Dried Blood Spot, Valid Screening Method for Viral Hepatitis and HIV in Real-Life

Author: Mössner BK, Staugaard B, Jensen J, Lillevang ST, Christensen PB, Holm DK

Theme: Epidemiology & Public Health Research Year: 2016


Mössner BK1, Staugaard B1, Jensen J2, Lillevang ST3, Christensen PB1, Holm DK3

1Department of Infectious Diseases, Odense University Hospital, Odense 5000, Denmark,

2Department of Medicine, Lillebaelt Hospital, Kolding, Kolding 6000, Denmark

3Department of Clinical Immunology, Odense University Hospital, Odense 5000, Denmark

Background: Chronic viral hepatitis B (CHB) and C (CHC) represent a major health burden worldwide. In most western countries, people who inject drugs (PWID) have the highest prevalence of CHC. Still the majority of PWIDs have never been tested. Existing literature indicates a wide range of barriers for testing. Recently it was shown that DBS can be combined with automatic analysis on a modern analysis platform. However most of these studies used venous whole blood for the DBS samples instead of capillary blood. The “real-life” performance and feasibility of DBS is to our knowledge not well described. The objective of this study was to investigate the performance of DBS for detecting CHB, CHC and Human Immunodeficiency virus (HIV) infection compared to venous blood sampling in real-life settings.

Methods: Patients with known viral infection were prospectively included from drug treatment centers, prison and outpatient clinics and blood donors as negative controls. Five drops of finger capillary blood on filter paper and a venous blood sample was obtained. Samples were analyzed for HBsAg, antiHBc, antiHBs, antiHCV, antiHIV and a combined nucleic acid test (NAT) for HBVDNA, HCVRNA and HIVRNA.

Results: 404 persons were included (85CHB, 116CHC, 114HIV and 99 blood donors). DBS had a sensitivity >96% and a specificity >98% for detection of all three infections. NAT testing did not improve sensitivity, but classified 95% of anti-HCV positive samples correctly in chronic and past infection.

Conclusion: DBS sampling combined with an automated analysis system is a feasible screening method to diagnose chronic viral hepatitis and HIV outside the health care system.

Disclosures of interest: This study has received research grants from Abbvie and Gilead

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