Combined use of dried blood spot and rapid molecular systems: A robust solution to monitor hepatitis B virus infection with potential for resource-limited countries

Chronic hepatitis B (CHB) particularly affects resource-limited countries. CHB management in these areas faces many obstacles for optimal care of patients, including poor access to HBV-DNA quantification, a key marker. This study aims to evaluate the quantification of HBV-DNA on dried blood spots (DBS) using rapid, standardized and fully automated on-demand systems. After a simple and rapid DBS elution protocol, HBV-DNA was simply and accurately quantified on this matrix using two different systems. Limit of quantification was estimated at 400 IU/mL. DBS and plasma HBV-DNA quantification provided comparable results. HBV-DNA stability for up to one month was demonstrated on DBS stored at room temperature, a condition compatible for preservation or transport before analysis. The combined use of DBS and commercially available automated molecular on-demand systems for HBV-DNA quantification could represent a reliable alternative in resource-limited countries to reach remote populations. The good sensitivity of this approach makes it attractive for mother-to-child transmission prevention, treatment decision and follow-up. Costs can be limited if such systems are also validated for other molecular markers.