HBs Ag
HBs Ag
HBs Ag
Rx ONLY
Intended Use
For in vitro diagnostic use only.
Reaction Sample
Test Type System * Incubation Time Time to first result Test Temperature Volume
ECi/ECiQ, 3600,
Immunometric 29 minutes 37 minutes 37 °C 80 μL
5600, XT 7600
* Not all products and systems are available in all countries.
Reaction Scheme
WARNING
Reagents
Reagent Pack Contents
1 reagent pack containing:
• 100 coated wells (mouse monoclonal anti-HBs, coated at 1 µg/well)
• 6.2 mL conjugate reagent (HRP-mouse monoclonal anti-HBs, 0.9 μg/mL) in buffer with bovine serum albumin, goat
serum and antimicrobial agent
• 8.4 mL assay reagent with human serum, calf serum, mouse serum and antimicrobial agent
Calibrator Contents
• VITROS HBsAg Calibrator (human HBsAg ad subtype, inactivated 2 mL; 0.70±0.30 PEI Units* /mL) in buffer with bovine
serum albumin and antimicrobial agent
• Lot calibration card
• Protocol card
• 8 calibrator bar code labels
* Paul-Ehrlich-Institute HBsAg reference serum
Calibrator Handling
• Use only with reagent packs of the same lot number. Mix thoroughly by inversion and bring to 15–30 °C (59–86 °F)
before use. Each pack contains sufficient for a minimum of 6 determinations of each calibrator.
• Handle calibrators in stoppered containers to avoid contamination and evaporation. To avoid evaporation, limit the
amount of time calibrators are on the system. Refer to the operating instructions for your system. Return to 2–8 °C (36–
46 °F) as soon as possible after use, or load only sufficient for a single determination.
Specimens Recommended
• Serum
• EDTA plasma
• Heparin plasma
• Citrate plasma
Note: Results from citrate plasma samples will be proportionally lower due to dilution
by the liquid anticoagulant.
Special Precautions
IMPORTANT: Certain collection devices have been reported to affect other analytes and tests. 6
Owing to the variety of specimen collection devices available, Ortho Clinical
Diagnostics is unable to provide a definitive statement on the performance of its
products with these devices. Confirm that your collection devices are compatible
with this test.
Testing Procedure
Materials Provided
• VITROS Immunodiagnostic Products HBsAg Reagent Pack
• VITROS Immunodiagnostic Products HBsAg Calibrator
Operating Instructions
Check the inventory regularly to aid the management of reagents and ensure that sufficient VITROS Signal Reagent,
VITROS Universal Wash Reagent and calibrated reagent lots are available for the work planned. When performing panels
of tests on a single sample, ensure that the sample volume is sufficient for the tests ordered.
For detailed information refer to the operating instructions for your system.
Note: Do not use visibly damaged product.
Calibration
Calibration Procedure
• Calibration is lot specific; reagent packs and calibrators are linked by lot number. Reagent packs from the same lot may
use the same calibration.
• A Master Calibration is established for each new reagent lot by performing multiple tests. This is the process by which a
lot-specific parameter [a] which links the signal at the cutoff (cutoff value) to the calibrator signal is determined.
Cutoff value = (a x Signal of Cal 1)
• Ensure that the Master Calibration for each new reagent lot is available on your system.
• Process the calibrator in the same manner as samples. Load sufficient for the automatic duplicate determination.
Calibration need not be programmed if bar code labels are used; Calibration will be initiated automatically.
• When the calibrator is processed the validity of the calibration is assessed against quality parameters which compares
the actual signal of the calibrator with the expected signal. If the calibration is acceptable the cutoff value is calculated
and stored for use with any reagent pack of that lot.
• The quality of calibration cannot be completely described by a single parameter. The calibration report should be used in
conjunction with acceptable control values to determine the validity of the calibration.
• Recalibration is required after a pre-determined calibration interval, or when a different reagent lot is loaded.
• Calibration results are assessed against a quality parameter. Failure to meet the defined quality parameter range will be
coded in the calibration report. For actions to be taken following a failed calibration, refer to the operating instructions for
your system.
Refer to the operating instructions for your system for detailed instructions on the calibration process.
When to Calibrate
• Calibrate when the reagent pack and calibrator lot changes.
• Calibrate every 28 days.
• After specified service procedures have been performed.
• If quality control results are consistently outside of your acceptable range.
For additional information on when to calibrate, refer to the operating instructions for your system.
Traceability of Calibration
The calibration of the VITROS HBsAg test is traceable to an in-house reference calibrator which has been value-assigned
to optimize the clinical sensitivity and specificity performance.
