A finger-stick assay for determination of immunity to hepatitis A: a preliminary report

A simple and reproducible method for determining immunity to hepatitis A has been developed, using whole blood obtained by finger-stick and fixed on small discs. This method permits screening of large populations of candidates prior to active or passive immunization, avoiding the discomfort and difficulty of venipuncture, especially in children. The technique involves a finger-stick with a blood lancet, collection of 20 microliter whole blood on a paper disc which is then dried at room temperature. Perforated discs are incubated with phosphate buffered saline and the eluate is then tested for anti-HAV using the HAVAB assay. Results of anti-HAV assays from finger-stick samples obtained from adults and from children, showed 100% conformance with the homologous venous serum samples obtained at the same time. The lower threshold for detection of anti-HAV by this method is currently below 100 mIU/ml, as compared to 20 mIU/ml by the modified HAVAB method. In conclusion, we have developed a simple and reliable method for determination of immunity to HAV using whole blood obtained by finger-stick and fixed on paper discs. Samples can be collected under field trial conditions, without immediate need for laboratory facilities for separation and storage of serum samples. This sampling method, which is mainly intended for qualitative determination of anti-HAV in HAV immune subjects, especially under field trial conditions, is rapid, economical, efficient and acceptable to populations that are generally apprehensive of conventional venipuncture specimen collection methods.