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P1482 Risk factors for systemic emboli in infective endocarditis
S414 P1479 Propionibacterium acnes endocarditis A.L. Gray, M.R. Sohail, L.M. Baddour, A. Virk (Rochester, US; Al Ain, AE) Objectives: Propionibacterium acnes is a rare cause of bacterial endocarditis. When identified in blood cultures, it is usually considered a skin contaminant. The purpose of this study is to describe the clinical presentation, management and outcome of the patients with P. acnes endocarditis based on our institutional experience and review of the published medical literature. Methods: We retrospectively reviewed all cases of P. acnes endocarditis identified at Mayo Clinic Rochester and searched the English language medical literature for all previously published reports. Results: We identified 34 cases in the medical literature and 5 cases from our institutional database (clinical details were available in only 27of these cases). Mean age of the patients was 53 years (range15−78) and 89% were males. Most of the cases (90%) presented with non-specific symptoms including fever, malaise and weakness while 3 patients had severe valvular insufficiency and 2 presented with embolic strokes. Blood cultures were positive in 81% (22/27) of the cases. All 5 cases with negative blood cultures were confirmed by positive valve tissue cultures. In 85% of the cases (29/34), the infection was in associated with presence of a foreign body (25 patients with prosthetic valves (PV), 1 left ventricular Teflon patch, 1 Carpentier mitral valve ring, and 2 involved pacemaker leads). Prosthetic valve infection was complicated by abscess formation in 50% of the cases and 17% demonstrated valve dehiscence on echocardiogram. Infection of the Carpentier mitral ring resulted in detachment of the ring in one case. Only 4 cases had native valve endocarditis with P. acnes. Majority of the patients (85%) required surgery; either valve replacement or removal of the pacemaker apparatus. Eleven percent (3/27) cases died secondary to the infection. In two of these, death was described as being secondary to splenic rupture and valve dehiscence. Penicillin resistant isolated was recovered in only one case. Median duration of post-operative antibiotics was 6 weeks (mean 7.1 weeks). Patients were typically treated with a penicillin derivative alone or in combination with gentamicin. Conclusions: P. acnes endocarditis should be considered when this organism is isolated from multiple blood cultures especially in the presence of a foreign cardiovascular device. Morbidity is high, and aggressive medical and surgical interventions are required to achieve cure. P1480 Persistent bacteraemic infective endocarditis L. Findova, A. Demitrovicova, V. Krcmery, P. Kisac, P. Marks (Trnava, Bratislava, SK; London, UK) Objectives: Persistent bacteraemic infective endocarditis (PBIE) is defined as persistence of positive blood cultures for 3 or more days despite antibiotic therapy. The reason for persistence of bacteraemia is deficient or inappropriate selection of antimicrobials, resistant organism, foreign body or prosthetic endocarditis. Objective of the study was to analyse persistent IE. Methods: Within 606 cases of IE in last 23 years in Slovakia, 85 (14%) fulfilled the definition and had positive blood cultures for 3 or more days (3 to 7 positive blood cultures). We compared these 85 cases of PBIE to 606 cases of all IE from the database of the national survey. Results: Several risk factors were observed more frequently among persistent IE: elderly age (60% vs. 33%, p < 0.045), diabetes mellitus (26.9% vs. 11.4%, p < 0.03), prior cardiosurgery (20% vs. 9.9%), prior surgery (19.4% vs. 42.7%), p for both is 0.04, right side IE (17.6% vs 11.4%, p < 0.01) and prosthetic valve (32.9% vs 2.4%, p < 0.001). Also aetiology was different in persistent IE in comparison to all IE. Viridans streptococci (37.5% vs. 15.2%, p < 0.01), coagulase-negative staphylococci (51.8% vs. 21.9%, p < 0.02) and enterococci (23.5% vs. 7.6%, p < 0.01) were observed more frequently among persistent IE and vice versa, embolisation (7.1% vs. 35.5%, p < 0.01), rheumatic fever (9% vs 22.3%, p < 0.05) were less frequent. However, mortality and
