Field study of dried blood spot specimens for HIV-1 drug resistance genotyping

Dried blood spots (DBS) are an alternative specimen type for HIV drug resistance genotyping in resource-limited settings. Data relating to the impact of DBS storage and shipment conditions on genotyping efficiency under field conditions are limited. We compared the genotyping efficiencies and resist...

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Bibliographic Details
Published in:	Journal of clinical microbiology Vol. 52; no. 8; pp. 2868 - 2875
Main Authors:	Parry, C M, Parkin, N, Diallo, K, Mwebaza, S, Batamwita, R, DeVos, J, Bbosa, N, Lyagoba, F, Magambo, B, Jordan, M R, Downing, R, Zhang, G, Kaleebu, P, Yang, C, Bertagnolio, S
Format:	Journal Article
Language:	English
Published:	United States American Society for Microbiology 01-08-2014
Subjects:	Blood - virology Desiccation Drug Resistance, Viral Genotyping Techniques - methods HIV Infections - virology HIV-1 - drug effects HIV-1 - genetics HIV-1 - isolation & purification Human immunodeficiency virus Human immunodeficiency virus 1 Humans Microbial Sensitivity Tests - methods Specimen Handling - methods Temperature Uganda United States Virology United States Uganda
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Summary:	Dried blood spots (DBS) are an alternative specimen type for HIV drug resistance genotyping in resource-limited settings. Data relating to the impact of DBS storage and shipment conditions on genotyping efficiency under field conditions are limited. We compared the genotyping efficiencies and resistance profiles of DBS stored and shipped at different temperatures to those of plasma specimens collected in parallel from patients receiving antiretroviral therapy in Uganda. Plasma and four DBS cards from anti-coagulated venous blood and a fifth card from finger-prick blood were prepared from 103 HIV patients with a median viral load (VL) of 57,062 copies/ml (range, 1,081 to 2,964,191). DBS were stored at ambient temperature for 2 or 4 weeks or frozen at -80 °C and shipped from Uganda to the United States at ambient temperature or frozen on dry ice for genotyping using a broadly sensitive in-house method. Plasma (97.1%) and DBS (98.1%) stored and shipped frozen had similar genotyping efficiencies. DBS stored frozen (97.1%) or at ambient temperature for 2 weeks (93.2%) and shipped at ambient temperature also had similar genotyping efficiencies. Genotyping efficiency was reduced for DBS stored at ambient temperature for 4 weeks (89.3%, P = 0.03) or prepared from finger-prick blood and stored at ambient temperature for 2 weeks (77.7%, P < 0.001) compared to DBS prepared from venous blood and handled similarly. Resistance profiles were similar between plasma and DBS specimens. This report delineates the optimal DBS collection, storage, and shipping conditions and opens a new avenue for cost-saving ambient-temperature DBS specimen shipments for HIV drug resistance (HIVDR) surveillances in resource-limited settings.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Undefined-1 ObjectType-Feature-3 content type line 23 ObjectType-Article-1 ObjectType-Feature-2 C.M.P., N.P., and K.D. contributed equally to this article.
ISSN:	0095-1137 1098-660X
DOI:	10.1128/JCM.00544-14