Hepatitis B dried blood spot (DBS) testing for children
Source: gov.uk (2025-06-11)

Information and resources to support UKHSA's national DBS testing service to improve uptake of testing in primary care of infants born to mothers living with hepatitis B.

National hepatitis B dried blood spot service

The dried blood spot test or DBS for infants born to women living with hepatitis B is a national service that is offered free of charge by the UK Health Security Agency (UKHSA) to increase testing in the primary care setting of at-risk infants born to women living with hepatitis B.

Taking a DBS in general practice has been standard practice since 2014 to support the selective neonatal hepatitis B programme. DBS testing can be undertaken at any time between one year and 18 months of age in primary care, for example at an opportunistic healthcare attendance or at a routine appointment. Taking a DBS to check if a child has acquired hepatitis B virus (HBV) infection via vertical transmission is essential to ensure early referral into services for those children found to be at risk.

Dried blood spot testing

UKHSA offers a DBS test that has been validated in detecting hepatitis B surface antigen (HBsAg).

The DBS test uses an age-appropriate safety lancet to prick the heel of the child, allowing the healthcare professional to obtain several drops of blood, which are then applied to a filter paper. It is a simple, safe and easy way to test the child in a primary care setting. Standard infection control precautions prevent any risk of cross-infection, and allowing the blood to air dry onto the filter paper renders it safe for posting to the laboratory.

Programme documents

UKHSA has developed a range of resources to support healthcare professionals in practice.

The DBS training slideset includes information on how to prepare for and take a good quality bloodspot, demonstrates how to use the lancet, how to complete the form and what to do after taking the sample.

Download the slideset detailing How to take a good quality blood spot sample (https://publichealthengland-immunisati.box.com/s/7g2l4hlu56xls48m623h5979p1ayht0y) for healthcare professionals.

Watch a video demonstrating How to take a good quality blood spot sample (https://publichealthengland-immunisati.box.com/s/525n2pi6f2sbtru4bw338ps7wbq1bw9c), reproduced with kind permission from North East and North Cumbria ICS.

For further information, see:
- Hepatitis B: antenatal screening and selective neonatal immunisation pathway (https://www.gov.uk/government/publications/hepatitis-b-antenatal-screening-and-selective-neonatal-immunisation-pathway)
- Hepatitis B: the green book, chapter 18 (https://www.gov.uk/government/publications/hepatitis-b-the-green-book-chapter-18)
- Hexavalent combination vaccine: programme guidance (https://www.gov.uk/government/publications/hexavalent-combination-vaccine-programme-guidance)
Attachments

(https://assets.publishing.service.gov.uk/media/68483f14ddc1cbd280bcb8aa/UKHSA_13352_Hepatitis_B_How_to_take_a_dried_blood_spot_sample_A4_02_WEB.pdf)

How to take a dried blood spot sample (https://assets.publishing.service.gov.uk/media/68483f14ddc1cbd280bcb8aa/UKHSA_13352_Hepatitis_B_How_to_take_a_dried_blood_spot_sample_A4_02_WEB.pdf)

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(https://assets.publishing.service.gov.uk/media/68407d19e550203c8209cd51/UKHSA_13160_Hep_B_vaccine_for_at_risk_infants_aide_memoire_June_2025_10_WEB.pdf)

Hepatitis B vaccine for at-risk infants aide memoire (https://assets.publishing.service.gov.uk/media/68407d19e550203c8209cd51/UKHSA_13160_Hep_B_vaccine_for_at_risk_infants_aide_memoire_June_2025_10_WEB.pdf)

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This file may not be suitable for users of assistive technology.

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Data reports in summary

Hepatitis B in England 2024 (https://www.gov.uk/government/publications/hepatitis-b-in-england/hepatitis-b-in-england-2024)

Additional resources

Testing of infants born to hepatitis B infected mothers: a 3-year review of the national DBS testing service (https://www.gov.uk/government/publications/the-national-hepatitis-b-dried-blood-spot-service-data-reports-in-summary), HPR 11(5), 3 February 2017.

You can view resources from previous years on the National Archives (https://webarchive.nationalarchives.gov.uk/ukgwa/20180104144915/https://www.gov.uk/government/collections/hepatitis-b-guidance-data-and-analysis), where you can also find the Rationale for not requiring high anti-HBs levels in infants born to HBsAg positive mothers (https://webarchive.nationalarchives.gov.uk/ukgwa/20240416120517/https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/742312/ST_PHE_Rationale_for_not_requiring_high_anti-HBs_levels_in_infants_born_to_HBsAg_positive_mothers_v3.pdf).