17th ECCMID / 25th ICC, Posters type of intervention (surgery, antimicrobials only) were similar in both groups. This surprising finding is difficult to explain because persistent bacteraemia in IE should be logically related with increased death rate. Conclusion: Diabetics or elderly patients after prior surgery as well as those with prosthetic or right side endocarditis may suffer from PBIE with multiple positive blood cultures. However, risk of embolisation as well as mortality rate were surprisingly lower. P1481 10-year epidemiology of operated endocarditis patients at a tertiary university hospital in Germany – a preliminary analysis F. Zauner, T. Gl¨uck, B. Salzberger, B. Ehrenstein, D. Birnbaum, H.J. Linde, F.X. Audebert (Regensburg, DE) Objectives: To describe retrospectively the epidemiology and clinical presentation among patients receiving heart valve surgery for endocarditis at the Regensburg University Medical Center and to compare these data with other national and international cohort studies. To correlate pathogen types with anatomic location and histopathologic damage patterns of affected heart valves. Methods: 211 intraoperatively confirmed endocarditis episodes of 205 patients were reviewed from September 1994 to February 2005. Data was obtained from surgical records, microbiology results, histopathology reports, in-house charts, and medical charts of admitting hospitals. Results: Altogether 252 valves were replaced or reconstructed. The median age at the time of operation was 61 years with female patients accounting for 25% of all patients. Heart valves were affected as follows: aortic valve (49.3%), mitral valve (28%), aortic and mitral valve (17.5%), and valves of the right heart (5.2%). Mechanical valves were inserted in 58%, biological valves in 19% of the episodes. Valve reconstruction without replacement was performed in 13% and any kind of combined multiple valve operation was done in 9% of the operations. Postoperative diagnoses were classified into florid natural valve endocarditis (NVE; 58%), florid prosthetic valve endocarditis (PVE; 12%), status after NVE (26%), and status after PVE (4%). As predisposing factor, diabetes mellitus was elicitable in 24% of all patients. Causative organisms could be delineated in 70% of the episodes. Streptococcus viridans spp. accounted for 30.8%, Staphylococcus aureus for 28.7%, Enterococcus spp. for 14.7%, Staphylococcus epidermidis for 9.8%, infections with any two pathogens at a time for 5.6%, Streptococcus spp. for 3.5% and other species for the remaining 7% of episodes with delineation of a causative organism. Among the episodes with confirmed Staphylococcus aureus, the aortic or mitral valves were approximately equally affected. In-hospital mortality after cardiac surgery was 10.4% from the day of surgery and the following 14 days. After 30 days, the mortality rate slightly increased by 3.3% and accounted for 13.7%. Conclusions: The distribution of affected valves and the 30-days mortality rate in our cohort is consistent with results from current international studies. The spectrum of causative organsims represents spectra observed in similar studies, although Staph. aureus was delineated at a lower rate. P1482 Risk factors for systemic emboli in infective endocarditis N. Esmailpour, M. Rasoolinejad, A. Ghoochani (Tehran, IR) Objectives: As one of the complications of infective endocarditis, embolisation has a great impact on prognosis. This study was undertaken to analyse the risk factors for systemic emboli in infective endocarditis. Methods: A retrospective study was conducted during 2001–2004 in two teaching hospitals in Iran, included patients with infective endocarditis as defined by Duke Criteria. Demographic, clinical, echocardiographic and microbiological data were entered in data base, and the relationship between emboli and these variables was reviewed. Results: We studied 76 cases (80.5% male, 19.7% female) with infective endocarditis according to Duke Criteria. Mean age of patients was 37.42 years. In 27.6% mitral valve was induced. The most common organism was Staph. aureus (14.5%). Systemic embolus was seen in
Hepatitis B virus 32.9% of patients. Most emboli (15.8%) affected the central nervous system. Mortality in patients with emboli was higher than cases without emboli (36% vs. 12.8% respectively, P = 0.03). The risk of emboli was 80% when the vegetation measured larger than 10 mm and only 15% when vegetation size was smaller than 10 mm (P < 0.05). There was no relationship between age, gender, kind of induced valve, site of vegetation, kind of pathogen and duration of symptoms and embolus formation. Conclusion: Mortality was higher in infective endocarditis patients with emboli. According to this study, vegetation size (larger than 10 mm) was the only factor that was associated with an increased risk of embolic episodes. P1483 Permanent pacemaker and implantable cardioverterdefibrillator-related infective endocarditis M. Sohail, D. Uslan, A. Khan, P. Friedman, D. Hayes, W. Wilson, J. Steckelberg, S. Stoner, L. Baddour (Al Ain, AE; Rochester, Atlanta, US) Objectives: Endocarditis is an uncommon but serious complication of permanent pacemaker (PPM) and implantable cardioverter-defibrillator (ICD) implantation. Purpose of this study is to describe the management and outcome of patients with PPM/ICD-related endocarditis. Methods: Retrospective review of all cases of PPM/ICD infection presenting