULTS Out of 242 presumed HBV infected donors from 26 318 donations, 131 (0.49%, [95% CI, 0.43-0.59]) chronic HBV infections (CHB, HBsAg detected with or without DNA), 58 (0.22%, [95% CI, 0.17-0.28]) occult hepatitis B infections (OBI, HBsAg not detected, assume anti-HBc positive and/or anti-HBs with HBV DNA) and 3 (0.011%, [95% CI, 0.0023-0.033]) window period (WP) infections were confirmed respectively. There were 28 CHBs (0.44%), 7 OBIs (0.11%) and 1 WP (0.016%) from vaccinated blood donor and 103 CHBs (0.52%), 51 OBIs (0.26%) and 2 WPs (0.01%) from non-vaccinated blood donor. The HBV+ (CHBs, OBIs and WPs) rate (0.56%) in vaccinated donors was lower than in non-vaccinated donors (0.78%, p < 0.05). The HBsAg titers of vaccinated infected blood donors (Median: 128.8 IU/ml) were much higher than non-vaccinated infected blood donors (58.4 IU/ml). The OBI yield rates in the vaccinated blood donors was significantly lower than the non-vaccinated blood donors (p < 0.05). There 102/124 (82.3%) samples were genotype B, 22/124 (17.7%) were genotype C respectively. There was no significant difference in the distribution of genotype between non-vaccinated blood donors (B/C, 86/17) and vaccinated blood donors (B/C, 23/6; p > 0.05). High frequency of vaccine escape mutations M133L (32.4%) and E164G in S region of genotype B strains and substitution L175S (40.9%) related to vaccine escape in S region of genotype C strains were identified. CONCLUSION The universal HBV vaccination program markedly reduces the risk of HBV infection in blood donors, and provides a significant guarantee for the safety of blood transfusion. Several important mutations detected related vaccine escape and notable mutations needed further investigated.
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Affiliation(s)
- Xianlin Ye
- Department of Laboratory, Shenzhen Blood Centre, Shenzhen, China
| | - Tong Li
- Department of Laboratory, Shenzhen Blood Centre, Shenzhen, China
| | - Yi Li
- Department of Laboratory, Shenzhen Blood Centre, Shenzhen, China
| | - Jinfeng Zeng
- Department of Laboratory, Shenzhen Blood Centre, Shenzhen, China
| | - Ran Li
- Department of Laboratory, Shenzhen Blood Centre, Shenzhen, China
| | - Xiaoxuan Xu
- Department of Laboratory, Shenzhen Blood Centre, Shenzhen, China
| | - Xiaoyu Guan
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu, China.,Key Laboratory of Transfusion Adverse Reactions, CAMS, Chengdu, China.,School of Public Health, Anhui Medical University, Hefei, China
| | - Ling Li
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu, China.,Key Laboratory of Transfusion Adverse Reactions, CAMS, Chengdu, China.,School of Public Health, Anhui Medical University, Hefei, China
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Ye X, Liu L, Chen L, Nie X, Huang L, Ye D, Zeng J, Li T, Li B, Xu M, Chen L. High-Frequency Notable HBV Mutations Identified in Blood Donors With Occult Hepatitis B Infection From Heyuan City of Southern China. Front Immunol 2022; 13:754383. [PMID: 35634299 PMCID: PMC9136029 DOI: 10.3389/fimmu.2022.754383] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 04/15/2022] [Indexed: 11/14/2022] Open
Abstract
Background All Chinese blood centers have implemented mini pool (MP) HBV nucleic acid testing (NAT) together with HBsAg ELISA in routine donor screening since 2015. The prevalence of occult hepatitis B virus infection (OBI) in donors from different regions varies, and the molecular characterization of the HBV DNA and clinical outcomes of these OBIs remain largely unexplored. Methods Blood donations from Heyuan city in Southern China were screened by HBsAg ELISA and HBV MP8 NAT. Donations with HBsAg-/HBV DNA+ were collected for this study. Molecular characterizations of HBV DNAs were further analyzed by various DNA amplification assays including quantitative PCR (qPCR) and nested PCR, amplifying the basic core and pre-core promoter regions (BCP/PC). The HBsAg (S) region from HBV DNA was isolated by high-volume nucleic acid extraction. Notable mutations were identified by comparison to the HBV reference sequences. The clinical outcomes of the donors with OBIs were further followed for nearly 3 years. Results Seventy OBIs from 44,592 donations (0.15%) that we identified and reported previously were enrolled for this current study. HBV sequences were obtained from 44/70 OBIs, and genotyping analysis showed that 42/44 (95.2%) OBIs were genotype B, and 2/44 (4.8%) were genotype C. Interestingly, mutation analysis revealed that various mutations including M133L/T, F134L, P142L, V168A, R169H, S174N, L175S, and V177A of HBV DNA affecting HBsAg detection were observed in genotype B OBIs. Two notable mutations, T47K and L53S, were identified in genotype C OBIs. Follow-up studies showed that 3/31 (9.7%) OBIs converted to HBsAg+ as chronic infections while 1/31 (3.2%) HBV DNA was undetectable (classified as recovery) and 27/31 (87.1%) remained as OBIs. Conclusion Various notable mutations affecting HBsAg detection were observed in blood donors with OBIs in Heyuan city of Southern China. Follow-up studies showed that most OBIs remained as OBIs with fluctuating or low viral loads. Higher sensitive HBV ID NAT is recommended for donor screening to further reduce the transmission risk of OBIs.
