{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T18:33:13Z","timestamp":1793212393914,"version":"4.5.0"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:00:00Z","timestamp":1778544000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"ANRS-MIE","award":["0245"],"award-info":[{"award-number":["0245"]}]},{"DOI":"10.13039\/501100001691","name":"JSPS","doi-asserted-by":"publisher","award":["21K10416"],"award-info":[{"award-number":["21K10416"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"JSPS","doi-asserted-by":"publisher","award":["24K13442"],"award-info":[{"award-number":["24K13442"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Mother-to-child transmission (MTCT) remains a major source of chronic hepatitis B virus (HBV) infection globally. Identifying pregnant women eligible for antiviral prophylaxis requires HBV DNA testing, which is often inaccessible in resource-limited settings. The hepatitis B core-related antigen rapid diagnostic test (HBcrAg-RDT) may offer a point-of-care alternative, yet prospective evaluation in antenatal care is lacking. We assessed its diagnostic performance, clinical impact, and user acceptability within a MTCT triple elimination program.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this multicenter prospective cross-sectional study, treatment-naive, hepatitis B surface antigen (HBsAg)-positive pregnant women were enrolled across 4 antenatal services in The Gambia. HBcrAg-RDT diagnostic accuracy for detecting high viral load (\u2265200 000 IU\/mL) was evaluated using plasma and capillary whole blood samples, with GeneXpert HBV viral load as the reference standard.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 343 HBsAg-positive pregnant women, 5.5% had high viral load. The HBcrAg-RDT demonstrated sensitivities of 89.5% (95% CI 66.9\u201398.7) with plasma and 88.2% (63.6\u201398.5) with capillary blood, and specificities of 98.5% (96.4\u201399.5) and 98.7% (96.6\u201399.6), respectively. At 1 site implementing universal tenofovir prophylaxis, 77 women started treatment, of whom only 4 had HBV DNA \u2265 200 000 IU\/mL. An HBcrAg-RDT\u2013guided strategy would have identified all eligible women (4\/4) while reducing unnecessary treatment from 100% (73\/73) to 4.1% (3\/73). Users rated RDT ease-of-use highly, although incubation time modestly increased workload.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The HBcrAg-RDT accurately identified pregnant women requiring antiviral prophylaxis and was accepted by users. It represents a feasible, lower-cost alternative to HBV DNA testing and may reduce unnecessary tenofovir use compared with universal prophylaxis strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciag311","type":"journal-article","created":{"date-parts":[[2026,5,10]],"date-time":"2026-05-10T11:32:28Z","timestamp":1778412748000},"page":"564-571","source":"Crossref","is-referenced-by-count":0,"title":["Field Performance and Acceptability of the Hepatitis B Core-Related Antigen Rapid Diagnostic Test for Detecting High Viral Load Among Pregnant Women in The Gambia (PROTECT-B)"],"prefix":"10.1093","volume":"83","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-6840-016X","authenticated-orcid":false,"given":"Alexandra M","family":"Famiglietti","sequence":"first","affiliation":[{"name":"Institut Pasteur, Universit\u00e9 Paris Cit\u00e9, Unit\u00e9 d'\u00c9pid\u00e9miologie des Maladies \u00c9mergentes , Paris ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sainabou","family":"Drammeh","sequence":"additional","affiliation":[{"name":"Medical Research Council Unit, The Gambia at the London School of Hygiene and Tropical Medicine , Fajara ,","place":["The Gambia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8280-3426","authenticated-orcid":false,"given":"Erwan","family":"Vo-Quang","sequence":"additional","affiliation":[{"name":"Medical Research Council Unit, The Gambia at the London School of Hygiene and Tropical Medicine , Fajara ,","place":["The Gambia"]},{"name":"Viruses, Hepatology, Cancer Team, INSERM U955 , Cr\u00e9teil ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3966-2194","authenticated-orcid":false,"given":"Bakary","family":"Dibba","sequence":"additional","affiliation":[{"name":"Medical Research Council Unit, The Gambia at the 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