to Mayo Clinic Rochester between 1991 and 2003. Devicerelated endocarditis was defined using modified Duke’s criteria. Results: We identified 189 PPM/ICD infections during study period. Forty-four (23%) of these met the case-definition for device-related endocarditis (33 PPM, 11 ICD). Mean age of patients was 68 years. (77% were males). Mean duration from device implantation to infection was 739 (median 419) days. Coagulase-negative staphylococci (18, 41%) and Staphylococcus aureus (18, 41%) were the most commonly isolated organisms. Blood cultures were positive in 77% of cases. Twenty-six (59%) patients had lead vegetations, 6 (14%) had valvular vegetations and 12 (27%) had both lead and valvular vegetations (tricuspid valve 11, pulmonic valve 1, mitral valve 3, aortic valve 5). The mean diameter of vegetations was 16 mm (median 11 mm). Forty-three (98%) patients were treated with a combined approach of hardware removal and parenteral antibiotics. Mean duration of systemic antibiotics after device explantation was 45 days (median, 28 days). Electrode leads were percutaneously removed in 34 (77%) cases using manual traction (7), locking stylet (13) or laser sheath (16); 7 (16%) cases underwent surgical lead extraction. Fifteen patients had lead diameter 10 mm and percutaneous lead extraction was complicated by pulmonary embolism in 5 cases as demonstrated per radiographic procedures. However, none of these patients were clinically symptomatic. Mean time from removal of an infected device to placement of new system was 14.7 days (median, 9.5 days). A replacement device was not necessary in 17 (39%) cases. Follow-up data were available for 33 (75%) cases (mean duration, 75 weeks); 27 (82%) of them were cured with device removal and antibiotics. Six (14%) patients died during index hospitalisation (4 sepsis, 1 nosocomial pneumonia, 1 tricuspid valve rupture). Conclusions: Device-related endocarditis is associated with severe morbidity and mortality. Electrode leads can be removed percutaneouly even in cases with large sized (10 mm) lead vegetations without increasing the risk of symptomatic pulmonary embolism. P1484 Diagnosis difficulties of infective endocarditis in children, adolescents and young adults without cardiac predisposing factors – results of a case series A. Radulescu, A. Slavcovici, M. Flonta, D. Tatulescu, V. Zanc (Cluj-Napoca, RO) Objectives: To evaluate infective endocarditis (IE) in previously healthy children, adolescents and young adults within a retrospective case study in a tertiary infectious diseases hospital. Methods: Between 1988 and 2006, 212 cases of infective endocarditis were documented based on the Duke criteria (range of age 7−83 years).
S415 Medical charts were reviewed for demographic and clinical data (age, clinical status at admission, signs and symptoms of endocardial infection, predisposing factors, echocardiographic documentation, predisposing factors, treatment and outcome). Results: There were 166 episodes of native valve IE (78%), the aetiology dominated by streptococci, staphylococci and Gram-negative bacteria being established in 122 cases (57%). Sixteen cases of IE occurred in children and young adults without known predisposing factor (median: 25.5 years, range 7 to 35 years, gender ratio1:1). Persistent fever, fatigue, malaise and heart murmurs were present at admission in all cases, vascular and immunological phenomena in 4 (splinter haemorrhages, Osler’s node). A 7 year old boy presented a meningitis clinical picture with petechial lesions. Dental procedures, poor dental condition and mild upper respiratory infections were described in all cases. All patients underwent transthoracic two-dimensional and Doppler transthoracic echocardiography, 10 patients underwent additional transoesophageal echocardiography. The initial echocardiogram suggested IE in 14 cases. Main findings were vegetations in 14, perivalvular abscesse in 2 and valvular leaks in 3 cases. Despite repeated blood cultures the aetiology was established in only 7 cases (44%): oral streptococci (4), Streptococcus bovis (1), S. agalactiae (1) and polymicrobial endocarditis (1), mainly due to empirical antibiotic treatment. Mitral and aortic valve involvement was prominent – 13 cases. Antimicrobial therapy was completed by cardiac surgery in 5 cases. All patients went well, one relapse was documented. Applying the modified Duke criteria to our patient series 11 were considered definite and 5 possible. Major echographic findings became particularly helpful in the cases without bacteriologic evidence. Conclusion: Diagnosis of IE is challenging especially in the absence of predisposing cardiac factors. Delayed diagnosis, empirical antibiotic treatments significantly limit the chance of positive blood cultures. Modified Duke classification is to be used in children and young adults.
