Gijs J van Halewijn1, Corine H Geurtsvankessel2, Janienne Klaasse2, Gertine W van Oord3, Robert J de Knegt3, Margo J van Campenhout3, André Boonstra3, Annemiek A van der Eijk4. 1. Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center Rotterdam, the Netherlands; Department of Viroscience, Erasmus MC, University Medical Center Rotterdam, the Netherlands. 2. Department of Viroscience, Erasmus MC, University Medical Center Rotterdam, the Netherlands. 3. Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center Rotterdam, the Netherlands. 4. Department of Viroscience, Erasmus MC, University Medical Center Rotterdam, the Netherlands. Electronic address: a.vandereijk@erasmusmc.nl.
Abstract
BACKGROUND: Novel serological markers for Hepatitis B virus (HBV) infection are needed for prognosis and guidance of therapy. OBJECTIVE: We evaluated the diagnostic performance of the Fujirebio Lumipulse G HBcrAg immunoassay on the Fujirebio LUMIPULSE G1200 analyzer. STUDY DESIGN: Analytical performance was examined using three HBeAg positive HBV samples. Diagnostic specificity was assessed using subpanels of 54 confirmed acute HAV, HCV, HEV, B19, CMV and EBV infections. Diagnostic sensitivity was investigated in well-defined HBV positive patient groups, both treated and untreated, including immunocompromised patients. RESULTS: The Lumipulse G HBcrAg immunoassay provided a linear measurement at a dilution between 1:100 and1:10,000. Six out of 54 samples showed non-specific reactivity in sera from acute CMV, EBV and HEV infections, of which 2 of them >3 log U/ml. The highest levels of HBcrAg were measured in HBeAg positive patients, in both treated and untreated as well as in immunocompromised patients. Untreated patients had relatively low serum HBcrAg levels in the inactive carrier phase, which increased upon progression into the HBeAg-negative hepatitis phase. Also, we showed that the applicability of HBcrAg to distinguish between patients with resolved HBV infection and false-positive reactivity to solitary anti-HBc is limited. CONCLUSIONS: Our study demonstrated significant differences in HBcrAg levels depending on HBeAg status, the clinical phase, as well as the treatment status. Specificity of the assay is good; only 2 out of 54 samples showed reactivity above 3 log U/ml. Before implementing the assay in clinical practice, additional research in larger patient cohorts should be carried out.
BACKGROUND: Novel serological markers for Hepatitis B virus (HBV) infection are needed for prognosis and guidance of therapy. OBJECTIVE: We evaluated the diagnostic performance of the Fujirebio Lumipulse G HBcrAg immunoassay on the Fujirebio LUMIPULSE G1200 analyzer. STUDY DESIGN: Analytical performance was examined using three HBeAg positive HBV samples. Diagnostic specificity was assessed using subpanels of 54 confirmed acute HAV, HCV, HEV, B19, CMV and EBV infections. Diagnostic sensitivity was investigated in well-defined HBV positive patient groups, both treated and untreated, including immunocompromised patients. RESULTS: The Lumipulse G HBcrAg immunoassay provided a linear measurement at a dilution between 1:100 and1:10,000. Six out of 54 samples showed non-specific reactivity in sera from acute CMV, EBV and HEV infections, of which 2 of them >3 log U/ml. The highest levels of HBcrAg were measured in HBeAg positive patients, in both treated and untreated as well as in immunocompromised patients. Untreated patients had relatively low serum HBcrAg levels in the inactive carrier phase, which increased upon progression into the HBeAg-negative hepatitis phase. Also, we showed that the applicability of HBcrAg to distinguish between patients with resolved HBV infection and false-positive reactivity to solitary anti-HBc is limited. CONCLUSIONS: Our study demonstrated significant differences in HBcrAg levels depending on HBeAg status, the clinical phase, as well as the treatment status. Specificity of the assay is good; only 2 out of 54 samples showed reactivity above 3 log U/ml. Before implementing the assay in clinical practice, additional research in larger patient cohorts should be carried out.
Authors: Ronald E Engle; Davide De Battista; Emily J Danoff; Hanh Nguyen; Zhaochun Chen; Paolo Lusso; Robert H Purcell; Patrizia Farci Journal: mBio Date: 2020-11-17 Impact factor: 7.867