hepatitis b surface antigen detection using pooled sera: a cost-benefit analysis detección de hbsag usando mezcla de sueros: estudio coste-beneficio

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ID: 243774
2006
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Abstract
Objectives: to examine the feasibility and to perform a cost benefit analysis of a 5-sample pooling strategy using an enzyme immunoassay (EIA) for the screening of hepatitis B surface antigen (HBsAg). Material and methods: to assess the sensitivity and specificity of the pooling method, each of the 40 positive sera (from weak to intensely HBsAg-positive) and 250 negative sera were tested in a pool with 4 HBsAg-negative sera. The limit of detection for HBsAg/ad and HBsAg/ay was evaluated using sera from a panel of purified subtypes. A study under real conditions was conducted using pools from 340 pregnant women. Results: the sensitivity and specificity of this technique were 100%. The correlation coefficient among the sample/cutoff ratios of 40 samples studied in single and in pooled conditions was 0.792 (p < 0.005). The pooling method has lower levels of detection for HBsAg/ad and HBsAg/ay at 0.20 ng/mL and 0.12 ng/mL, and the single method at 0.34 ng/mL and 0.29 ng/mL, respectively. The pooling method loses no sensitivity for values up to 100 IU/L of anti-HBs in the four sera mixed with a positive serum. The cost-benefit analysis showed that the pooling method could save from 30% up to 75% of the cost of HBsAg determination, according to whether seroprevalences were 10% or 1%, respectively. Conclusions: the pooled HBsAg EIA yielded no worse than the single EIA test, and was a cost-effective and valid strategy in areas with a high, medium or low prevalence.
Objetivos: examinar la fiabilidad y realizar un estudio coste beneficio de una estrategia de mezcla de 5 muestras usando un enzimainmunoanálisis (EIA) para el cribado del HBsAg. Material y métodos: para evaluar la sensibilidad y especificidad del método de mezcla de sueros se determinaron 40 sueros HBsAg positivos (de débil a intensamente positivos) y 250 sueros HBsAg negativos en mezcla con 4 sueros HBsAg negativos. El límite de detección para el HBsAg/ad y HBsAg/ay se evaluó usando suero de un panel de subtipos purificados. Se llevó a cabo un estudio en condiciones reales usando mezcla de sueros de 314 mujeres gestantes. Resultados: la sensibilidad y especificidad de esta técnica fue del 100%. El coeficiente de correlación entre los ratios muestra / punto de corte de las 40 muestras estudiadas en determinación simple y en mezcla fue 0,792 (p < 0,005). El método de mezcla de sueros detectó niveles más bajos de HBsAg/ad y HBsAg/ay (0,20 ng/mL y 0,12 ng/mL) que el método simple (0,34 ng/mL y 0,29 ng/mL, respectivamente). Un análisis coste-beneficio mostró que el método de mezcla puede ahorrar de un 30 a un 75% de el coste de la determinación de HBsAg para seroprevalencias de un 10 y 1%, respectivamente. Conclusiones: el método de determinación de HBsAg en mezcla de sueros no muestra peor rendimiento diagnóstico que el método simple y es una estrategia coste efectiva válida en áreas de baja prevalencia.
Reference Key
fernndez2006revistahepatitis Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors E. Fernández, L. Rodrigo, S. García, S. Riestra, C. Blanco
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Journal chemistry of heterocyclic compounds
Year 2006
DOI
DOI not found
URL
http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082006000200006
Keywords
Gastroenterology

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