title: Pooled HIV-1 viral load testing using dried blood spots to reduce the cost of monitoring antiretroviral treatment in a resource-limited setting.
abstract: Rollout of routine HIV-1 viral load monitoring is hampered by high costs and logistical difficulties associated with sample collection and transport. New strategies are needed to overcome these constraints. Dried blood spots from finger pricks have been shown to be more practical than the use of plasma specimens, and pooling strategies using plasma specimens have been demonstrated to be an efficient method to reduce costs. This study found that combination of finger-prick dried blood spots and a pooling strategy is a feasible and efficient option to reduce costs, while maintaining accuracy in the context of a district hospital in Malawi.
authors.affiliation: *Médecins Sans Frontières, Southern Africa Medical Unit, Cape Town, South Africa; †Médecins Sans Frontières, Thyolo, Malawi; ‡Ministry of Health, Health Technical Support Services, Diagnostics, District Management Office, Thyolo, Malawi; §Ministry of Health, Lilongwe, Malawi; ‖Médecins Sans Frontières, Operational Research Unit, Brussels, Belgium; and ¶Division of Medical Virology, Stellenbosch University, and National Health Laboratory Service, Tygerberg, South Africa.
authors.forename: Pieter
authors.initials: P
authors.lastname: Pannus
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Fajardo
authors.forename: Carol
authors.initials: C
authors.lastname: Metcalf
authors.forename: Rebecca M
authors.initials: RM
authors.lastname: Coulborn
authors.forename: Laura T
authors.initials: LT
authors.lastname: Durán
authors.forename: Helen
authors.initials: H
authors.lastname: Bygrave
authors.forename: Tom
authors.initials: T
authors.lastname: Ellman
authors.forename: Daniela
authors.initials: D
authors.lastname: Garone
authors.forename: Michael
authors.initials: M
authors.lastname: Murowa
authors.forename: Reuben
authors.initials: R
authors.lastname: Mwenda
authors.forename: Tony
authors.initials: T
authors.lastname: Reid
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Preiser
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D003906:Developing Countries; D059788:Dried Blood Spot Testing / Q000379:methods*; D016903:Drug Monitoring / Q000191:economics* / Q000379:methods; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D015497:HIV-1 / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D008295:Malawi; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood*; D015203:Reproducibility of Results; D019562:Viral Load / Q000191:economics / Q000379:methods / Q000502:physiology
chemical_list: D019380:Anti-HIV Agents; D012367:RNA, Viral
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