title: Field study of dried blood spot specimens for HIV-1 drug resistance genotyping.
abstract: Dried blood spots (DBS) are an alternative specimen type for HIV drug resistance genotyping in resource-limited settings. Data relating to the impact of DBS storage and shipment conditions on genotyping efficiency under field conditions are limited. We compared the genotyping efficiencies and resistance profiles of DBS stored and shipped at different temperatures to those of plasma specimens collected in parallel from patients receiving antiretroviral therapy in Uganda. Plasma and four DBS cards from anti-coagulated venous blood and a fifth card from finger-prick blood were prepared from 103 HIV patients with a median viral load (VL) of 57,062 copies/ml (range, 1,081 to 2,964,191). DBS were stored at ambient temperature for 2 or 4 weeks or frozen at -80 °C and shipped from Uganda to the United States at ambient temperature or frozen on dry ice for genotyping using a broadly sensitive in-house method. Plasma (97.1%) and DBS (98.1%) stored and shipped frozen had similar genotyping efficiencies. DBS stored frozen (97.1%) or at ambient temperature for 2 weeks (93.2%) and shipped at ambient temperature also had similar genotyping efficiencies. Genotyping efficiency was reduced for DBS stored at ambient temperature for 4 weeks (89.3%, P = 0.03) or prepared from finger-prick blood and stored at ambient temperature for 2 weeks (77.7%, P < 0.001) compared to DBS prepared from venous blood and handled similarly. Resistance profiles were similar between plasma and DBS specimens. This report delineates the optimal DBS collection, storage, and shipping conditions and opens a new avenue for cost-saving ambient-temperature DBS specimen shipments for HIV drug resistance (HIVDR) surveillances in resource-limited settings.
authors.affiliation: MRC/UVRI Uganda Research Unit on AIDS, Uganda Virus Research Institute, Entebbe, Uganda MRC/UCL Centre for Medical Molecular Virology, UCL, London, United Kingdom.
authors.forename: C M
authors.initials: CM
authors.lastname: Parry
authors.affiliation: Data First Consulting, Belmont, California, USA nparkin34@gmail.com CYang1@cdc.gov.
authors.forename: N
authors.initials: N
authors.lastname: Parkin
authors.affiliation: Division of Global HIV/AIDS, CGH, CDC, Atlanta, Georgia, USA.
authors.forename: K
authors.initials: K
authors.lastname: Diallo
authors.affiliation: Mildmay Centre, Kampala, Uganda.
authors.forename: S
authors.initials: S
authors.lastname: Mwebaza
authors.affiliation: Mildmay Centre, Kampala, Uganda.
authors.forename: R
authors.initials: R
authors.lastname: Batamwita
authors.affiliation: Division of Global HIV/AIDS, CGH, CDC, Atlanta, Georgia, USA.
authors.forename: J
authors.initials: J
authors.lastname: DeVos
authors.affiliation: GAP-CDC Uganda, Entebbe, Uganda.
authors.forename: N
authors.initials: N
authors.lastname: Bbosa
authors.affiliation: MRC/UVRI Uganda Research Unit on AIDS, Uganda Virus Research Institute, Entebbe, Uganda.
authors.forename: F
authors.initials: F
authors.lastname: Lyagoba
authors.affiliation: MRC/UVRI Uganda Research Unit on AIDS, Uganda Virus Research Institute, Entebbe, Uganda.
authors.forename: B
authors.initials: B
authors.lastname: Magambo
authors.affiliation: Division of Geographic Medicine and Infectious Disease, Tufts University School of Medicine, Boston, Massachusetts, USA.
authors.forename: M R
authors.initials: MR
authors.lastname: Jordan
authors.affiliation: GAP-CDC Uganda, Entebbe, Uganda.
authors.forename: R
authors.initials: R
authors.lastname: Downing
authors.affiliation: Division of Global HIV/AIDS, CGH, CDC, Atlanta, Georgia, USA.
authors.forename: G
authors.initials: G
authors.lastname: Zhang
authors.affiliation: MRC/UVRI Uganda Research Unit on AIDS, Uganda Virus Research Institute, Entebbe, Uganda.
authors.forename: P
authors.initials: P
authors.lastname: Kaleebu
authors.affiliation: Division of Global HIV/AIDS, CGH, CDC, Atlanta, Georgia, USA nparkin34@gmail.com CYang1@cdc.gov.
authors.forename: C
authors.initials: C
authors.lastname: Yang
authors.affiliation: HIV Department, World Health Organization, Geneva, Switzerland.
authors.forename: S
authors.initials: S
authors.lastname: Bertagnolio
mesh_terms: D001769:Blood / Q000821:virology*; D003890:Desiccation; D024882:Drug Resistance, Viral; D060005:Genotyping Techniques / Q000379:methods*; D015658:HIV Infections / Q000821:virology*; D015497:HIV-1 / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D008826:Microbial Sensitivity Tests / Q000379:methods*; D013048:Specimen Handling / Q000379:methods*; D013696:Temperature; D014454:Uganda; D014481:United States