Blood collection on filter paper for HIV antibodies detection: experience of SampaCentro Project

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Abstract

Introduction: Blood samples collected on filter paper (dried blood spot [DBS]) is an immunoassay that has been used for antibodies screening. Objective: To evaluate the strategy of DBS blood collection for detection of HIV antibodies, evaluation of Q-Preven HIV 1 + 2 - DBS kit lot, and to analyze the stability of DBS samples. Methods: Blood collection on DBS was performed according to World Health Organization (WHO) recommendations. The evaluation of the kit lot for HIV antibodies detection was performed using delta (d) values from the results of 774 DBS samples from volunteers men who have sex with men (MSM) recruited in the central region of São Paulo city, Brazil. Results: DBS blood collection was performed without complications. The positive (5.26) and negative (5.23) delta values allowed to clearly differentiate HIV antibodies reactive and non-reactive samples. We observed good performance of the kit lot and samples were stable on DBS form. Conclusion: Blood collection on DBS is feasible for the study of MSM population and is suitable for laboratory routine. The overall performance of Q Preven HIV-1 + 2 - DBS kit was satisfactory, having reached the quality levels required for the development of this study.

Translated abstract

Introdução: As amostras de sangue colhidas em papel filtro (DBS) têm sido utilizadas na triagem de anticorpos por meio de imunoensaios. Objetivos: Avaliar a estratégia de colheita de sangue em DBS para detecção de anticorpos contra o vírus da imunodeficiência humana (HIV), verificar o lote do kit Q-Preven HIV 1+2 - DBS e analisar a estabilidade das amostras DBS. Métodos: A colheita de sangue em DBS foi realizada conforme recomendações da Organização Mundial da Saúde (OMS). A avaliação do lote do kit para detecção de anticorpos anti-HIV foi feita por meio do valor de delta a partir dos resultados das 774 amostras DBS provenientes de voluntários homens que fazem sexo com homens (HSH) recrutados na região central da cidade de São Paulo, Brasil. Resultados: A colheita de sangue em DBS foi realizada sem intercorrências. O indicador delta positivo (5,26) e negativo (5,23) permitiu discriminar com clareza amostras anti-HIV reagentes e não reagentes. O lote do kit apresentou bom desempenho e as amostras permaneceram estáveis na forma de DBS. Conclusão: A colheita de sangue em DBS mostrou-se factível para o estudo realizado com a população HSH e foi adequada para a rotina laboratorial. O desempenho global do kit Q-Preven HIV 1+2 - DBS foi satisfatório, com a qualidade requerida para o desenvolvimento deste estudo.

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HIV testing in national population-based surveys: experience from the Demographic and Health Surveys.

Fred Arnold, Danielle A. Way, Navjyot Sangha … (2006)

To describe the methods used in the Demographic and Health Surveys (DHS) to collect nationally representative data on the prevalence of human immunodeficiency virus (HIV) and assess the value of such data to country HIV surveillance systems. During 2001-04, national samples of adult women and men in Burkina Faso, Cameroon, Dominican Republic, Ghana, Mali, Kenya, United Republic of Tanzania and Zambia were tested for HIV. Dried blood spot samples were collected for HIV testing, following internationally accepted ethical standards. The results for each country are presented by age, sex, and urban versus rural residence. To estimate the effects of non-response, HIV prevalence among non-responding males and females was predicted using multivariate statistical models for those who were tested, with a common set of predictor variables. Rates of HIV testing varied from 70% among Kenyan men to 92% among women in Burkina Faso and Cameroon. Despite large differences in HIV prevalence between the surveys (1-16%), fairly consistent patterns of HIV infection were observed by age, sex and urban versus rural residence, with considerably higher rates in urban areas and in women, especially at younger ages. Analysis of non-response bias indicates that although predicted HIV prevalence tended to be higher in non-tested males and females than in those tested, the overall effects of non-response on the observed national estimates of HIV prevalence are insignificant. Population-based surveys can provide reliable, direct estimates of national and regional HIV seroprevalence among men and women irrespective of pregnancy status. Survey data greatly enhance surveillance systems and the accuracy of national estimates in generalized epidemics.

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Application of human immunodeficiency virus type 1 BED enzyme immunoassay on dried blood spots in India.

Vemu Lakshmi, Talasila Sudha, Rakhi Dandona … (2009)

Dried blood spots (DBSs) on filter paper are being used increasingly in population-based human immunodeficiency virus (HIV) studies. This study evaluated the application of a BED enzyme immunoassay (EIA) on DBSs to estimate HIV incidence in a population-based study in India. The Calypte HIV-1 BED Incidence EIA was performed on 224 HIV-1-positive DBS samples, after screening 12 617 individuals from a population-based sample in Guntur district in the southern Indian state of Andhra Pradesh. The number of recently infected HIV cases was identified using this BED assay and was used to estimate the annual HIV incidence rate based on calculations and adjustment formulae suggested by the Centers for Disease Control and Prevention (CDC). The updated BED data management software provided by the CDC was used for analyses. Of the 224 HIV-1 antibody-positive DBS samples, 29 (12.95 %) were estimated by the BED HIV-1 assay to have been infected within the past 155 days. After adjusting for age, gender and rural/urban distribution of the population, the annual incidence rate of HIV-1 infection was estimated to be 0.32 % (95 % confidence interval 0.20-0.44 %). This annual incidence was 18.6 % of the HIV prevalence of 1.72 % in this study. Thus, the BED assay revealed a higher incidence of HIV in this study than was expected from the prevalence. Correlation of the BED assay with panel testing and longitudinal incidence data in the Indian population is needed to calibrate it for use in India.