title: Evaluation of the dried blood spot filter paper technology and five testing strategies of HIV-1 and HIV-2 infections in West Africa.
abstract: Simple robust approaches are needed to monitor the prevalence and incidence of HIV in Africa. The aim of this study was to evaluate the use of dried blood spot (DBS) as an alternative to serum or plasma for sentinel surveillance. Paired DBS and blood samples were obtained from 200 patients attending a genito-urinary medicine clinic in West Africa. The gold standard of diagnosis was based on the combination of 3 enzyme-linked immunosorbent assays (ELISA) using serum. The presence of HIV antibodies in eluates of dried blood spots was detected by ELISA, Gelatin Particle Assay (GPA) and Pepti-Lav 1-2 in 5 different testing strategies. All 200 eluates were tested individually, and in addition pools of 5 eluates each were tested. The sensitivity of the testing strategies ranged from 95.0% (83.1 - 99.4%) to 100% and the specificity from 97.5% (93.7 - 99.3%) to 100%. Testing in pools of 5 did not affect sensitivity. Dried blood spots were easy to work with. Test kit and laboratory consumable costs varied between 492 pounds and 1037 pounds (unpooled strategies) and 163 pounds and 421 pounds (pooled). The monospecific ELISAs used in this study are no longer in production; currently available differentiating assays need to be tested. DBS are recommended for sentinel surveillance in Africa.
authors.affiliation: Medical Research Council Laboratories, Fajara, UK.
authors.forename: Ramu
authors.initials: R
authors.lastname: Sarge-Njie
authors.forename: Maarten
authors.initials: M
authors.lastname: Schim Van Der Loeff
authors.forename: Saihou
authors.initials: S
authors.lastname: Ceesay
authors.forename: David
authors.initials: D
authors.lastname: Cubitt
authors.forename: Saihou
authors.initials: S
authors.lastname: Sabally
authors.forename: Tumani
authors.initials: T
authors.lastname: Corrah
authors.forename: Hilton
authors.initials: H
authors.lastname: Whittle
mesh_terms: D015492:AIDS Serodiagnosis / Q000379:methods*; D001800:Blood Specimen Collection / Q000379:methods*; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005714:Gambia; D015483:HIV Antibodies / Q000097:blood / Q000302:isolation & purification*; D006679:HIV Seropositivity / Q000097:blood / Q000175:diagnosis*; D015528:HIV Seroprevalence; D015497:HIV-1 / Q000276:immunology*; D015498:HIV-2 / Q000276:immunology*; D006801:Humans; D011933:Reagent Kits, Diagnostic / Q000821:virology*; D012680:Sensitivity and Specificity; D018571:Sentinel Surveillance
chemical_list: D015483:HIV Antibodies; D011933:Reagent Kits, Diagnostic