Finger-Stick Test Could Transform Hepatitis B Care In Remote And Underserved Communities

According to World Health Organization estimates, around 254 million people were living with chronic hepatitis B infection in 2022. Yet only 14 percent had been diagnosed, and just 8 percent were receiving treatment. No country is currently on track to meet the WHO’s goal of eliminating hepatitis B as a public health threat by 2030.

Recognizing these gaps, recently WHO had issued guidelines recommending the use of point-of-care hepatitis B DNA finger-stick tests. Now, a new study published in the Journal of Clinical Microbiology has provided strong evidence to support this policy shift, showing that point-of-care testing for hepatitis B DNA is as accurate as the current laboratory-based standard, thus offering a faster and more accessible option for communities with limited health services.

The findings come from a clinical trial led by researchers at the Kirby Institute, a world-leading health research organization in Sydney. The trial demonstrated that hepatitis B DNA testing using a small finger-stick blood sample delivers results that closely match those obtained through conventional laboratory testing, which typically requires venous blood samples and centralized facilities.

“This is a very important finding,” said Professor Gail Matthews, who led the study. “The finger-stick point-of-care test is highly accurate and has the potential to expand access to testing and treatment globally, especially in resource-limited or remote settings where access to standard testing is poor.”

Hepatitis B is a viral infection that attacks the liver and can lead to serious long-term complications such as cirrhosis, liver failure, and liver cancer. It is responsible for more than one million deaths each year worldwide. While the disease is preventable through vaccination and treatable in people with chronic infection, millions remain undiagnosed and untreated.

Although high-income countries generally have robust vaccination programs and better access to care, the majority of people living with chronic hepatitis B are in low- and middle-income countries, where diagnostic services are often limited. Even in Australia, access to hepatitis B DNA testing remains challenging for people living in remote and regional areas.

“Not everyone with hepatitis B needs treatment,” explained Associate Professor Behzad Hajarizadeh, the study’s first author. “People with higher levels of the virus are more likely to benefit, and DNA testing is essential to determine viral load. It is also used to monitor whether treatment is working once it begins.”

At present, hepatitis B DNA testing requires blood samples to be sent to central laboratories, often located far from where patients live. This can mean long travel times, multiple clinic visits, and delays of days or even weeks before results are available—all of which can discourage patients from seeking or continuing care.

Point-of-care testing offers a practical alternative. Using a finger-stick blood sample, the test can be performed in small clinics by a wider range of healthcare workers and provides results within about 60 minutes. While this approach is already used successfully for several infectious diseases, including hepatitis C, its effectiveness for hepatitis B DNA testing had not previously been confirmed.

“Our research shows that finger-stick point-of-care testing for hepatitis B DNA is both accurate and effective,” said Associate Professor Tanya Applegate from the Kirby Institute. “This opens the door to integrating hepatitis B care into existing health services and reaching people regardless of where they live.”

“Access to testing is one of the biggest barriers to hepatitis B elimination,” said Associate Professor Thomas Tu from Hepatitis B Voices. “This research could help scale up testing, improve access to treatment, and ultimately save lives.”