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Affiliation(s)
- Xianlin Ye
- Department of Laboratory, Shenzhen Blood Center, Shenzhen, China
| | - Lihua Liu
- Department of Laboratory, Heyuan Blood Center, Heyuan, China
| | - Lina Chen
- Department of Laboratory, Heyuan Blood Center, Heyuan, China
| | - Xianghui Nie
- Department of Laboratory, Heyuan Blood Center, Heyuan, China
| | - Lu Huang
- Department of Laboratory, Heyuan Blood Center, Heyuan, China
| | - Denghuang Ye
- Department of Laboratory, Heyuan Blood Center, Heyuan, China
| | - Jinfeng Zeng
- Department of Laboratory, Shenzhen Blood Center, Shenzhen, China
| | - Tong Li
- Department of Laboratory, Shenzhen Blood Center, Shenzhen, China
| | - Bin Li
- The Joint Laboratory on Transfusion-Transmitted Diseases (TTDs) between Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Nanning Blood Center, Nanning Blood Center, Nanning, China
- *Correspondence: Bin Li, ; Min Xu, ; Limin Chen,
| | - Min Xu
- Provincial Key Laboratory for Transfusion-Transmitted Diseases, Institute of Blood Transfusion, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Chengdu, China
- *Correspondence: Bin Li, ; Min Xu, ; Limin Chen,
| | - Limin Chen
- The Joint Laboratory on Transfusion-Transmitted Diseases (TTDs) between Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Nanning Blood Center, Nanning Blood Center, Nanning, China
- Provincial Key Laboratory for Transfusion-Transmitted Diseases, Institute of Blood Transfusion, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Chengdu, China
- *Correspondence: Bin Li, ; Min Xu, ; Limin Chen,
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Jones PD, Gmunder K, Batrony S, Martin P, Kobetz E, Carrasquillo O. Acceptability and Feasibility of Home-Based Hepatitis B Screening Among Haitian Immigrants. J Immigr Minor Health 2021; 23:1170-1178. [PMID: 33686574 PMCID: PMC9166933 DOI: 10.1007/s10903-021-01165-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2021] [Indexed: 10/22/2022]
Abstract
Hepatitis B (HBV) is endemic in Haiti, therefore Haitian immigrants should be screened to identify and link affected individuals to care. Current screening approaches are ineffective. We assessed the acceptability and feasibility of home-based screening among Haitian immigrants using community health workers (CHWs). We recruited participants exiting a pragmatic trial evaluating strategies to improve care delivery (NCT02970136). Participants completed an acceptability questionnaire. Blood drawn by CHWs at participants' homes or community sites was tested for hepatitis B surface antigen, hepatitis B surface antibody and hepatitis B core antibody. Of 60 participants, 59 found screening acceptable; 53 had blood drawn. Of those, 45.3% had HBV previously, 49.1% remained susceptible and 5.7% were vaccinated. Respondents cited various reasons community members might find screening unacceptable. The high prior HBV rate highlights the need for effective outreach programs. Home-based HBV screening was both acceptable and feasible among Haitian immigrants.
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Affiliation(s)
- Patricia D Jones
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA.
- Department of Medicine, Division of Digestive Health and Liver Diseases, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 1112, Miami, FL, 33136, USA.
| | - Kristin Gmunder
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Saradjine Batrony
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Paul Martin
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Medicine, Division of Digestive Health and Liver Diseases, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 1112, Miami, FL, 33136, USA
| | - Erin Kobetz
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Medicine, Division of Computational Medicine and Population Health, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Olveen Carrasquillo
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Medicine, Division of General Internal Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
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Nasrollahi F, Haghniaz R, Hosseini V, Davoodi E, Mahmoodi M, Karamikamkar S, Darabi MA, Zhu Y, Lee J, Diltemiz SE, Montazerian H, Sangabathuni S, Tavafoghi M, Jucaud V, Sun W, Kim H, Ahadian S, Khademhosseini A. Micro and Nanoscale Technologies for Diagnosis of Viral Infections. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2021; 17:e2100692. [PMID: 34310048 PMCID: PMC8420309 DOI: 10.1002/smll.202100692] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 03/19/2021] [Indexed: 05/16/2023]
Abstract
Viral infection is one of the leading causes of mortality worldwide. The growth of globalization significantly increases the risk of virus spreading, making it a global threat to future public health. In particular, the ongoing coronavirus disease 2019 (COVID-19) pandemic outbreak emphasizes the importance of devices and methods for rapid, sensitive, and cost-effective diagnosis of viral infections in the early stages by which their quick and global spread can be controlled. Micro and nanoscale technologies have attracted tremendous attention in recent years for a variety of medical and biological applications, especially in developing diagnostic platforms for rapid and accurate detection of viral diseases. This review addresses advances of microneedles, microchip-based integrated platforms, and nano- and microparticles for sampling, sample processing, enrichment, amplification, and detection of viral particles and antigens related to the diagnosis of viral diseases. Additionally, methods for the fabrication of microchip-based devices and commercially used devices are described. Finally, challenges and prospects on the development of micro and nanotechnologies for the early diagnosis of viral diseases are highlighted.