Hepatitis B virus P1485 Performance evaluation of VIDIA HBs Ag, a new automated immunoassay test for the qualitative detection of HBs antigen in serum and plasma human samples B. Seign`eres, N. Ripoll, P. Gradon, P. Desmottes (Marcy l’Etoile, FR) Objective: The VIDIA system is a new automated, primary tube immunoassay instrument designed to reinforce traceability, simplifying the daily workload for routine testing. The qualitative detection of HbsAg is used as a first-line diagnostic test for hepatitis B infection or for the follow-up of HBV chronic carriers. Then, we performed an evaluation of VIDIA HbsAg (bioM´erieux) compared to VIDAS HbsAg Ultra (bioM´erieux) and AxSYM HBsAg (V2) (Abbott). Methods: The VIDIA HbsAg assay principle combines a two-step enzyme immunoassay sandwich method with a final chemiluminescence detection. HBsAg present in the sample binds with monoclonal antiHBs antibodies coated on the magnetic particles and with a mixture of monoclonal anti-HBs conjugates used in the revelation phase. The antibodies have been selected for their binding ability towards wild type and variant HBs antigen. The comparative study was performed by testing 180 positive samples from Chronic HBV carriers and 213 negative samples including blood donors and pregnant women. The serological status of 3 samples was established according to the results obtained with 3 CE-Marked immunoassays. In case of discrepant samples, the positive samples were retested and confirmed if repeatedly positive. Results: In the comparative study, specificity and sensitivity of VIDIA HBsAg was assessed according to the clinical status of the samples and compared to VIDAS HBsAg Ultra and AxSYM HbsAg (V2). VIDIA HBsAg sensitivity was tested on 30 seroconversion panels. According to NCCLS recommendations, VIDIA HBsAg precision was evaluated inferior at 15%.
17th ECCMID / 25th ICC, Posters type of intervention (surgery, antimicrobials only) were similar in both groups. This surprising finding is difficult to explain because persistent bacteraemia in IE should be logically related with increased death rate. Conclusion: Diabetics or elderly patients after prior surgery as well as those with prosthetic or right side endocarditis may suffer from PBIE with multiple positive blood cultures. However, risk of embolisation as well as mortality rate were surprisingly lower. P1481 10-year epidemiology of operated endocarditis patients at a tertiary university hospital in Germany – a preliminary analysis F. Zauner, T. Gl¨uck, B. Salzberger, B. Ehrenstein, D. Birnbaum, H.J. Linde, F.X. Audebert (Regensburg, DE) Objectives: To describe retrospectively the epidemiology and clinical presentation among patients receiving heart valve surgery for endocarditis at the Regensburg University Medical Center and to compare these data with other national and international cohort studies. To correlate pathogen types with anatomic location and histopathologic damage patterns of affected heart valves. Methods: 211 intraoperatively confirmed endocarditis episodes of 205 patients were reviewed from September 1994 to February 2005. Data was obtained from surgical records, microbiology results, histopathology reports, in-house charts, and medical charts of admitting hospitals. Results: Altogether 252 valves were replaced or reconstructed. The median age at the time of operation was 61 years with female patients accounting for 25% of all patients. Heart valves were affected as follows: aortic valve (49.3%), mitral valve (28%), aortic and mitral valve (17.5%), and valves of the right heart (5.2%). Mechanical valves were inserted in 58%, biological valves in 19% of the episodes. Valve reconstruction without replacement was performed in 13% and any kind of combined multiple valve operation was done in 9% of the operations. Postoperative diagnoses were classified into florid natural valve endocarditis (NVE; 58%), florid prosthetic valve endocarditis (PVE; 12%), status after NVE (26%), and status after PVE (4%). As predisposing factor, diabetes mellitus was elicitable in 24% of all patients. Causative organisms could be delineated in 70% of the episodes. Streptococcus viridans spp. accounted for 30.8%, Staphylococcus aureus for 28.7%, Enterococcus spp. for 14.7%, Staphylococcus epidermidis for 9.8%, infections with any two pathogens at a time for 5.6%, Streptococcus spp. for 3.5% and other species for the remaining 7% of episodes with delineation of a causative organism. Among the episodes with confirmed Staphylococcus aureus, the aortic or mitral valves were approximately equally affected. In-hospital mortality after cardiac surgery was 10.4% from the day of surgery and the following 14 days. After 30 days, the mortality rate slightly increased by 3.3% and accounted for 13.7%. Conclusions: The distribution of affected valves and the 30-days mortality rate in our cohort is consistent with results from current international studies. The spectrum of causative organsims represents spectra observed in similar