This study aims to examine the diagnostic accuracy of dried blood spot (DBS) samples contrast to serum samples for detection of hepatitis B virus (HBV) and hepatitis C virus (HCV) sero-markers in large scale epidemiological study in the resource limited settings and then to determine the prevalence of each sero-marker from DBS samples collected during 2017 Cambodia nationwide study.
This study included 921 paired DBS and serum samples. HBsAg, HBsAg-HQ, anti-HBs, anti-HBc and anti-HCV were detected in all DBS/serum pairs but HBeAg and anti-HBe in 109 DBS/serum pairs using chemiluminescent enzyme immunoassay (CLEIA). Thereafter, the individual DBS's diagnostic accuracy was calculated. Additionally, the prevalence of each sero-marker was calculated in 4541 DBS samples from nationwide study in Cambodia.
The sensitivity of DBS for detection of HBsAg, HBsAg-HQ, HBeAg and antiHBe were high (≥90%) with 100% specificity. Anti-HBc and anti-HBs showed low sensitivity (70.73% and 69.25% respectively) than other sero-markers, but their diagnostic accuracies were 94.58% and 89.32%. Therefore, the overall prevalence of HBsAg, HBsAg-HQ, anti-HBc, anti-HBs and anti-HCV using DBS samples in Cambodia were 2.38%, 2.53%, 14.27%, 31.84% and 0.15%, respectively. HBeAg and anti-HBe positivity among HBsAg positives were 31.48% and 53.7%.
Our study indicates that DBS has high diagnostic accuracy for HBsAg, HBsAg-HQ, HBeAg and anti-HBe. Having the benefit of simple procedure, easy and compact transportation and storage, it is considered as an alternative to serum samples in examining the serological profiles of HBV infection through a large-scale epidemiological study in the resource limited settings.