title: Reliability of rapid testing for hepatitis B in a region of high HIV endemicity.
abstract: Hepatitis B (HBV) and HIV co-infection is common in resource-poor settings. A recent study from Malawi revealed poor correlation between hepatitis B surface antigen (HBsAg) point-of-care tests and reference tests in patients co-infected with HIV. We studied a cohort of 300 Malawian adults entering a treatment programme for HIV. Sera were tested for HBsAg first using the Determine rapid test and re-tested using a commercial enzyme immunoassay (EIA). All tests were done under optimal conditions in Liverpool, UK. Sera from all 25 patients positive for HBsAg using the rapid test and from 50 who were negative, were re-tested using the EIA, with complete concordance of results. The kappa correlation was 1, specificity 100% (93-100%) and sensitivity 100% (86-100%) compared to the reference test. Patients had advanced immune suppression (mean CD4=175 cells x 10(6)/l). In a non-field setting, the results of point-of-care Determine rapid hepatitis B tests appear reliable in patients with HIV-1 co-infection.
authors.affiliation: Tropical and Infectious Disease Unit, Royal Liverpool University Hospital, Liverpool L7 8XP, UK.
authors.forename: J
authors.initials: J
authors.lastname: Davies
authors.forename: J J G
authors.initials: JJ
authors.lastname: van Oosterhout
authors.forename: M
authors.initials: M
authors.lastname: Nyirenda
authors.forename: J
authors.initials: J
authors.lastname: Bowden
authors.forename: E
authors.initials: E
authors.lastname: Moore
authors.forename: I J
authors.initials: IJ
authors.lastname: Hart
authors.forename: E E
authors.initials: EE
authors.lastname: Zijlstra
authors.forename: M
authors.initials: M
authors.lastname: Chaponda
authors.forename: B
authors.initials: B
authors.lastname: Faragher
authors.forename: N J
authors.initials: NJ
authors.lastname: Beeching
authors.forename: M B J
authors.initials: MB
authors.lastname: Beadsworth
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006509:Hepatitis B / Q000175:diagnosis* / Q000276:immunology; D006514:Hepatitis B Surface Antigens / Q000097:blood*; D006515:Hepatitis B virus / Q000302:isolation & purification*; D006801:Humans; D008295:Malawi / Q000453:epidemiology; D008297:Male; D011933:Reagent Kits, Diagnostic; D012680:Sensitivity and Specificity; D012698:Serologic Tests / Q000379:methods; D014773:Virology / Q000379:methods
chemical_list: D006514:Hepatitis B Surface Antigens; D011933:Reagent Kits, Diagnostic