Feasibility of dried blood spot for hepatitis C diagnosis in vulnerable subjects and people living in remote areas from Brazil

Abstract

Background Agile, accessible and cheap diagnosis of hepatitis C virus (HCV) infection is essential to achieve the elimination of this infection, worldwide, as mandated by the World Health Organzation as part of its strategy for 2030. Dried blood spots (DBS) can be an attractive alternative for sample collection among people living in remote areas and vulnerable populations due to the less invasive collection, its biosafety, and storage & transportation of samples at room temperature. Design This study aims to estimate the usefulness of dried blood spot samples for the diagnosis and the assessment of HCV infection rates in three different settings in Brazil. Cross-sectional analysis of a sample collection from different populations, aiming to assess the performance of the testing algorithms and respective procedures among different populations with diverse background infection rates. Methods We reported the evaluation of DBS as alternative samples for detecting anti-HCV in different groups in real life conditions: (I) Vulnerable subjects living in remote areas of Southeast, North and Northeast Brazil (n = 1464); (II) Beauticians (n = 288); (III) People who use non-injectable drugs (n = 201); (IV) patients referred to outpatient care (n = 275). Results General assay accuracy was 99%, with a weighted kappa value of 0.9, showing an excellent performance. Sensitivities ranged from 87.5% to 100.0% between groups and specificities were above 99.2%. A total of 194 individuals had HCV RNA in serum and concordance of anti-HCV detection in DBS was 98.4%. Conclusions DBS samples could be used for anti-HCV detection in different populations recruited in real life conditions and ambulatory settings, with a high overall sensitivity and specificity.

The role of dried blood spot tests in the detection of hepatitis B infection: A systematic review

“…Its simplicity makes it feasible for individuals to collect specimens at home or in other convenient settings. 90 Notably, common infections that can be detected using DBS in conjunction with HBV are HIV and HCV infections, as they are also blood-borne viral infections. 91 The selection of a filter card primarily depends on the availability, cost and reputation of known brands.…”

“…It is an attractive alternative collection tool especially among people in remote areas and high‐risk populations with high risk due to the less invasive collection process, its biosafety, and storage and transportation of samples. Its simplicity makes it feasible for individuals to collect specimens at home or in other convenient settings 90 . Notably, common infections that can be detected using DBS in conjunction with HBV are HIV and HCV infections, as they are also blood‐borne viral infections 91 …”