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Affiliation(s)
- Fatemeh Nasrollahi
- Terasaki Institute for Biomedical Innovation (TIBI)Los AngelesCA90024USA
- Department of BioengineeringUniversity of California‐Los AngelesLos AngelesCA90095USA
| | - Reihaneh Haghniaz
- Terasaki Institute for Biomedical Innovation (TIBI)Los AngelesCA90024USA
- Department of BioengineeringUniversity of California‐Los AngelesLos AngelesCA90095USA
| | - Vahid Hosseini
- Terasaki Institute for Biomedical Innovation (TIBI)Los AngelesCA90024USA
- Department of BioengineeringUniversity of California‐Los AngelesLos AngelesCA90095USA
| | - Elham Davoodi
- Terasaki Institute for Biomedical Innovation (TIBI)Los AngelesCA90024USA
- Department of BioengineeringUniversity of California‐Los AngelesLos AngelesCA90095USA
- Department of Mechanical and Mechatronics EngineeringUniversity of WaterlooWaterlooONN2L 3G1Canada
| | - Mahboobeh Mahmoodi
- Department of BioengineeringUniversity of California‐Los AngelesLos AngelesCA90095USA
- Department of Biomedical EngineeringYazd BranchIslamic Azad UniversityYazd8915813135Iran
| | | | - Mohammad Ali Darabi
- Terasaki Institute for Biomedical Innovation (TIBI)Los AngelesCA90024USA
- Department of BioengineeringUniversity of California‐Los AngelesLos AngelesCA90095USA
| | - Yangzhi Zhu
- Terasaki Institute for Biomedical Innovation (TIBI)Los AngelesCA90024USA
| | - Junmin Lee
- Terasaki Institute for Biomedical Innovation (TIBI)Los AngelesCA90024USA
| | - Sibel Emir Diltemiz
- Department of BioengineeringUniversity of California‐Los AngelesLos AngelesCA90095USA
- Department of ChemistryFaculty of ScienceEskisehir Technical UniversityEskisehir26470Turkey
| | - Hossein Montazerian
- Terasaki Institute for Biomedical Innovation (TIBI)Los AngelesCA90024USA
- Department of BioengineeringUniversity of California‐Los AngelesLos AngelesCA90095USA
| | | | - Maryam Tavafoghi
- Department of BioengineeringUniversity of California‐Los AngelesLos AngelesCA90095USA
| | - Vadim Jucaud
- Terasaki Institute for Biomedical Innovation (TIBI)Los AngelesCA90024USA
| | - Wujin Sun
- Terasaki Institute for Biomedical Innovation (TIBI)Los AngelesCA90024USA
| | - Han‐Jun Kim
- Terasaki Institute for Biomedical Innovation (TIBI)Los AngelesCA90024USA
| | - Samad Ahadian
- Terasaki Institute for Biomedical Innovation (TIBI)Los AngelesCA90024USA
| | - Ali Khademhosseini
- Terasaki Institute for Biomedical Innovation (TIBI)Los AngelesCA90024USA
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Bragina VA, Orlov AV, Znoyko SL, Pushkarev AV, Novichikhin DO, Guteneva NV, Nikitin MP, Gorshkov BG, Nikitin PI. Nanobiosensing based on optically selected antibodies and superparamagnetic labels for rapid and highly sensitive quantification of polyvalent hepatitis B surface antigen. ANALYTICAL METHODS : ADVANCING METHODS AND APPLICATIONS 2021; 13:2424-2433. [PMID: 33998615 DOI: 10.1039/d1ay00354b] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Hepatitis B surface antigen (HBsAg) is the most clinically relevant serological marker of hepatitis B virus (HBV) infection. Its detection in blood is extremely important for identification of asymptomatic individuals or chronic HBV carriers, screening blood donors, and early seroconversion. Rapid point-of-care HBsAg tests are predominantly qualitative, and their analytical sensitivity does not meet the requirements of regulatory agencies. We present a highly sensitive lateral flow assay based on superparamagnetic nanoparticles for rapid quantification (within 30 min) of polyvalent HBsAg in serum. The demonstrated limit of detection (LOD) of 80 pg mL-1 in human serum is better than both the FDA recommendations for HBsAg assays (which is 0.5 ng mL-1) and the sensitivity of traditional laboratory-based methods such as enzyme linked immunosorbent assays. Along with the attractive LOD at lower concentrations and the wide linear dynamic range of more than 2.5 orders, the assay features rapidity, user-friendliness, on-site operation and effective performance in the complex biological medium. These are due to the combination of the immunochromatographic approach with a highly sensitive electronic registration of superparamagnetic nanolabels over the entire volume of a 3D test structure by their non-linear magnetization and selection of optimal antibodies by original optical label-free methods. The developed cost-efficient bioanalytical technology can be used in many socially important fields such as out-of-lab screening and diagnosis of HBV infection at a point-of-demand, especially in hard-to-reach or sparsely populated areas, as well as highly endemic regions.
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Affiliation(s)
- Vera A Bragina
- Prokhorov General Physics Institute of the Russian Academy of Sciences, 38 Vavilov St, Moscow, 119991, Russia.
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Xiao Y, Thompson AJ, Howell J. Point-of-Care Tests for Hepatitis B: An Overview. Cells 2020; 9:cells9102233. [PMID: 33023265 PMCID: PMC7650625 DOI: 10.3390/cells9102233] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 09/30/2020] [Accepted: 09/30/2020] [Indexed: 12/15/2022] Open
Abstract
Despite the heavy disease burden posed by hepatitis B, around 90% of people living with hepatitis B are not diagnosed globally. Many of the affected populations still have limited or no access to essential blood tests for hepatitis B. Compared to conventional blood tests which heavily rely on centralised laboratory facilities, point-of-care testing for hepatitis B has the potential to broaden testing access in low-resource settings and to engage hard-to-reach populations. Few hepatitis B point-of-care tests have been ratified for clinical use by international and regional regulatory bodies, and countries have been slow to adopt point-of-care testing into hepatitis B programs. This review presents currently available point-of-care tests for hepatitis B and their roles in the care cascade, reviewing evidence for testing performance, utility, acceptability, costs and cost-effectiveness when integrated into hepatitis B diagnosis and monitoring programs. We further discuss challenges and future directions in aspects of technology, implementation, and regulation when adopting point-of-care testing in hepatitis B programs.
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Affiliation(s)
- Yinzong Xiao
- Burnet Institute, 3004 Melbourne, VIC, Australia;
- Department of Gastroenterology, St Vincent’s Hospital, 3065 Fitzroy, VIC, Australia;
- Faculty of Medicine, University of Melbourne, 3010 Parkville, VIC, Australia
| | - Alexander J. Thompson
- Department of Gastroenterology, St Vincent’s Hospital, 3065 Fitzroy, VIC, Australia;
- Faculty of Medicine, University of Melbourne, 3010 Parkville, VIC, Australia
| | - Jessica Howell
- Burnet Institute, 3004 Melbourne, VIC, Australia;
- Department of Gastroenterology, St Vincent’s Hospital, 3065 Fitzroy, VIC, Australia;
- Faculty of Medicine, University of Melbourne, 3010 Parkville, VIC, Australia
- School of Public Health and Preventive Medicine, Monash University, 3004 Melbourne, VIC, Australia
- Correspondence:
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Guan Y, Liu Y, Lei H, Liu S, Xu F, Meng X, Bai M, Wang X, Yang G. Dielectrophoresis Separation of Platelets Using a Novel Zigzag Microchannel. MICROMACHINES 2020; 11:E890. [PMID: 32992689 PMCID: PMC7599473 DOI: 10.3390/mi11100890] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 09/16/2020] [Accepted: 09/22/2020] [Indexed: 11/30/2022]
Abstract
Platelet separation and purification are required in many applications including in the detection and treatment of hemorrhagic and thrombotic diseases, in addition to transfusions and in medical research. In this study, platelet separation was evaluated using a novel zigzag microchannel fluidic device while leveraging a dielectrophoresis (DEP) electric field using the COMSOL multiphysics software package and additional experimentation. The zigzag-shaped microchannel was superior to straight channel devices for cell separation because the sharp corners reduced the required horizontal distance needed for separation and also contributed to an asymmetric DEP electric field. A perfect linear relationship was observed between the separation distance and the corner angles. A quadratic relationship (R2 = 0.99) was observed between the driving voltage and the width and the lengths of the channel, allowing for optimization of these properties. In addition, the voltage was inversely proportional to the channel width and proportional to the channel length. An optimal velocity ratio of 1:4 was identified for the velocities of the two device inlets. The proposed device was fabricated using laser engraving and lithography with optimized structures including a 0.5 mm channel width, a 120° corner angle, a 0.3 mm channel depth, and a 17 mm channel length. A separation efficiency of 99.4% was achieved using a voltage of 20 V and a velocity ratio of 1:4. The easy fabrication, lower required voltage, label-free detection, high efficiency, and environmental friendliness of this device make it suitable for point-of-care medicine and biological applications. Moreover, it can be used for the separation of other types of compounds including lipids.