Calibration Model
Results are calculated as a normalized signal, relative to a cutoff value. During the calibration process a lot-specific
parameter is used to determine a valid stored cutoff value for the VITROS Immunodiagnostic and VITROS Integrated
Systems.
Quality Control
Quality Control Material Selection
VITROS HBsAg Controls are recommended for use with the VITROS Immunodiagnostic and VITROS Integrated Systems.
There are 2 VITROS HBsAg Controls (a negative control and a HBsAg positive control). The performance of other
commercial control fluids should be evaluated for compatibility with this test before they are used for quality control.
Control materials may show a difference when compared with other HBsAg methods if they contain high concentrations of
preservatives, stabilizers, or other nonphysiological additives, or otherwise depart from a true human sample matrix.
Appropriate quality control value ranges must be established for all quality control materials used with the VITROS HBsAg
test.
Results
Results are automatically calculated by the VITROS Immunodiagnostic and VITROS Integrated Systems.
Result Calculation
Results are calculated as a normalized signal, relative to the cutoff value. During the calibration process a lot-specific
parameter is used to determine a valid stored cutoff value for the VITROS Immunodiagnostic and VITROS Integrated
Systems.
A result of ≥1.00 indicates a reactive sample and the possible presence of HBsAg.
A result of <0.90 indicates a non-reactive sample, negative for HBsAg.
A result of ≥0.90 and <1.00 indicates a borderline sample.
Interpretation of Results
A sample found borderline or reactive in the VITROS HBsAg test should be retested in duplicate to verify its status. Before
retesting, the sample should be centrifuged to ensure freedom from cells, cellular debris or fibrin. If results on repeat testing
are <0.90 for both replicates, the sample should be considered negative. If either duplicate retest result is ≥0.90, the
sample should be tested by supplemental tests to confirm the result. A repeatedly reactive sample confirmed by
supplemental tests should be considered positive for HBsAg. In the case of repeatedly borderline results, analysis of follow
up samples is recommended.
Expected Values
In a random blood donor population the number of samples found to be repeatedly reactive for HBsAg by the VITROS
HBsAg test was <0.1%. In a population of samples positive for HBsAg, 100% (400/400) were found to be reactive in the
VITROS HBsAg test.
Other Limitations
• The results from this or any other diagnostic test should be used and interpreted only in the context of the overall clinical
picture.
• HBsAg results should only be used and interpreted in the context of the overall clinical picture. A negative test result
does not exclude the possibility of exposure to or infection with hepatitis B virus. Levels of HBsAg may be undetectable
both in early infection and late after infection. In rare cases HBsAg tests do not detect certain HBV mutant strains. 11
• Heterophilic antibodies in serum or plasma samples may cause interference in immunoassays. 12 These antibodies may
be present in blood samples from individuals regularly exposed to animals or who have been treated with animal serum
products. Results which are inconsistent with clinical observations indicate the need for additional testing.
• Do not use quality control materials preserved with azide.
Performance Characteristics
Sensitivity
Sensitivity was determined by testing serial dilutions of the WHO 2nd International Standard (NIBSC code 00/588) with 2
determinations using six reagent lots. The overall sensitivity of the VITROS HBsAg assay for the 2nd International Standard
was <0.10 IU/mL. A linear regression of the mean VITROS HBsAg result versus the calculated concentration of each
dilution was used to determine the HBsAg concentration at the cut-off. The mean value for the amount of HBsAg present at
the cut-off, determined as described above, was 0.080 IU/mL. The detection limit of the VITROS HBsAg test with the
Agence du Médicament SFTS 1996 Sensitivity Panel was <0.16 ng HBsAg/mL at the cutoff.
25 positive fresh serum and plasma samples, (≤1 day after sampling), were tested in direct comparison with a commercially
available CE-marked test. Both tests gave comparable results.
Specificity
Samples from 4013 presumed healthy blood donors, and 400 clinical samples were tested in the VITROS HBsAg test and
another commercially available test with the same intended use.
Samples Number of test samples Initially Reactive Repeatedly Reactive Confirmed Positive
Donor 4013 2 2 1
Clinical 400 0 0 0
The specificity for the VITROS HBsAg test for the donor samples was calculated as 99.98% (1/4012) based on repeat
reactives.
Precision
VITROS ECi/ECiQ Immunodiagnostic System
Precision was evaluated consistent with NCCLS document EP5. 13 2 replicates each of 4 freeze-dried control sera were
tested on 1 occasion per day on at least 20 different days. The experiment was performed using 2 reagent lots on 2
different systems. The data presented are a representation of the product performance.
