Comparison of ICT and ELISA Techniques for the Detection of HBsAg in Apparently Healthy Individuals in North West General Hospital Peshawar Pakistan

Abstract

Background: Hepatitis B is mostly asymptomatic clinically and therefore it is considered as the most dangerous type of hepatitis among the 5 different types of hepatitis. Hepatitis B virus infection causes liver damage over many years without being diagnosed. It is one common risk of liver complications in Khyber Pakhtunkhwa (KP), Pakistan with an average prevalence rate of 2.70%.

Aim: we aimed to investigate the diagnostic efficacy of hepatitis B surface antigen (HBsAg) by Rapid Immunochromatography test (ICT) and by Enzyme linked Immunosorbent Assay (ELISA).

Methodology: A total of 2434 Out Patients Department (OPD) patients within age range 20-65 years (1451 (59.61%) males and 983 (40.38%) females) were screened for the hepatitis B virus infection using commercially available diagnostic kits at North West General Hospital, Peshawar, Khyber Pakhtunkhwa, Pakistan. Blood samples were collected in EDTA tubes from each subject after taking informed consent. Serum was separated by centrifuging the samples at 5000rpm for 5 minutes. Sample were initially screened for HBsAg by the rapid ICT device (Accurate, UK) using manufacturers standard protocol and later on by ELISA.

Results: Result indicated that 42 patients (1.72%) were positive for HBsAg by ICT including 31 (73.80%) males and 11 (26.19%) females. Follow up was done using 3rd generation ELISA technique. Blood samples of the patients declared positive by ICT were then tested by ELISA and it was found that 39 patients (1.60%) reacted positively including 29 (74.35%) males and 10 (25.64%) females.

Conclusion: Implementation of preventive and control strategies as well as proper evaluation and monitoring mechanism are urgently needed. ICT screening method gives false positive results and it should be confirmed by ELISA and PCR techniques.