Sub-Saharan Africa has around 80 million people infected with hepatitis B, a liver infection caused by the hepatitis B virus, but it infects around 250 million people worldwide. It can be a mild illness lasting a few weeks or a serious, lifelong condition. It is transmitted through blood and bodily fluids.  

An accurate diagnostic score that consists of inexpensive blood tests costing around $20 could help diagnose thousands of patients with hepatitis B in need of treatment in some of Africa's poorest regions, far more affordable than the $100-500 for current tests.

Called TREAT-B, the score consists of two simple blood tests: one measuring presence of antigens, proteins produced by the virus, and another for enzymes produced by the liver in response, to accurately assess patients for treatment. It was found to accurately identify HBV positive patients who require treatment in 85% of cases (sensitivity), and could accurately identify those who do not need treatment in 77% of cases ( the specificity).  

It is also far more accessible than existing methods - such as liver biopsy or HBV DNA, a much more complicated blood sample analysis - which requires resources and laboratories that are not always accessible in sub-Saharan Africa.

The researchers used  clinical data from more than 800 hepatitis B patients in The Gambia who were part of the PROLIFICA (Prevention of Liver Fibrosis and Cancer in Africa) study. The tests were then validated with data from African patients in Senegal, Burkina Faso, Germany, France and the UK. The results are published in the Journal of Hepatology.

The scientists say that further research is needed but if the test is successful in larger studies it could be used widely to identify patients in need of hepatitis B treatment and refer thousands of people for life-saving treatment. The test could also be developed further to be implemented as a finger-prick test, similar to those used to detect HIV, to get quicker results.