studies, although Staph. aureus was delineated at a lower rate. P1482 Risk factors for systemic emboli in infective endocarditis N. Esmailpour, M. Rasoolinejad, A. Ghoochani (Tehran, IR) Objectives: As one of the complications of infective endocarditis, embolisation has a great impact on prognosis. This study was undertaken to analyse the risk factors for systemic emboli in infective endocarditis. Methods: A retrospective study was conducted during 2001–2004 in two teaching hospitals in Iran, included patients with infective endocarditis as defined by Duke Criteria. Demographic, clinical, echocardiographic and microbiological data were entered in data base, and the relationship between emboli and these variables was reviewed. Results: We studied 76 cases (80.5% male, 19.7% female) with infective endocarditis according to Duke Criteria. Mean age of patients was 37.42 years. In 27.6% mitral valve was induced. The most common organism was Staph. aureus (14.5%). Systemic embolus was seen in
Hepatitis B virus 32.9% of patients. Most emboli (15.8%) affected the central nervous system. Mortality in patients with emboli was higher than cases without emboli (36% vs. 12.8% respectively, P = 0.03). The risk of emboli was 80% when the vegetation measured larger than 10 mm and only 15% when vegetation size was smaller than 10 mm (P < 0.05). There was no relationship between age, gender, kind of induced valve, site of vegetation, kind of pathogen and duration of symptoms and embolus formation. Conclusion: Mortality was higher in infective endocarditis patients with emboli. According to this study, vegetation size (larger than 10 mm) was the only factor that was associated with an increased risk of embolic episodes. P1483 Permanent pacemaker and implantable cardioverterdefibrillator-related infective endocarditis M. Sohail, D. Uslan, A. Khan, P. Friedman, D. Hayes, W. Wilson, J. Steckelberg, S. Stoner, L. Baddour (Al Ain, AE; Rochester, Atlanta, US) Objectives: Endocarditis is an uncommon but serious complication of permanent pacemaker (PPM) and implantable cardioverter-defibrillator (ICD) implantation. Purpose of this study is to describe the management and outcome of patients with PPM/ICD-related endocarditis. Methods: Retrospective review of all cases of PPM/ICD infection presenting to Mayo Clinic Rochester between 1991 and 2003. Devicerelated endocarditis was defined using modified Duke’s criteria. Results: We identified 189 PPM/ICD infections during study period. Forty-four (23%) of these met the case-definition for device-related endocarditis (33 PPM, 11 ICD). Mean age of patients was 68 years. (77% were males). Mean duration from device implantation to infection was 739 (median 419) days. Coagulase-negative staphylococci (18, 41%) and Staphylococcus aureus (18, 41%) were the most commonly isolated organisms. Blood cultures were positive in 77% of cases. Twenty-six (59%) patients had lead vegetations, 6 (14%) had valvular vegetations and 12 (27%) had both lead and valvular vegetations (tricuspid valve 11, pulmonic valve 1, mitral valve 3, aortic valve 5). The mean diameter of vegetations was 16 mm (median 11 mm). Forty-three (98%) patients were treated with a combined approach of hardware removal and parenteral antibiotics. Mean duration of systemic antibiotics after device explantation was 45 days (median, 28 days). Electrode leads were percutaneously removed in 34 (77%) cases using manual traction (7), locking stylet (13) or laser sheath (16); 7 (16%) cases underwent surgical lead extraction. Fifteen patients had lead diameter 10 mm and percutaneous lead extraction was complicated by pulmonary embolism in 5 cases as demonstrated per radiographic procedures. However, none of these patients were clinically symptomatic. Mean time from removal of an infected device to placement of new system was 14.7 days (median, 9.5 days). A replacement device was not necessary in 17 (39%) cases. Follow-up data were available for 33 (75%) cases (mean duration, 75 weeks); 27 (82%) of them were cured with device removal and antibiotics. Six (14%) patients died during index hospitalisation (4 sepsis, 1 nosocomial pneumonia, 1 tricuspid valve rupture). Conclusions: Device-related endocarditis is associated with severe morbidity and mortality. Electrode leads can be removed percutaneouly even in cases with large sized (10 mm) lead vegetations without increasing the risk of symptomatic pulmonary embolism. P1484 Diagnosis difficulties of infective endocarditis in children, adolescents and young adults without cardiac predisposing factors – results of a case series A. Radulescu, A. Slavcovici, M. Flonta, D. Tatulescu, V. Zanc (Cluj-Napoca, RO) Objectives: To evaluate infective endocarditis (IE) in previously healthy children, adolescents and young adults within a retrospective case study in a tertiary infectious diseases hospital. Methods: Between 1988 and 2006, 212 cases of infective endocarditis were documented based on the Duke criteria (range of age 7−83 years).