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Affiliation(s)
- Yanfang Guan
- School of Electromechanical Engineering, Henan University of Technology, Zhengzhou 450001, China; (Y.L.); (H.L.); (S.L.); (F.X.); (X.M.); (M.B.); (X.W.); (G.Y.)
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10
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Evaluation of Four Rapid Tests for Detection of Hepatitis B Surface Antigen in Ivory Coast. J Immunol Res 2020; 2020:6315718. [PMID: 32676509 PMCID: PMC7335398 DOI: 10.1155/2020/6315718] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 05/04/2020] [Accepted: 06/11/2020] [Indexed: 12/12/2022] Open
Abstract
Background Hepatitis B virus (HBV) infection is a leading cause of liver disease worldwide. Hepatitis B surface antigen (HBsAg) rapid diagnostic tests (RDTs) could be an ideal tool for a large-scale HBV screening in settings with high endemicity but limited infrastructure. The aim of this study was to evaluate the diagnosis performance of such RDTs for screening HBV infection in Ivory Coast. Methods From September 2018 to January 2019, a cross-sectional phase I evaluation study of RDTs was conducted in three laboratories of Abidjan (CeDReS, CNTS and IPCI), on a panel of 405 whole blood samples and 699 plasmas. Four HBsAg RDTs (Determine™ HBsAg, SD Bioline HBsAg WB®, Standard Q HBsAg® and Vikia HBsAg®) were evaluated. The diagnostic performance (sensitivity and specificity) was calculated in comparison to the reference sequential algorithms of two EIA tests (Dia.Pro HBsAg® one version ULTRA and Monolisa™ HBsAg ULTRA). Results The Determine™ HBsAg and Vikia HBsAg® tests performed well, with 100% of sensitivity, specificity both on plasma and on whole blood. For SD Bioline HBsAg WB® and Standard Q HBsAg®, the specificities were 99.8% and the sensitivities 99.3% and 97.1% respectively. Finally, there were a total of 19 false negative results: 3 with SD Bioline HBsAg WB® and 16 with Standard Q HBsAg®. Conclusion Determine HBsAg® from Alere and Vikia HBsAg® from Biomérieux are the most suitable RDTs for screening for HBV in Ivory Coast. A phase II evaluation must be initiated.
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Reardon JM, O'Connor SM, Njau JD, Lam EK, Staton CA, Cookson ST. Cost-effectiveness of birth-dose hepatitis B vaccination among refugee populations in the African region: a series of case studies. Confl Health 2019; 13:5. [PMID: 30858875 PMCID: PMC6390570 DOI: 10.1186/s13031-019-0188-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 02/12/2019] [Indexed: 12/30/2022] Open
Abstract
Background Hepatitis B affects 257 million people worldwide. Mother-to-child hepatitis B virus (HBV) transmission is a preventable cause of substantial morbidity and mortality and poses greatest risk for developing chronic HBV infection. The World Health Organization recommends that all countries institute universal hepatitis B birth dose (HepB BD) vaccination during the first 24 h of life, followed by timely completion of routine immunization. The objective of this analysis was to assess the cost-effectiveness of adding HepB BD vaccination among sub-Saharan African refugee populations where the host country’s national immunization policy includes HepB BD. Methods We performed a cost-effectiveness analysis of three hepatitis B vaccination strategy scenarios for camp-based refugee populations in the African Region (AFR): routine immunization (RI), RI plus universal HepB BD, and RI plus HepB BD only for newborns of hepatitis B surface antigen-positive mothers identified through rapid diagnostic testing (RDT). We focused analyses on refugee populations living in countries that include HepB BD in national immunization schedules: Djibouti, Algeria and Mauritania. We used a decision tree model to estimate costs of vaccination and testing, and costs of life-years lost due to complications of chronic hepatitis B. Results Compared with RI alone, addition of HepB BD among displaced Somali refugees in Djibouti camps would save 9807 life-years/year, with an incremental cost-effectiveness ratio (ICER) of 0.15 USD (US dollars) per life-year saved. The RI plus HepB BD strategy among Western Saharan refugees in Algerian camps and Malian refugees in Mauritania camps would save 27,108 life-years/year with an ICER of 0.11 USD and 18,417 life-years/year with an ICER of 0.16 USD, respectively. The RI plus RDT-directed HepB BD was less cost-effective than RI plus delivery of universal HepB BD vaccination or RI alone. Conclusions Based on our model, addition of HepB BD vaccination is very cost-effective among three sub-Saharan refugee populations, using relative life-years saved. This analysis shows the potential benefit of implementing HepB BD vaccination among other camp-based refugee populations as more AFR countries introduce national HepB BD policies.
