Overseas processing of dried blood spots for timely diagnosis of HIV in Haitian infants.
OBJECTIVE
To determine the feasibility of sending dried blood spots (DBS) to an overseas processing center for the diagnosis of HIV infection in infants in rural Haiti.


METHODS
The program took place in the Central Department of Haiti. Children under 18 months of age who were born to an HIV-infected mother or who had a positive HIV antibody test had blood collected on filter paper. Once dry, specimens were labeled with a unique identifying number, placed in sealed gas-impermeable envelopes containing a desiccant, stored at room temperature, and mailed to a commercial laboratory in The Netherlands, where blood was eluted from the filter paper and analyzed by the Retina(trade mark) rainbow HIV-1 RNA assay. Infants were tested at 1 month of age and again at 4 months of age.


RESULTS
The DBS protocol was easily scaled up. During the study period, 138 infants had HIV status confirmed; 15 of them were found to be HIV infected and were enrolled in appropriate HIV care, and 123 were confirmed to be HIV uninfected, avoiding unnecessary prophylactic antibiotics and providing reassurance to caregivers.


CONCLUSIONS
Central, overseas processing of DBS is a feasible solution for the timely diagnosis of HIV infection in infants where local capacity is unavailable. Regional processing centers for DBS could improve the access of millions of children in Latin America and the Caribbean to timely diagnosis of HIV infection.
Ivers
Louise C
LC
Division of Global Health Equity, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA. livers@pih.org
Smith Fawzi
Mary Catherine
MC
Mann
Julie
J
Jerome
Jean-Gregory
JG
Raymonville
Maxi
M
Mukherjee
Joia S
JS
D001800:Blood Specimen Collection / Q000379:methods; D005240:Feasibility Studies; D015658:HIV Infections / Q000175:diagnosis*; D006205:Haiti; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009426:Netherlands; D010865:Pilot Projects; D013997:Time Factors