title: Evaluation of Two Techniques for Viral Load Monitoring Using Dried Blood Spot in Routine Practice in Vietnam (French National Agency for AIDS and Hepatitis Research 12338).
abstract: Background.Although it is the best method to detect early therapeutic failure, viral load (VL) monitoring is still not widely available in many resource-limited settings because of difficulties in specimen transfer, personnel shortage, and insufficient laboratory infrastructures. Dried blood spot (DBS) use, which was introduced in the latest World Health Organization recommendations, can overcome these difficulties. This evaluation aimed at validating VL measurement in DBS, in a laboratory without previous DBS experience and in routine testing conditions.Methods.Human immunodeficiency virus (HIV)-infected adults were observed in a HIV care site in Hanoi, and each patient provided 2 DBS cards with whole blood spots and 2 plasma samples. Viral load was measured in DBS and in plasma using the COBAS Ampliprep/TaqMan and the Abbott RealTime assays. To correctly identify those with VL ≥ 1000 copies/mL, sensitivity and specificity were estimated.Results.A total of 198 patients were enrolled. With the Roche technique, 51 plasma VL were ≥1000 copies/mL; among these, 28 presented a VL in DBS that was also ≥1000 copies/mL (sensitivity, 54.9; 95% confidence interval [CI], 40.3-68.9). On the other hand, all plasma VL < 1000 copies/mL were also <1000 copies/mL in DBS (specificity, 100; 95% CI, 97.5-100). With the Abbott technique, 45 plasma VL were ≥1000 copies/mL; among these, 42 VL in DBS were also ≥1000 copies/mL (sensitivity, 93.3%; 95% CI, 81.7-98.6); specificity was 94.8 (95% CI, 90.0-97.7).Conclusions.The Abbott RealTime polymerase chain reaction assay provided adequate VL results in DBS, thus allowing DBS use for VL monitoring.
authors.affiliation: Emerging Diseases Epidemiology Unit, Institut Pasteur,; Direction de la Recherche Clinique et du Développement-Assistance Publique des Hôpitaux de Paris, Saint-Louis Hospital, Paris, France.
authors.forename: Fabien
authors.initials: F
authors.lastname: Taieb
authors.affiliation: National Reference HIV Molecular Laboratory , National Institute of Hygiene and Epidemiology.
authors.forename: Tran Hong
authors.initials: TH
authors.lastname: Tram
authors.affiliation: Department of HIV/AIDS Prevention and Control , Hanoi School of Public Health.
authors.forename: Hien Thi
authors.initials: HT
authors.lastname: Ho
authors.affiliation: Department of HIV/AIDS Prevention and Control , Hanoi School of Public Health.
authors.forename: Van Anh
authors.initials: VA
authors.lastname: Pham
authors.affiliation: Dong Da Outpatient Clinic.
authors.forename: Lan
authors.initials: L
authors.lastname: Nguyen
authors.affiliation: Dong Da Outpatient Clinic.
authors.forename: Ban Hien
authors.initials: BH
authors.lastname: Pham
authors.affiliation: Vietnam Administration of HIV/AIDS Control , Hanoi.
authors.forename: Linh An
authors.initials: LA
authors.lastname: Tong
authors.affiliation: Institut National de la Santé et de la Recherche Médicale Unité 1058, Pathogenesis and Control of Chronic Infections , Montpellier University Hospital.
authors.forename: Edouard
authors.initials: E
authors.lastname: Tuaillon
authors.affiliation: Unité Mixte Internationale 233 Recherche Translationnelle Appliquée au VIH et aux Maladies Infectieuses, Institut de Recherche pour le Développement and Université de Montpellier 1 , France.
authors.forename: Eric
authors.initials: E
authors.lastname: Delaporte
authors.affiliation: National Reference HIV Molecular Laboratory , National Institute of Hygiene and Epidemiology.
authors.forename: Anh Tuan
authors.initials: AT
authors.lastname: Nguyen
authors.affiliation: Vietnam Administration of HIV/AIDS Control , Hanoi.
authors.forename: Duc Duong
authors.initials: DD
authors.lastname: Bui
authors.affiliation: Vietnam Administration of HIV/AIDS Control , Hanoi.
authors.forename: NhanThi
authors.initials: N
authors.lastname: Do
authors.affiliation: Emerging Diseases Epidemiology Unit , Institut Pasteur.
authors.forename: Yoann
authors.initials: Y
authors.lastname: Madec
keywords: Dried Blood Spots (DBS); HIV; Viral load; sensitivity; virological failure