HIV-1 diagnosis using dried blood spots from patients in Kinshasa, DRC: a tool to detect misdiagnosis and achieve World Health Organization 2030 targets

Barquín, David; Ndarabu, Adolphe; Carlos, Silvia; Fernández-Alonso, Mirian; Rubio-Garrido, Marina; Makonda, Benit; Holguín, África; Reina, Gabriel

doi:10.1016/j.ijid.2021.08.035

Cited by 7 publications

(6 citation statements)

References 30 publications

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“…Our pilot study provides pioneer data related to the seroprotection to six infectious diseases preventable by vaccination in a cohort of children and adolescents living in Kinshasa (DRC) using samples collected during 2016–2018. The quantification of IgG levels in DBS did not present any difficulty compared to plasma, and we detected IgG in the plasma fraction present in the dried blood drop collected on Whatman paper, as we previously did for other pathogens 20 , 21 , 25 – 27 .…”

Section: Discussionsupporting

confidence: 73%

Immune surveillance for six vaccinable pathogens using paired plasma and dried blood spots in HIV infected and uninfected children in Kinshasa

Rodriguez-Galet

Rubio-Garrido

Valadés-Alcaraz

et al. 2022

Sci Rep

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Child vaccination reduces infant mortality rates. HIV-infected children present higher risk of diseases than non-infected. We report the protection coverage rates for 6 vaccine-preventable diseases in a paediatric population from the Democratic Republic of the Congo (DRC) and the impact of HIV infection, providing the first data on the validity of dried blood samples (DBS) to monitor the immune protection. During 2016–2018 DBS from 143 children/adolescents were collected in Kinshasa (DRC), being 52 HIV-infected. Forty-two had a paired plasma sample. Protective IgG was quantified (VirClia-IgG,VIRCELL) to obtain the optimal cut-off in IgG detection in DBS. ROC curves were generated with R software and statistical analyses with Stata. Protective IgG levels varied across pathogens, not reaching herd immunity. HIV-infected presented lower vaccine protection than uninfected for all analyzed pathogens, except rubella, with statistically significant differences for measles (30.8% vs. 53.8%; p = 0.008) and tetanus (3.8% vs. 22%; p = 0.0034). New cut-offs were calculated when using DBS to improve test performance. We reinforce the necessity to increase pediatric vaccination coverage in Kinshasa, especially in HIV seropositive, with less capacity to maintain adequate antibody levels. DBS were useful to monitor vaccination coverage in seroprevalence studies in resource-limited settings, after optimizing the cut-off value for each pathogen.

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Section: Discussionsupporting

confidence: 73%

Immune surveillance for six vaccinable pathogens using paired plasma and dried blood spots in HIV infected and uninfected children in Kinshasa

Rodriguez-Galet

Rubio-Garrido

Valadés-Alcaraz

et al. 2022

Sci Rep

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“…It is also applicable to many other regions in Europe with similar challenges in health care outreach to the population. The use of capillary blood sampling for large-scale serological studies is not limited to SARS-CoV-2 S protein, and the feasibility of the strategy for detection of antibodies to other antigens has previously been demonstrated [26,[32][33][34]. It is easy to envision a comprehensible national surveillance system of vaccine effectiveness, especially focussed upon populations that receive care outside of centralised hospital facilities, such as vulnerable and frail individuals at nursing homes or long-term care facilities.…”

Section: Discussionmentioning

confidence: 99%

At-home sampling to meet geographical challenges for serological assessment of SARS-CoV-2 exposure in a rural region of northern Sweden, March to May 2021: a retrospective cohort study

et al. 2023

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Background The current SARS-CoV-2 pandemic has highlighted a need for easy and safe blood sampling in combination with accurate serological methodology. Venipuncture for testing is usually performed by trained staff at healthcare centres. Long travel distances to healthcare centres in rural regions may introduce a bias of testing towards relatively large communities with closer access. Rural regions are therefore often not represented in population-based data. Aim The aim of this retrospective cohort study was to develop and implement a strategy for at-home testing in a rural region of Sweden during spring 2021, and to evaluate its role to provide equal health care for its inhabitants. Methods We developed a sensitive method to measure antibodies to the S-protein of SARS-CoV-2 and optimised this assay for clinical use together with a strategy of at-home capillary blood sampling. Results We demonstrated that our ELISA gave comparable results after analysis of capillary blood or serum from SARS-CoV-2-experienced individuals. We demonstrated stability of the assay under conditions that reflected temperature and humidity during winter or summer. By assessment of capillary blood samples from 4,122 individuals, we could show both feasibility of the strategy and that implementation shifted the geographical spread of testing in favour of rural areas. Conclusion Implementation of at-home sampling enabled citizens living in remote rural areas access to centralised and sensitive laboratory antibody tests. The strategy for testing used here could therefore enable disease control authorities to get rapid access to information concerning immunity to infectious diseases, even across vast geographical distance.

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“…This is considerably lower compared to performance reported by others using DBS. In a study conducted among PLWH on ART in Kinshasa, Democratic Republic of Congo Barquín et al 12 reported a sensitivity of 100% (95% CI 98.6%, 100%) and specificity of 100% (95% CI 96.0%, 100%) for the VIDAS HIV Duo Quick. Differences in performance between our study and Barquín et al .…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the bioMérieux VIDAS HIV Duo Quick and Anti-HCV assays for dried blood spot based serosurveillance

Cholette

Farmer

Balakireva³

et al. 2022

Sci Rep

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Serosurveillance is central to monitoring our progress towards HIV and HCV elimination targets proposed for 2030. However, serosurveillance systems are ineffective without reliable serological assays for the detection of HIV and HCV antibodies. Assays should also be compatible with dried blood spot (DBS) samples to facilitate biological sample collection. The VIDAS HIV Duo Quick and Anti-HCV assays are sold as reagents strips and processed by the automated VIDAS benchtop immunoanalyser. While both assays have shown excellent performance in serum and plasma, performance data in DBS samples is lacking. In our study, we evaluate the performance of the VIDAS HIV Duo Quick and Anti-HCV assays in DBS (n = 725) collected during a cross-sectional serosurvey (the Transitions study). The VIDAS HIV Duo quick had a sensitivity and specificity of 94.5% (95% CI 85.1%, 98.5%) and 95.7% (95% CI 93.9%, 97.0%) respectively. Likewise, the VIDAS Anti-HCV had a sensitivity and specificity of 95.6% (95% CI 91.6%, 97.8%) and 95.6% (95% CI 93.5%, 97.0%) respectively. These assays are unlikely to be helpful in low-prevalence settings due to sub-optimal performance, but their performance could likely be improved by optimizing DBS elution protocols which was, unfortunately, not possible during our study.

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HIV-1 diagnosis using dried blood spots from patients in Kinshasa, DRC: a tool to detect misdiagnosis and achieve World Health Organization 2030 targets

Cited by 7 publications

References 30 publications

Immune surveillance for six vaccinable pathogens using paired plasma and dried blood spots in HIV infected and uninfected children in Kinshasa

Immune surveillance for six vaccinable pathogens using paired plasma and dried blood spots in HIV infected and uninfected children in Kinshasa

At-home sampling to meet geographical challenges for serological assessment of SARS-CoV-2 exposure in a rural region of northern Sweden, March to May 2021: a retrospective cohort study

Evaluation of the bioMérieux VIDAS HIV Duo Quick and Anti-HCV assays for dried blood spot based serosurveillance

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