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Affiliation(s)
- Joseph Michael Reardon
- 1Department of Emergency Medicine, Greenville Health System, 701 Grove Rd, Greenville, SC 29605 USA
| | - Siobhán M O'Connor
- 2Division of Viral Hepatitis, United States Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30329 USA
| | - Joseph D Njau
- 3Division of Global Migration and Quarantine, United States Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30329 USA
| | - Eugene K Lam
- 4Division of Global Health Protection, United States Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30329 USA
| | - Catherine A Staton
- 5Division of Emergency Medicine, Duke University Medical Center, DUMC Box 3096, 2301 Erwin Road, Durham, NC 27701 USA
| | - Susan T Cookson
- 6Emergency Response and Recovery Branch, Division of Global Health Protection, United States Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30329 USA
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12
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Kweon OJ, Lim YK, Kim HR, Kim TH, Lee MK. Analytical performance of newly developed rapid point-of-care test for the simultaneous detection of hepatitis A, B, and C viruses in serum samples. J Med Virol 2019; 91:1056-1062. [PMID: 30668895 DOI: 10.1002/jmv.25405] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 01/03/2019] [Accepted: 01/18/2019] [Indexed: 01/24/2023]
Abstract
ABSTRACTBACKGROUND Although immunoassays play a major role in the detection of hepatitis viruses, there is a need for a point-of-care (POC) test. We evaluated the EuDx-HE (A,B,C) kit (EUDIPIA, Cheongju, Korea), which detects anti-hepatitis A virus (HAV) immunoglobulin M (IgM), hepatitis B virus surface antigen (HBsAg), and anti-hepatitis C virus (HCV) immunoglobulin G (IgG) simultaneously using an immunochromatographic method within 15 minutes. METHODS A total of 1581 serum samples including 57, 477, and 451 samples positive for anti-HAV IgM, HBsAg, and anti-HBV IgG, respectively, were analyzed. We investigated the diagnostic accuracy of the EuDx-HE (A,B,C) kit by comparison with SD BIOLINE POC kits (Abbott, Chicago, IL) using Architect immunoassays as a reference method. RESULTS For anti-HAV IgM and HBsAg detection, the EuDx-HE (A,B,C) kit showed a higher sensitivity and a slightly lower specificity than the SD BIOLINE kit. For anti-HCV IgG detection, the EuDx-HE (A,B,C) kit had a higher sensitivity and a higher specificity than the SD BIOLINE kit. The agreement for positivity between the POC tests was >89.47%, with κ values of 0.844, 0.941, and 0.943 for HAV, HBV, and HCV, respectively. CONCLUSION The EuDx-HE (A,B,C) kit showed an acceptable clinical performance for detecting anti-HAV IgM, HBsAg, and anti-HCV.
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Affiliation(s)
- Oh Joo Kweon
- Department of Laboratory Medicine, Aerospace Medical Center, Cheongju, Republic of Korea.,Department of Laboratory Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Yong Kwan Lim
- Department of Laboratory Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Hye Ryoun Kim
- Department of Laboratory Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Tae-Hyoung Kim
- Department of Urology, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Mi-Kyung Lee
- Department of Laboratory Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea
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13
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Coffin C, Zhou K, Terrault N. New and Old Biomarkers for Diagnosis and Management of Chronic Hepatitis B Virus Infection. Gastroenterology 2019; 156:355-368.e3. [PMID: 30472225 PMCID: PMC6433165 DOI: 10.1053/j.gastro.2018.11.037] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 11/01/2018] [Indexed: 12/15/2022]
Abstract
Tests to detect the presence and activity of hepatitis B virus (HBV) are the cornerstones of diagnosis and management. Assays that detect or measure serum levels of HB surface antigen, HB surface antibody, and HB core antibody are used to identify patients with exposure to HBV, whereas other tests provide information on the level of virus replication, presence of specific variants, and presence of virus reservoirs. Newer diagnostic tests, used only in research settings so far, aim to quantify levels of intrahepatic HBV replication. Other tests have been developed to detect HBV infection in resource-limited settings. We review point-of-care tests (essential in global screening efforts), standard diagnostic tests used in routine clinical management, and newer tests that might be used in clinical trials of agents designed to cure HBV infection.
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Affiliation(s)
- C.S. Coffin
- Division of Gastroenterology and Hepatology, University of Calgary, Calgary, Canada
| | - K. Zhou
- Division of Gastroenterology/Hepatology University of California San Francisco
| | - N.A. Terrault
- Division of Gastroenterology/Hepatology University of California San Francisco
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14
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Liu K, Xie M, Lu X, Yu H, Wang H, Xu Y, Yang Q, Lin Y, Ma Q. Mutations within the major hydrophilic region (MHR) of Hepatitis B virus from individuals with simultaneous HBsAg and anti-HBs in Guangzhou, Southern China. J Med Virol 2018; 90:1337-1342. [PMID: 29663445 DOI: 10.1002/jmv.25188] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 04/02/2018] [Indexed: 12/21/2022]
Abstract
The mechanism of the coexistence of HBsAg and anti-HBs is still unclear. This study investigated the variations located in the major hydrophilic region (MHR) of HBV from individuals with simultaneous HBsAg and anti-HBs in Guangzhou, southern China. Among 4455 samples analyzed, 179 (4.02%) patients were discovered with both HBsAg and anti-HBs. Finally, 44 individuals with concurrent HBsAg and anti-HBs (defined as group I), and 88 patients with positive HBsAg and negative anti-HBs (defined as group II, served as control) were enrolled in the study. The number of residue changes per 100 residues within the MHR in group I was 7.1 times more frequent than group II (P < 0.001) and was discovered mostly in the MHR1 (aa99-119) (P < 0.001). Two or more residue changes in the MHR were discovered in 15 patients (34.1%) of group I, but were found in only one (1.1%) patient of group II (P < 0.001). The most common variants in group I were at positions s101Q, s133M, s126T/I, s131T, s145G, s120P, and s129Q. In addition, sQ101 K, sT131N, and sM133L were more frequently discovered in group I with significant difference (P < 0.05). In chronic hepatitis B (CHB) patients, the simultaneous of HBsAg and anti-HBs were accompanied with an increase of MHR variants, and suggested that the HBsAg mutants were selected by naturally acquired anti-HBs during chronic carriage.
