Combining rapid diagnostic tests and dried blood spot assays for point-of-care testing of human immunodeficiency virus, hepatitis B and hepatitis C infections in Burkina Faso, West Africa

People screened for human immunodeficiency virus (HIV) using rapid diagnostic tests (RDTs) in Africa remain generally unaware of their status for hepatitis B (HBV) and hepatitis C (HCV) infections. We evaluated atwo-step screening strategy in Burkina Faso, using both HIV RDTs and Dried Blood Spot (D...

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Published in:	Clinical microbiology and infection Vol. 19; no. 12; pp. E533 - E541
Main Authors:	Kania, D., Bekalé, A.M., Nagot, N., Mondain, A.-M., Ottomani, L., Meda, N., Traoré, M., Ouédraogo, J.B., Ducos, J., Van de Perre, P., Tuaillon, E.
Format:	Journal Article
Language:	English
Published:	England Elsevier Ltd 01-12-2013 Elsevier Limited
Subjects:	Africa AIDS Serodiagnosis Burkina Faso Cross-Sectional Studies dried blood spot Dried Blood Spot Testing - economics Enzyme-Linked Immunosorbent Assay Hepacivirus - immunology Hepatitis B - diagnosis Hepatitis B - immunology Hepatitis B Surface Antigens - blood Hepatitis B virus Hepatitis B virus - immunology Hepatitis C - diagnosis Hepatitis C - immunology Hepatitis C Antibodies - blood Hepatitis C virus HIV Infections - diagnosis HIV-1 - immunology Human immunodeficiency virus Humans Pilot Projects Point-of-Care Systems Poverty screening strategy Burkina Faso hepatitis C virus human immunodeficiency virus screening strategy dried blood spot hepatitis B virus Africa
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Summary:	People screened for human immunodeficiency virus (HIV) using rapid diagnostic tests (RDTs) in Africa remain generally unaware of their status for hepatitis B (HBV) and hepatitis C (HCV) infections. We evaluated atwo-step screening strategy in Burkina Faso, using both HIV RDTs and Dried Blood Spot (DBS) assays to confirm an HIV-positive test, and to test for HBV and HCV infections. HIV counselling and point-of-care testing were performed at a voluntary counselling and testing centre with HBV, HCV status and HIV confirmation using DBS specimens, being assessed at a central laboratory. Serological testing on plasma was used as the reference standard assay to control for the performance of DBS assays. Nineteen out of 218 participants included in the study were positive for HIV using RDTs. A fourth-generation HIV ELISA and immunoblot assays on DBS confirmed HIV status. Twenty-four out of 25 participants infected with HBV were found positive for hepatitis B surface antigen (HBsAg) using DBS. One sample with a low HBsAg concentration on plasma was not detected on DBS. Five participants tested positive for HCV antibodies were confirmed positive with an immunoblot assay using DBS specimens. Laboratory results were communicated within 7 days to participants with no loss to follow up of participants between the first and second post-test counselling sessions. In conclusion, DBS collection during HIV point-of-care testing enables screening and confirmation of HBV, HCV and HIV infections. Diagnosis using DBS may assist with implementation of national programmes for HBV, HCV and HIV screening and clinical care in middle- to low-income countries.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Article-2 ObjectType-Feature-1
ISSN:	1198-743X 1469-0691
DOI:	10.1111/1469-0691.12292