S415 Medical charts were reviewed for demographic and clinical data (age, clinical status at admission, signs and symptoms of endocardial infection, predisposing factors, echocardiographic documentation, predisposing factors, treatment and outcome). Results: There were 166 episodes of native valve IE (78%), the aetiology dominated by streptococci, staphylococci and Gram-negative bacteria being established in 122 cases (57%). Sixteen cases of IE occurred in children and young adults without known predisposing factor (median: 25.5 years, range 7 to 35 years, gender ratio1:1). Persistent fever, fatigue, malaise and heart murmurs were present at admission in all cases, vascular and immunological phenomena in 4 (splinter haemorrhages, Osler’s node). A 7 year old boy presented a meningitis clinical picture with petechial lesions. Dental procedures, poor dental condition and mild upper respiratory infections were described in all cases. All patients underwent transthoracic two-dimensional and Doppler transthoracic echocardiography, 10 patients underwent additional transoesophageal echocardiography. The initial echocardiogram suggested IE in 14 cases. Main findings were vegetations in 14, perivalvular abscesse in 2 and valvular leaks in 3 cases. Despite repeated blood cultures the aetiology was established in only 7 cases (44%): oral streptococci (4), Streptococcus bovis (1), S. agalactiae (1) and polymicrobial endocarditis (1), mainly due to empirical antibiotic treatment. Mitral and aortic valve involvement was prominent – 13 cases. Antimicrobial therapy was completed by cardiac surgery in 5 cases. All patients went well, one relapse was documented. Applying the modified Duke criteria to our patient series 11 were considered definite and 5 possible. Major echographic findings became particularly helpful in the cases without bacteriologic evidence. Conclusion: Diagnosis of IE is challenging especially in the absence of predisposing cardiac factors. Delayed diagnosis, empirical antibiotic treatments significantly limit the chance of positive blood cultures. Modified Duke classification is to be used in children and young adults.
Hepatitis B virus P1485 Performance evaluation of VIDIA HBs Ag, a new automated immunoassay test for the qualitative detection of HBs antigen in serum and plasma human samples B. Seign`eres, N. Ripoll, P. Gradon, P. Desmottes (Marcy l’Etoile, FR) Objective: The VIDIA system is a new automated, primary tube immunoassay instrument designed to reinforce traceability, simplifying the daily workload for routine testing. The qualitative detection of HbsAg is used as a first-line diagnostic test for hepatitis B infection or for the follow-up of HBV chronic carriers. Then, we performed an evaluation of VIDIA HbsAg (bioM´erieux) compared to VIDAS HbsAg Ultra (bioM´erieux) and AxSYM HBsAg (V2) (Abbott). Methods: The VIDIA HbsAg assay principle combines a two-step enzyme immunoassay sandwich method with a final chemiluminescence detection. HBsAg present in the sample binds with monoclonal antiHBs antibodies coated on the magnetic particles and with a mixture of monoclonal anti-HBs conjugates used in the revelation phase. The antibodies have been selected for their binding ability towards wild type and variant HBs antigen. The comparative study was performed by testing 180 positive samples from Chronic HBV carriers and 213 negative samples including blood donors and pregnant women. The serological status of 3 samples was established according to the results obtained with 3 CE-Marked immunoassays. In case of discrepant samples, the positive samples were retested and confirmed if repeatedly positive. Results: In the comparative study, specificity and sensitivity of VIDIA HBsAg was assessed according to the clinical status of the samples and compared to VIDAS HBsAg Ultra and AxSYM HbsAg (V2). VIDIA HBsAg sensitivity was tested on 30 seroconversion panels. According to NCCLS recommendations, VIDIA HBsAg precision was evaluated inferior at 15%.