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Affiliation(s)
- Kemin Liu
- Department of Clinical Laboratory, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Mingyu Xie
- Dongguan Eighth People's Hospital, Dongguan, China
| | - Xiaomei Lu
- Dongguan Eighth People's Hospital, Dongguan, China
| | - Hui Yu
- Department of Clinical Laboratory, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Hui Wang
- Department of Clinical Laboratory, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Yunjian Xu
- Department of Clinical Laboratory, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Qingqing Yang
- Department of Clinical Laboratory, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Yongping Lin
- Department of Clinical Laboratory, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Qiang Ma
- Department of Clinical Laboratory, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China.,School of Life Sciences, Zhengzhou University, Zhengzhou, China
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15
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Diagnostic accuracy of tests to detect hepatitis B surface antigen: a systematic review of the literature and meta-analysis. BMC Infect Dis 2017; 17:698. [PMID: 29143619 PMCID: PMC5688498 DOI: 10.1186/s12879-017-2772-3] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Chronic Hepatitis B Virus (HBV) infection is characterised by the persistence of hepatitis B surface antigen (HBsAg). Expanding HBV diagnosis and treatment programmes into low resource settings will require high quality but inexpensive rapid diagnostic tests (RDTs) in addition to laboratory-based enzyme immunoassays (EIAs) to detect HBsAg. The purpose of this review is to assess the clinical accuracy of available diagnostic tests to detect HBsAg to inform recommendations on testing strategies in 2017 WHO hepatitis testing guidelines. METHODS The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines using 9 databases. Two reviewers independently extracted data according to a pre-specified plan and evaluated study quality. Meta-analysis was performed. HBsAg diagnostic accuracy of rapid diagnostic tests (RDTs) was compared to enzyme immunoassay (EIA) and nucleic-acid test (NAT) reference standards. Subanalyses were performed to determine accuracy among brands, HIV-status and specimen type. RESULTS Of the 40 studies that met the inclusion criteria, 33 compared RDTs and/or EIAs against EIAs and 7 against NATs as reference standards. Thirty studies assessed diagnostic accuracy of 33 brands of RDTs in 23,716 individuals from 23 countries using EIA as the reference standard. The pooled sensitivity and specificity were 90.0% (95% CI: 89.1, 90.8) and 99.5% (95% CI: 99.4, 99.5) respectively, but accuracy varied widely among brands. Accuracy did not differ significantly whether serum, plasma, venous or capillary whole blood was used. Pooled sensitivity of RDTs in 5 studies of HIV-positive persons was lower at 72.3% (95% CI: 67.9, 76.4) compared to that in HIV-negative persons, but specificity remained high. Five studies evaluated 8 EIAs against a chemiluminescence immunoassay reference standard with a pooled sensitivity and specificity of 88.9% (95% CI: 87.0, 90.6) and 98.4% (95% CI: 97.8, 98.8), respectively. Accuracy of both RDTs and EIAs using a NAT reference were generally lower, especially amongst HIV-positive cohorts. CONCLUSIONS HBsAg RDTs have good sensitivity and excellent specificity compared to laboratory immunoassays as a reference standard. Sensitivity of HBsAg RDTs may be lower in HIV infected individuals.
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16
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Wang Y, Yu L, Kong X, Sun L. Application of nanodiagnostics in point-of-care tests for infectious diseases. Int J Nanomedicine 2017; 12:4789-4803. [PMID: 28740385 PMCID: PMC5503494 DOI: 10.2147/ijn.s137338] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Although tremendous efforts have been put into the treatment of infectious diseases to prevent epidemics and mortality, it is still one of the major health care issues that have a profound impact on humankind. Therefore, the development of specific, sensitive, accurate, rapid, low-cost, and easy-to-use diagnostic tools is still in urgent demand. Nanodiagnostics, defined as the application of nanotechnology to medical diagnostics, can offer many unique opportunities for more successful and efficient diagnosis and treatment for infectious diseases. In this review, we provide an overview of the nanodiagnostics for infectious diseases from nanoparticle-based, nanodevice-based, and point-of-care test (POCT) platforms. Most importantly, emphasis focused on the recent trends in the nanotechnology-based POCT system. The current state-of-the-art and most promising point-of-care nanodiagnostic technologies, including miniaturized diagnostic magnetic resonance platform, magnetic barcode assay system, cell phone-based polarized light microscopy platform, cell phone-based dongle platform, and paper-based POCT platform, for infectious diseases were fully examined. The limitations, challenges, and future trends of the nanodiagnostics in POCTs for infectious diseases are also discussed.
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Affiliation(s)
- Yongzhong Wang
- Anhui Key Laboratory of Modern Biomanufacturing, School of Life Sciences, Anhui University, Hefei, Anhui, People's Republic of China
| | - Li Yu
- Department of Microbiology and Parasitology, Anhui Provincial Laboratory of Microbiology and Parasitology, Anhui Key Laboratory of Zoonoses, Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Xiaowei Kong
- Anhui Key Laboratory of Modern Biomanufacturing, School of Life Sciences, Anhui University, Hefei, Anhui, People's Republic of China
| | - Leming Sun
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, USA
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17
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Prevalence of S gene mutations within the major hydrophilic region of hepatitis B virus in patients in Dongguan, southern China. Arch Virol 2017; 162:2949-2957. [DOI: 10.1007/s00705-017-3437-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 05/18/2017] [Indexed: 12/30/2022]
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18
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Sehr MA, Joshi KD, Fontanesi JM, Wong RJ, Bitmead RR, Gish RG. Markov modeling in hepatitis B screening and linkage to care. Theor Biol Med Model 2017; 14:11. [PMID: 28521828 PMCID: PMC5437626 DOI: 10.1186/s12976-017-0057-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 05/09/2017] [Indexed: 12/23/2022] Open
Abstract
Background With up to 240 million people chronically infected with hepatitis B worldwide, including an estimated 2 million in the United States, widespread screening is needed to link the infected to care and decrease the possible consequences of untreated infection, including liver cancer, cirrhosis and death. Screening is currently fraught with challenges in both the developed and developing world. New point-of-care tests may have advantages over standard-of-care tests in terms of cost-effectiveness and linkage to care. Stochastic modeling is applied here for relative utility assessment of point-of-care tests and standard-of-care tests for screening. Methods We analyzed effects of point-of-care versus standard-of-care testing using Markov models for disease progression in individual patients. Simulations of large cohorts with distinctly quantified models permitted the assessment of particular screening schemes. The validity of the trends observed is supported by sensitivity analyses for the simulation parameters. Results Increased utilization of point-of-care screening was shown to decrease hepatitis B-related mortalities and increase life expectancy at low projected expense. Conclusions The results suggest that standard-of-care screening should be substituted by point-of-care tests resulting in improved linkage to care and decrease in long-term complications.
