Dried blood spots, valid screening for viral hepatitis and human immunodeficiency virus in real-life.
OBJECTIVE
To detect chronic hepatitis B (CHB), chronic hepatitis C (CHC) and human immunodeficiency virus (HIV) infections in dried blood spot (DBS) and compare these samples to venous blood sampling in real-life.


METHODS
We included prospective patients with known viral infections from drug treatment centers, a prison and outpatient clinics and included blood donors as negative controls. Five drops of finger capillary blood were spotted on filter paper, and a venous blood sample was obtained. The samples were analyzed for HBsAg, anti-HBc, anti-HBs, anti-HCV, and anti-HIV levels as well as subjected to a combined nucleic acid test (NAT) for HBV DNA, HCV RNA and HIV RNA.


RESULTS
Samples from 404 subjects were screened (85 CHB, 116 CHC, 114 HIV and 99 blood donors). DBS had a sensitivity of > 96% and a specificity of > 98% for the detection of all three infections. NAT testing did not improve sensitivity, but correctly classified 95% of the anti-HCV-positive patients with chronic and past infections. Anti-HBc and anti-HBS showed low sensitivity in DBS (68% and 42%).


CONCLUSIONS
DBS sampling, combined with an automated analysis system, is a feasible screening method to diagnose chronic viral hepatitis and HIV infections outside of the health care system.
Belinda K Mössner, Benjamin Staugaard, Peer B Christensen, Department of Infectious Diseases, Odense University Hospital, 5000 Odense, Denmark.
Belinda K
BK
Mössner
Belinda K Mössner, Benjamin Staugaard, Peer B Christensen, Department of Infectious Diseases, Odense University Hospital, 5000 Odense, Denmark.
Benjamin
B
Staugaard
Belinda K Mössner, Benjamin Staugaard, Peer B Christensen, Department of Infectious Diseases, Odense University Hospital, 5000 Odense, Denmark.
Janne
J
Jensen
Belinda K Mössner, Benjamin Staugaard, Peer B Christensen, Department of Infectious Diseases, Odense University Hospital, 5000 Odense, Denmark.
Søren Thue
ST
Lillevang
Belinda K Mössner, Benjamin Staugaard, Peer B Christensen, Department of Infectious Diseases, Odense University Hospital, 5000 Odense, Denmark.
Peer B
PB
Christensen
Belinda K Mössner, Benjamin Staugaard, Peer B Christensen, Department of Infectious Diseases, Odense University Hospital, 5000 Odense, Denmark.
Dorte Kinggaard
DK
Holm
D001782:Blood Donors; D059788:Dried Blood Spot Testing / Q000379:methods*; D006678:HIV; D015658:HIV Infections / Q000097:blood / Q000175:diagnosis*; D016174:Hepacivirus; D006515:Hepatitis B virus; D019694:Hepatitis B, Chronic / Q000097:blood / Q000175:diagnosis*; D019698:Hepatitis C, Chronic / Q000097:blood / Q000175:diagnosis*; D006801:Humans; D011237:Predictive Value of Tests; D015995:Prevalence; D011330:Prisons; D011446:Prospective Studies; D012372:ROC Curve; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
Dried blood spot; Drug-users; Hepatitis B; Hepatitis C; Human immunodeficiency virus; People who inject drugs; Prisoners; Real-life; Screening
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