Screening test accuracy among potential blood donors of HBsAg, anti-HBc and anti-HCV to detect hepatitis B and C virus infection in rural Cambodia and Vietnam.

The aim of this study was to determine the accuracy of rapid tests for HBsAg, anti-HBc and anti-HCV in rural Cambodia and Vietnam to detect hepatitis B and C. In a cross-sectional epidemiological study of two populations of 1,200 potential blood donors in rural Cambodia and Vietnam the prevalence rates of HBsAg, anti-HBc and anti-HCV as established by enzyme immunoassay (EIA) tests were compared to rapid test outcomes. The EIA reference test results were validated by Architect Chemiluminescent Microparticle Immunoassay (CMIA) technique. The actual rapid test demonstrated high specificity for all three test categories as claimed by the manufacturer. The test sensitivity observed was significantly lower than that claimed by the manufacturer: 86.5% for HBsAg, 86.6% for anti-HBc, and 76.4% for anti-HCV. There were large and significant variations in test performance between the two countries, especially for HBsAg detection. The low sensitivity of the actual rapid tests for HBsAg, anti-HBc and anti-HCV make them useless for blood donor screening in rural Southeast Asia. Rapid tests may be useful screening tools in blood transfusion services in low-resource settings, but tests should be carefully validated locally before being used for screening purposes since test performance varies by location.