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Affiliation(s)
- Martin A Sehr
- Department of Mechanical and Aerospace Engineering, University of California, San Diego, 9500 Gilman Drive, MS 0411, La Jolla, CA, 92093-0411, USA
| | - Kartik D Joshi
- Midwestern University, Arizona College of Osteopathic Medicine, 19555 North 59th Avenue, Glendale, AZ, 85308, USA
| | - John M Fontanesi
- Department of Medicine, Division of General Internal Medicine, University of California, San Diego, 200 W. Arbor Drive #8415, San Diego, CA, 92103, USA
| | - Robert J Wong
- Division of Gastroenterology and Hepatology, Alameda Health System - Highland Hospital, 1411 East 31st Street, Highland Care Pavilion - 5th Floor Endoscopy Unit, Oakland, CA, 94602, USA
| | - Robert R Bitmead
- Department of Mechanical and Aerospace Engineering, University of California, San Diego, 9500 Gilman Drive, MS 0411, La Jolla, CA, 92093-0411, USA
| | - Robert G Gish
- Department of Medicine, Division of Gastroenterology and Hepatology, Stanford University, Alway Building, Room M211, 300 Pasteur Drive, MC: 5187, Stanford, CA, 94305-5187, USA. .,National Viral Hepatitis Roundtable, 1612 K Street NW, Suite 1202, Washington, DC, 20006, USA. .,Hepatitis B Foundation, 3805 Old Easton Road, Doylestown, PA, USA.
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Schnelltest-Diagnostik sexuell übertragbarer Infektionen in niedrigschwelligen Einrichtungen. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2016; 60:245-254. [DOI: 10.1007/s00103-016-2496-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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20
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Lean and Agile Point-of-Care Diagnostic Services Quality Systems Management for Low- and Middle-Income Countries. ACTA ACUST UNITED AC 2016. [DOI: 10.1097/poc.0000000000000111] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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21
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Design of dual working electrodes for concentration process in metalloimmunoassay. Biomed Microdevices 2016; 18:86. [PMID: 27572238 DOI: 10.1007/s10544-016-0114-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Electrochemical immunosensing, particularly through a metalloimmunoassay, is a promising approach for development of point-of-care (POC) diagnostics devices. This study investigated the structure of dual working electrodes (W1 and W2), used in a silver nanoparticles-labeled sandwich-type immunoassay and silver concentration process, paying special attention to the position of W1 relative to W2. The new structures of the dual working electrodes were fabricated for efficient silver concentration and evaluated experimentally, which showed that the duration of prereduction before current measurement decreased from 480 s to 300 s by transforming the position of W1 from 1 line to 2 lines or 6 parts. The experimental results were also compared with numerical simulations based on three-dimensional diffusion, and the prereduction step almost followed the three-dimensional diffusion equation. Using numerical simulations, the ideal structures of dual working electrodes were designed based on relationships between the structures and duration of prereduction or the LOD. In the case of 36 lines at an area ratio of W1 to W1 + W2 of 1 to 10, the prereduction duration decreased to 96 s. The dual working electrodes designed in this study promise to shorten the total analysis time and lower the LOD for POC diagnostics.
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22
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Mueller A, Stoetter L, Kalluvya S, Stich A, Majinge C, Weissbrich B, Kasang C. Prevalence of hepatitis B virus infection among health care workers in a tertiary hospital in Tanzania. BMC Infect Dis 2015; 15:386. [PMID: 26399765 PMCID: PMC4581415 DOI: 10.1186/s12879-015-1129-z] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Accepted: 09/18/2015] [Indexed: 02/06/2023] Open
Abstract
Background Sub-Saharan Africa has a high prevalence of hepatitis B virus (HBV) infections. Health care workers (HCWs) are at high risk of contracting HBV infection through their occupation. Vaccination of HCWs against HBV is standard practice in many countries, but is often not implemented in resource-poor settings. We aimed with this cross-sectional study to determine HBV prevalence, HCW vaccination status, and the risk factors for HCWs contracting HBV infection in Tanzania. Methods We enrolled 600 HCWs from a tertiary Tanzanian hospital. Their demographics, medical histories, HBV vaccination details and risk factors for contracting blood-borne infections were collected using a standardized questionnaire. Serum samples were tested for HBV and hepatitis C virus (HCV) markers by ELISA techniques, PCR and an anti-HBs rapid test. HCWs were divided in two subgroups: those at risk of contracting HBV (rHCW 79.2 %) via exposure to potentially infectious materials, and those considered not at risk of contracting HBV (nrHCW, 20.8 %). Results The overall prevalence of chronic HBV infection (HBsAg+, anti-HBc+, anti-HBs-) was 7.0 % (42/598). Chronic HBV infection was found in 7.4 % of rHCW versus 5.6 % of nrHCW (p-value = 0.484). HCWs susceptible to HBV (HBsAg-, anti-HBc-, anti-HBs-) comprised 31.3 %. HBV immunity achieved either by healed HBV infection (HBsAg-, anti-HBc+, anti-HBs+) or by vaccination (HBsAg-, anti-HBc-, anti-HBs+) comprised 36.5 % and 20.2 %, respectively. 4.8 % of participants had indeterminate results (HBsAg-, anti-HBc+, anti-HBc-IgM-, anti-HBs-). Only 77.1 % of HCWs who received a full vaccination course had an anti-HBs titer >10 ml/U. An anti-HBs point-of-care test was 80.7 % sensitive and 96.9 % specific. There was a significantly higher risk for contracting HBV (anti-HBc+) among those HCW at occupational risk (rHCW) of older age (odds ratios (OR) in rHCW 3.297, p < 0.0001 vs. nrHCW 1.385, p = 0.606) and among those HCW being employed more than 11 years (OR 2.51, p < 0.0001***). HCV prevalence was low (HCV antibodies 1.2 % and HCV-RNA 0.3 %). Conclusions Chronic HBV infection is common among Tanzanian HCWs. One third of HCWs were susceptible to HBV infection, highlighting the need for vaccination. Due to high prevalence of naturally acquired immunity against HBV pre-testing might be a useful tool to identify susceptible individuals.
