title: Combining rapid diagnostic tests and dried blood spot assays for point-of-care testing of human immunodeficiency virus, hepatitis B and hepatitis C infections in Burkina Faso, West Africa.
abstract: People screened for human immunodeficiency virus (HIV) using rapid diagnostic tests (RDTs) in Africa remain generally unaware of their status for hepatitis B (HBV) and hepatitis C (HCV) infections. We evaluated a two-step screening strategy in Burkina Faso, using both HIV RDTs and Dried Blood Spot (DBS) assays to confirm an HIV-positive test, and to test for HBV and HCV infections. HIV counselling and point-of-care testing were performed at a voluntary counselling and testing centre with HBV, HCV status and HIV confirmation using DBS specimens, being assessed at a central laboratory. Serological testing on plasma was used as the reference standard assay to control for the performance of DBS assays. Nineteen out of 218 participants included in the study were positive for HIV using RDTs. A fourth-generation HIV ELISA and immunoblot assays on DBS confirmed HIV status. Twenty-four out of 25 participants infected with HBV were found positive for hepatitis B surface antigen (HBsAg) using DBS. One sample with a low HBsAg concentration on plasma was not detected on DBS. Five participants tested positive for HCV antibodies were confirmed positive with an immunoblot assay using DBS specimens. Laboratory results were communicated within 7 days to participants with no loss to follow up of participants between the first and second post-test counselling sessions. In conclusion, DBS collection during HIV point-of-care testing enables screening and confirmation of HBV, HCV and HIV infections. Diagnosis using DBS may assist with implementation of national programmes for HBV, HCV and HIV screening and clinical care in middle- to low-income countries.
authors.affiliation: Laboratoire de Virologie, Centre Muraz, Bobo-Dioulasso, Burkina Faso; Unité de Recherche Santé de la Reproduction, VIH et Maladies Associées Centre Muraz, Bobo-Dioulasso, Burkina Faso; INSERM U 1058, Infection by HIV and by Agents With Mucocutaneous Tropism: from Pathogenesis to Prevention, Montpellier, France; Université Montpellier 1, Montpellier, France.
authors.forename: D
authors.initials: D
authors.lastname: Kania
authors.forename: A M
authors.initials: AM
authors.lastname: Bekalé
authors.forename: N
authors.initials: N
authors.lastname: Nagot
authors.forename: A-M
authors.initials: AM
authors.lastname: Mondain
authors.forename: L
authors.initials: L
authors.lastname: Ottomani
authors.forename: N
authors.initials: N
authors.lastname: Meda
authors.forename: M
authors.initials: M
authors.lastname: Traoré
authors.forename: J B
authors.initials: JB
authors.lastname: Ouédraogo
authors.forename: J
authors.initials: J
authors.lastname: Ducos
authors.forename: P
authors.initials: P
authors.lastname: Van de Perre
authors.forename: E
authors.initials: E
authors.lastname: Tuaillon
mesh_terms: D015492:AIDS Serodiagnosis; D002050:Burkina Faso; D003430:Cross-Sectional Studies; D059788:Dried Blood Spot Testing / Q000191:economics; D004797:Enzyme-Linked Immunosorbent Assay; D015658:HIV Infections / Q000175:diagnosis*; D015497:HIV-1 / Q000276:immunology; D016174:Hepacivirus / Q000276:immunology; D006509:Hepatitis B / Q000175:diagnosis* / Q000276:immunology; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000276:immunology; D006526:Hepatitis C / Q000175:diagnosis* / Q000276:immunology; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D010865:Pilot Projects; D019095:Point-of-Care Systems; D011203:Poverty
chemical_list: D006514:Hepatitis B Surface Antigens; D018937:Hepatitis C Antibodies
keywords: Africa; dried blood spot; hepatitis B virus; hepatitis C virus; human immunodeficiency virus; screening strategy