title: Performance of a new rapid test for the detection of hepatitis B surface antigen in various patient populations.
abstract: BACKGROUND
  Rapid diagnostic tests (RDT) have been developed for the detection of hepatitis B surface antigen (HBsAg). They represent a promising alternative to enzyme immunoassays and a powerful tool for large-scale screening and diagnosis of HBV infection, especially in regions without easy access to serological and molecular testing.
  
  
  OBJECTIVE
  The aims of the present study were to evaluate the characteristics and clinical performance of a new CE-marked HBsAg RDT, DRW-HBsAg v2.0 assay (Diagnostics for the Real World™, Ltd., USA), in various patient populations, including those chronically infected with HBV, patients with severe acute hepatitis of unknown origin and pregnant women with unknown HBV serological status at delivery.
  
  
  RESULTS
  The lower limit of detection of the assay, evaluated in 21 clinical samples, ranged from 0.30 ± 0.07 to 0.97 ± 0.26 international units/mL (using Abbott Architect as a reference), depending on the HBV genotype. The assay tested positive in 100% of patients with chronic hepatitis B, 96.3% of HBsAg-positive acute hepatitis patients, and 95.2% of HBsAg-positive pregnant women. Its specificity was 98.8% in HBsAg-negative patients, 98.7% in HBsAg-negative patients with acute hepatitis of unknown origin and 97.8% in HBsAg-negative pregnant women. Amino acid substitutions in the HBsAg major hydrophilic region did not affect HBsAg detection by DRW-HBsAg v2.0.
  
  
  CONCLUSIONS
  The new DRW-HBsAg v2.0 assay is a simple, rapid, easy-to-run and highly sensitive assay that can be used in both high- and low-risk populations for the diagnosis of HBsAg carriage. It appears to be a promising new tool for large-scale screening and diagnosis of HBV infection.
authors.affiliation: National Reference Center for Viral Hepatitis B, C and Delta, Department of Virology, Hôpital Henri Mondor, Université Paris-Est, Créteil, France; INSERM U955, Créteil, France. Electronic address: stephane.chevaliez@hmn.aphp.fr.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Chevaliez
authors.affiliation: National Reference Center for Viral Hepatitis B, C and Delta, Department of Virology, Hôpital Henri Mondor, Université Paris-Est, Créteil, France; INSERM U955, Créteil, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Challine
authors.affiliation: National Reference Center for Viral Hepatitis B, C and Delta, Department of Virology, Hôpital Henri Mondor, Université Paris-Est, Créteil, France.
authors.forename: Habiba
authors.initials: H
authors.lastname: Naija
authors.affiliation: Diagnostics for the Real World Ltd., Sunnyvale, CA, United States of America.
authors.forename: Tony C
authors.initials: TC
authors.lastname: Luu
authors.affiliation: National Reference Center for Viral Hepatitis B, C and Delta in Blood Transfusion, Institut National de la Transfusion Sanguine, Paris, France.
authors.forename: Syria
authors.initials: S
authors.lastname: Laperche
authors.affiliation: Diagnostics for the Real World Ltd., Sunnyvale, CA, United States of America.
authors.forename: Lourdes
authors.initials: L
authors.lastname: Nadala
authors.affiliation: Division of Transfusion Medicine, Department of Hematology, University of Cambridge, Cambridge, United Kingdom.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Allain
authors.affiliation: Diagnostics for the Real World Ltd., Sunnyvale, CA, United States of America; Diagnostics Development Unit, Department of Hematology, University of Cambridge, Cambridge, United Kingdom.
authors.forename: Helen H
authors.initials: HH
authors.lastname: Lee
authors.affiliation: National Reference Center for Viral Hepatitis B, C and Delta, Department of Virology, Hôpital Henri Mondor, Université Paris-Est, Créteil, France; INSERM U955, Créteil, France.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Pawlotsky
mesh_terms: D003955:Diagnostic Tests, Routine / Q000379:methods*; D005260:Female; D006509:Hepatitis B / Q000175:diagnosis*; D006514:Hepatitis B Surface Antigens / Q000097:blood*; D006801:Humans; D008297:Male; D010949:Plasma / Q000821:virology; D011247:Pregnancy; D012680:Sensitivity and Specificity; D044967:Serum / Q000821:virology; D014481:United States
chemical_list: D006514:Hepatitis B Surface Antigens
keywords: Diagnostic; HBsAg; Hepatitis B; Rapid diagnostic test