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Affiliation(s)
- A Mueller
- Department of Tropical Medicine, Medical Mission Hospital, Salvatorstrasse 7, 97074, Wuerzburg, Germany.
| | - L Stoetter
- Department of Tropical Medicine, Medical Mission Hospital, Salvatorstrasse 7, 97074, Wuerzburg, Germany.
| | - S Kalluvya
- Bugando Medical Centre, P.O. Box 1370, Mwanza, United Republic of Tanzania. .,CUHAS, P.O. Box 1370, Mwanza, United Republic of Tanzania.
| | - A Stich
- Department of Tropical Medicine, Medical Mission Hospital, Salvatorstrasse 7, 97074, Wuerzburg, Germany.
| | - C Majinge
- Bugando Medical Centre, P.O. Box 1370, Mwanza, United Republic of Tanzania.
| | - B Weissbrich
- Institute of Virology and Immunobiology, University of Wuerzburg, Versbacher Strasse 7, 97078, Wuerzburg, Germany.
| | - C Kasang
- Medical Mission Institute, Salvatorstrasse 7, 97067, Wuerzburg, Germany.
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Immunochromatographic assay for quantitative and sensitive detection of hepatitis B virus surface antigen using highly luminescent quantum dot-beads. Talanta 2015; 142:145-9. [DOI: 10.1016/j.talanta.2015.04.058] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Revised: 04/18/2015] [Accepted: 04/20/2015] [Indexed: 11/22/2022]
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24
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Ying R, Sharma M, Heffron R, Celum CL, Baeten JM, Katabira E, Bulya N, Barnabas RV. Cost-effectiveness of pre-exposure prophylaxis targeted to high-risk serodiscordant couples as a bridge to sustained ART use in Kampala, Uganda. J Int AIDS Soc 2015; 18:20013. [PMID: 26198348 PMCID: PMC4509901 DOI: 10.7448/ias.18.4.20013] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Revised: 03/24/2015] [Accepted: 04/15/2015] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Despite scale-up of antiretroviral therapy (ART) for treating HIV-positive persons, HIV incidence remains elevated among those at high risk such as persons in serodiscordant partnerships. Antiretrovirals taken by HIV-negative persons as pre-exposure prophylaxis (PrEP) has the potential to avert infections in individuals in serodiscordant partnerships. Evaluating the cost-effectiveness of implementing time-limited PrEP as a short-term bridge during the first six months of ART for the HIV-positive partner to prevent HIV transmission compared to increasing ART coverage is crucial to informing policy-makers considering PrEP implementation. METHODS To estimate the real world delivery costs of PrEP, we conducted micro-costing and time and motion analyses in an open-label prospective study of PrEP and ART delivery targeted to high-risk serodiscordant couples in Uganda (the Partners Demonstration Project). The cost (in USD, in 2012) of PrEP and ART for serodiscordant couples was assessed, with and without research components, in the study setting. Using Ministry of Health costs, the cost of PrEP and ART provision within a government programme was estimated, as was the cost of providing PrEP in addition to ART. We parameterized an HIV transmission model to estimate the health and economic impacts of 1) PrEP and ART targeted to high-risk serodiscordant couples in the context of current ART use and 2) increasing ART coverage to 55% of HIV-positive persons with CD4 ≤500 cells/µL without PrEP. The incremental cost-effectiveness ratios (ICERs) per HIV infection and disability-adjusted life year (DALY) averted were calculated over 10 years. RESULTS The annual cost of PrEP and ART delivery for serodiscordant couples was $1058 per couple in the study setting and $453 in the government setting. The portion of the programme cost due to PrEP was $408 and $92 per couple per year in the study and government settings, respectively. Over 10 years, a programme of PrEP and ART for high-risk serodiscordant couples was projected to avert 43% of HIV infections compared to current practice with an ICER of $1340 per infection averted. This was comparable to ART expansion alone, which would avert 37% of infections with an ICER of $1452. CONCLUSIONS Using Uganda's gross domestic product per capita of $1681 as a threshold, PrEP and ART for high-risk persons have the potential for synergistic action and are cost-effective in preventing HIV infections in high prevalence settings. The annual cost of PrEP in this programme is less than $100 per serodiscordant couple if implemented in public clinics.
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Affiliation(s)
- Roger Ying
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Monisha Sharma
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Renee Heffron
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Connie L Celum
- Department of Global Health, University of Washington, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Jared M Baeten
- Department of Global Health, University of Washington, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Elly Katabira
- Infectious Disease Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Nulu Bulya
- Infectious Disease Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Ruanne V Barnabas
- Department of Global Health, University of Washington, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Department of Medicine, University of Washington, Seattle, WA, USA
- Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA;
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Cáceres CF, Mayer KH, Baggaley R, O'Reilly KR. PrEP Implementation Science: State-of-the-Art and Research Agenda. J Int AIDS Soc 2015; 18:20527. [PMID: 26198351 PMCID: PMC4581083 DOI: 10.7448/ias.18.4.20527] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
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Arya SC, Agarwal N. Apropos 'A simple and inexpensive point-of-care test for hepatitis B surface antigen detection: serological and molecular evaluation' - a suggestion. J Viral Hepat 2014; 21:e143. [PMID: 25268595 DOI: 10.1111/jvh.12297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Affiliation(s)
- S C Arya
- Sant Parmanand Hospital, Delhi, India.
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