We evaluated the performance of a 4th Ag/Ab generation assay at detecting HIV-1 infection on dried blood spots (DBS) both in a conventional laboratory environment and in an epidemiological survey corresponding to a real-life situation. Although a 2-log loss of sensitivity compared to plasma was observed when using DBS in an analytical analysis, the median delay of positivity between DBS and crude serum during the early phase post-acute infection was 7 days. The performance of the 4th generation assay on DBS was approximately similar to that of a 3rd generation (antibody only) assay using crude serum samples. Among 2646 participants of a cross-sectional study in a population of men having sex with men, 428 DBS were found reactive but 5 DBS provided a negative result although having been collected from individuals who self-reported a positive HIV status, confirmed by detection of antiretroviral (ARV) drugs in their DBS. The data generated allowed to estimate a sensitivity of 98.8% of the 4th generation assay/DBS strategy in a high risk population, even including a broad majority of individuals on ARV treatment among those HIV positive. Our study brings additional proofs that DBS testing using a 4th generation immunoassay is a reliable strategy able to provide alternative approaches for both individual HIV testing and surveillance of various populations.
Auteur : Stefic Karl, Guinard Jerome, Peytavin Gilles, Saboni Leïla, Sommen Cécile, Sauvage Claire, Lot Florence, Laperche Syria, Velter Annie, Barin Francis
Journal of Clinical Microbiology, 2019, vol. 58, n°. 1, p. 1-10
