Evaluation of the dried blood spot (DBS) collection method as a tool for detection of HIV Ag/Ab, HBsAg, anti-HBs and anti-HCV in a Malaysian tertiary referral hospital

Ann Acad Med Singap. 2011 Oct;40(10):448-53.

Abstract

Introduction: Dried blood spot (DBS) collection is an appealing alternative to whole blood or plasma sampling, as it has technical and economic advantages over the latter.

Materials and methods: A prospective cross-sectional study was conducted at a Malaysian tertiary referral hospital from November 2009 to March 2010. One hundred and fifty paired specimens of DBS and plasma were analysed by the standard assays for HIV Ag/Ab, HBsAg, anti-HBS and anti-HCV, separately (total 600 paired specimens). DBS sample titres were then compared to the results of plasma testing, which was used as the gold standard.

Results: For the HIV Ag/Ab assay with a cut-off point of 0.35 Relative Light Units (RLUs), the sensitivity and specificity were both 100%. For the HBsAg assay, the sensitivity was 96.5% and the specificity was 97.8%, with a cut-off point of 1.72 RLUs. Sensitivity for the anti-HBs test was 74.2% and the specificity was 86.9%, using a cut-off point of 0.635 RLUs. For the anti-HCV assay, the sensitivity was 97.3% and the specificity was 100%, with a cut-off point of 0.10 RLUs.

Conclusion: DBS is an ideal choice to be used as a screening tool for the detection of HIV, Hepatitis B and Hepatitis C virus infections. However, different cut-off values need to be used for the validation of test positivity in DBS samples because the small amount of blood in the DBS specimens leads to lower assay titres.

Publication types

  • Validation Study

MeSH terms

  • Cross-Sectional Studies
  • Dried Blood Spot Testing*
  • HIV Antibodies / blood*
  • HIV Antibodies / immunology
  • HIV Antigens / blood*
  • HIV Antigens / immunology
  • HIV Infections / diagnosis*
  • Hepacivirus / isolation & purification*
  • Hepatitis B / diagnosis*
  • Hepatitis B Antibodies / blood*
  • Hepatitis B Antibodies / immunology
  • Hepatitis B Surface Antigens / blood*
  • Hepatitis B Surface Antigens / immunology
  • Hepatitis C / diagnosis*
  • Hepatitis C Antibodies / blood*
  • Hepatitis C Antibodies / immunology
  • Hepatitis C Antigens / blood*
  • Hepatitis C Antigens / immunology
  • Humans
  • Malaysia
  • Plasma / virology
  • Prospective Studies
  • Referral and Consultation*
  • Sensitivity and Specificity
  • Specimen Handling

Substances

  • HIV Antibodies
  • HIV Antigens
  • Hepatitis B Antibodies
  • Hepatitis B Surface Antigens
  • Hepatitis C Antibodies
  • Hepatitis C Antigens