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©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
Dried blood spot sampling as an alternative for the improvement of hepatitis B and C diagnosis in key populations
Geane Lopes Flores, Jakeline Ribeiro Barbosa, Helena Medina Cruz, Juliana Custódio Miguel, Denise Vigo Potsch, José Henrique Pilotto, Danielle Malta Lima, Jeová Keny Baima Colares, Carlos Eduardo Brandão-Mello, Marcia Maria Amendola Pires, Jurema Corrêa da Mota, Francisco I Bastos, Lia Laura Lewis-Ximenez, Livia Melo Villar
Geane Lopes Flores, Helena Medina Cruz, Juliana Custódio Miguel, Lia Laura Lewis-Ximenez, Livia Melo Villar, Viral Hepatitis Laboratory, FIOCRUZ, Rio de Janeiro 21040360, Brazil
Jakeline Ribeiro Barbosa, Jeová Keny Baima Colares, Postgraduate Program in Pathology, Federal University of Ceará, Fortaleza 60020181, Ceara, Brazil
Denise Vigo Potsch, Clementino Fraga Filho Hospital, Federal University of Rio de Janeiro, Rio de Janeiro 21040360, Brazil
José Henrique Pilotto, Nova Iguaçu General Hospital, Nova Iguaçu 26041061, Brazil
José Henrique Pilotto, Molecular Immunology Laboratory, Oswaldo Cruz Institute, Rio de Janeiro 21040360, Brazil
Danielle Malta Lima, Postgraduate Program in Medical Sciences, University of Fortaleza, Fortaleza 60811905, Ceará, Brazil
Carlos Eduardo Brandão-Mello, Marcia Maria Amendola Pires, Escola de Medicina e Cirurgia, Gaffrée & Guinle University Hospital, Federal University of Rio de Janeiro State, Rio de Janeiro 20270901, Brazil
Jurema Corrêa da Mota, Francisco I Bastos, Institute of Communication and Information on Science and Technology in Health, FIOCRUZ, Rio de Janeiro 21040360, Brazil
Author contributions: Villar LM conceived the study; Villar LM and Flores GL designed the research and the study protocol; Potsch DV, Pilotto JH, Lima DM, Baima Colares JK, Brandão-Mello CE, Pires MMA and Lewis-Ximenez LL carried out the participants’ selection and recruitment; Cruz HM, Barbosa JR, Miguel JC and Flores GL performed laboratory assays; da Mota JC and Bastos FI performed the statistical analysis; Flores GL, Villar LM, Mota JC and Bastos FI performed the analysis and interpretation of the data; Flores GL and Villar LM drafted the manuscript; Flores GL, Mota JC, Bastos FI and Villar LM critically revised the manuscript for intellectual content; All authors read and approved the final manuscript.
Supported by National Council for Scientific and Technological Development (CNPq); and Foundation for Research Support of the State of Rio de Janeiro (FAPERJ).
Institutional review board statement: The study was reviewed and approved by FIOCRUZ Ethics Committee, CAAE No. 34055514.9.3010.5258 and No. 1.001.477.
Informed consent statement: All study participants provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
http://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Livia Melo Villar, PhD, Research Scientist, Viral Hepatitis Laboratory, FIOCRUZ, Avenida Brasil, 4365, Rio de Janeiro 21040360, Brazil. liviafiocruz@gmail.com
Received: August 17, 2020
Peer-review started: August 17, 2020
First decision: October 21, 2020
Revised: November 24, 2020
Accepted: December 13, 2020
Article in press: December 13, 2020
Published online: April 27, 2021
ARTICLE HIGHLIGHTS
Research background
Diagnosis of hepatitis B virus and hepatitis C virus (HCV) can be difficult in chronic kidney disease (CKD) individuals undergoing hemodialysis, coagulopathy individuals and people living with human immunodeficiency virus (HIV) due to the difficulty of blood sample collection by venipuncture, remote location and lack of health care.
Research motivation
There is no information regarding the performance of electrochemiluminescence (ECLIA) for the detection of hepatitis B virus and HCV markers in dried blood spot (DBS) samples in key populations, such as individuals with coagulopathies, CKD patients and people living with HIV.
Research objectives
To investigate the putative influence of HIV infection as well as pathophysiological alterations in individuals with coagulopathies (hemophilia and von Willebrand disease) or CKD in the performance of optimized ECLIA for the detection of HBsAg, anti-HBc and anti-HCV markers in DBS samples.
Research methods
The ECLIA technique was used for the evaluation of HBsAg, anti-HBc, and anti-HCV tests in DBS samples of CKD individuals undergoing hemodialysis, coagulopathy individuals and people living with HIV.
Research results
HBsAg detection presented sensitivities of 100% among coagulopathy and CKD patients and low sensitivity (85.0%) in people living with HIV. Anti-HBc detection had the best performance in people living with HIV followed by coagulopathy and CKD patients. Anti-HCV detection showed sensitivities above 83.0% in all groups. Specificities of these assays varied from 88.9% to 100%. Estimated prevalence was similar among serum and DBS except for the anti-HBc marker.
Research conclusions
This study demonstrated the utility of HBsAg, anti-HBc and anti-HCV detection in DBS using ECLIA in high-risk populations.
Research perspectives
Automated assays such as ECLIA using DBS increases diagnostic speed, generating the diagnosis of many samples at once, which can be important during potential outbreaks in hemotherapy clinics.