VITROS 3600 Immunodiagnostic System and VITROS 5600 Integrated System
Precision was evaluated consistent with NCCLS document EP5. 14 2 replicates each of 2 freeze-dried control samples and
4 patient sample pools were tested on 2 separate occasions per day on at least 20 different days. The experiment was
performed using 1 reagent lot on each system. The data presented are a representation of the product performance.
Compound Concentration
Bilirubin 0.342 mmol/L 20 mg/dL
Hemoglobin 0.310 mmol/L 500 mg/dL
Triolein 33.9 mmol/L 3000 mg/dL
References
1. Maynard JE et al. In Zuckermann AJ (ed), Viral Hepatitis and Liver Disease. Alan R Liss Inc: 967‑969 (1988) Control of
hepatitis B by Immunisation: Global Perspectives.
2. Beasley RP & Hwang L. In Vyas GN (ed), Viral Hepatitis and Liver Disease. Grune & Stratton, New York: 209‑224
(1984) Epidemiology of hepatocellular carcinoma.
3. Summers M et al. Clin Chem 41. S73 (1995) Luminogenic Reagent Using 3-Chloro 4-Hydroxy Acetanilide to Enhance
Peroxidase/Luminol Chemiluminscence.
4. CLSI. Protection of Laboratory Workers from Occupationally Acquired Infections; Approved Guideline - Fourth Edition.
CLSI document M29-A4. Wayne, PA: Clinical and Laboratory Standards Institute; 2014.
5. Regulation (EC) No 1272/2008 of the European Parliament and of the Council of 16 December 2008 on classification,
labelling and packaging of substances and mixtures, amending and repealing Directives 67/548/EEC and 1999/45/EC,
and amending Regulation (EC) No 1907/2006.
6. Calam RR. Specimen Processing Separator Gels: An Update. J Clin Immunoassay. 11:86–90; 1988.
7. CLSI. Collection of Diagnostic Venous Blood Specimens. 7th ed.CLSI standard GP41. Wayne, PA: Clinical and
Laboratory Standards Institute; 2017.
8. NCCLS. Procedures and Devices for the Collection of Diagnostic Capillary Blood Specimens; Approved Standard –
Fifth Edition. NCCLS document H4-A5 [ISBN 1-56238-538-0]. CLSI, 940 West Valley Road, Suite 1400, Wayne, PA
19087-1898 USA, 2004.
9. CLSI. Statistical Quality Control for Quantitative Measurements: Principles and Definitions; Approved Guideline - Third
Edition. CLSI document C24‑A3 [ISBN 1-56238-613-1]. CLSI, 940 West Valley Road, Suite 1400, Wayne, PA
19087-1898 USA, 2006.
10. NCCLS. Interference Testing in Clinical Chemistry; Proposed Guideline. NCCLS document EP7-P (ISBN
1-56238-020-6). CLSI, 940 West Valley Road, Suite 1400, Wayne, Pennsylvania 19087, 1986.
11. Carmen WF. Journal of Viral hepatitis, 1997; 4 (Suppl.1): 11‑20. The clinical significance of surface antigen variants of
hepatitis B virus.
12. Levinson SS. J Clin Immunoassay 15: 108‑115 (1992) The Nature of Heterophilic Antibodies and Their Role in
Immunoassay Interference.
13. National Committee for Clinical Laboratory Standards. Order Code EP5-T2. (1992) Evaluation of Precision
Performance of Clinical Chemistry Devices - Second Edition.
14. NCCLS. Evaluation of Precision Performance of Quantitative Measurement Methods; Approved Guideline - Second
Edition. NCCLS document EP5‑A2 [ISBN 1-56238-542-9]. CLSI, 940 West Valley Road, Suite 1400, Wayne, PA
19087-1898 USA, 2004.
Glossary of Symbols
Revision History
Date of Revision Version Description of Technical Changes*
2019-09-06 9.1 • Glossary of Symbols: updated
• Added EC Representative address
2017-09-25 9.0 • Added information for the VITROS XT 7600 Integrated System
• Minor formatting and wording updates
• References: updated
• Glossary of Symbols: updated
* The change bars indicate the position of a technical amendment to the text with respect to the previous version of the document.
When this Instructions For Use is replaced, sign and date below and retain as specified by local regulations or laboratory
policies, as appropriate.
Conditions of supply: all supplies are made subject to the standard terms and conditions of Ortho Clinical
Diagnostics or its distributors. Copies of these are available on request.
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