ArticleJournal of clinical virology : the official publication of the Pan American Society for Clinical Virology2014
Measures of viral load using Abbott RealTime HIV-1 Assay on venous and fingerstick dried blood spots from provider-collected specimens in Malawian District Hospitals.
Article in Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 2 of them syntheses that pooled it.
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Who cites it
26 citing papers in PubMed, 2 syntheses or guidelines pooled it, 43 citations in OpenAlex.
- The performance of using dried blood spot specimens for HIV-1 viral load testing: A systematic review and meta-analysis.PLoS medicine · 2022Pooled it
- Pooled it
- Viral Suppression and HIV Drug Resistance at 6 Months Among Women in Malawi's Option B+ Program: Results From the PURE Malawi Study.Journal of acquired immune deficiency syndromes (1999) · 2017Trial
- Comparison of dried blood spot (DBS) and plasma HIV-1 viral load measurements using Roche COBAS AmpliPrep/COBAS TaqMan assay, Northwest Ethiopia.Virology journal · 2025Article
- Validity of dried blood spot testing for sexually transmitted and blood-borne infections: A narrative systematic review.PLOS global public health · 2024Article
- The plasma separation card as a novel solution for enhancing central laboratory capability for HIV-1 viral load monitoring in limited-access settings.PLOS global public health · 2023Article
- HIV suppression was maintained during the COVID-19 pandemic in Malawi: a program-level cohort study.Journal of clinical epidemiology · 2022Article
- The feasibility of modified HIV and antiretroviral drug testing using self-collected dried blood spots from men who have sex with men.BMC infectious diseases · 2021Article
- Field evaluation of HIV-1 viral load monitoring in adults and children receiving antiretroviral treatment in Nigeria by dried blood spot testing with RealTime HIV-1 on m2000.Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology · 2021Article
- Performance evaluation of the Aptima HIV-1 RNA Quant assay on the Panther system using the standard and dilution protocols.Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology · 2020Article
- HIV RNA measurement in dried blood spots of HIV-infected patients in Thailand using Abbott m2000 system.PloS one · 2020Article
- Comparison of Alere q whole blood viral load with DBS and plasma viral load in the classification of HIV virological failure.PloS one · 2020Article
- Observational
- Clinical Consequences of Using an Indeterminate Range for Early Infant Diagnosis of HIV: A Decision Model.Journal of acquired immune deficiency syndromes (1999) · 2019Article
- Point-of-care device to diagnose and monitor neonatal jaundice in low-resource settings.Proceedings of the National Academy of Sciences of the United States of America · 2017Article
- Effects of schistosomiasis on susceptibility to HIV-1 infection and HIV-1 viral load at HIV-1 seroconversion: A nested case-control study.PLoS neglected tropical diseases · 2017Article
- The association between substance use and sub-optimal HIV treatment engagement among HIV-infected female sex workers in Lilongwe, Malawi.AIDS care · 2017Article
- Article
- Article
- Differentiated Care Pathways for Antiretroviral Therapy Monitoring in Malawi: Expanding Viral Load Testing in Setting of Highly Prevalent Resistance.Open forum infectious diseases · 2017Article
Corrections and comments
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Authors and funding
13 authors at 5 institutions in 2 countries.
Funding
Abstract
backgroundViral suppression is a key indicator of antiretroviral therapy (ART) response among HIV-infected patients. Dried blood spots (DBS) are an appealing alternative to conventional plasma-based virologic testing, improving access to monitoring in resource-limited settings. However, validity of DBS obtained from fingerstick in field settings remains unknown.
objectivesInvestigate feasibility and accuracy of DBS vs plasma collected by healthcare workers in real-world settings of remote hospitals in Malawi. Compare venous DBS to fingerstick DBS for identifying treatment failure. STUDY
designWe recruited patients from ART clinics at two district hospitals in Malawi, collecting plasma, venous DBS (vDBS), and fingerstick DBS (fsDBS) cards for the first 149 patients, and vDBS and fsDBS only for the subsequent 398 patients. Specimens were tested using Abbott RealTime HIV-1 Assay (lower detection limit 40 copies/ml (plasma) and 550 copies/ml (DBS)).
results21/149 (14.1%) had detectable viremia (>1.6 log copies/ml), 13 of which were detectable for plasma, vDBS, and fsDBS. Linear regression demonstrated high correlation for plasma vs. DBS (vDBS: β=1.19, R(2)=0.93 (p<0.0001); fsDBS β=1.20, R(2)=0.90 (p<0.0001)) and vDBS vs. fsDBS (β=0.88, R(2)=0.73, (p<0.0001)). Mean difference between plasma and vDBS was 1.1 log copies/ml [SD: 0.27] and plasma and fsDBS 1.1 log copies/ml [SD: 0.31]. At 5000 copies/ml, sensitivity was 100%, and specificity was 98.6% and 97.8% for vDBS and fsDBS, respectively, compared to plasma.
conclusionsDBS from venipuncture and fingerstick perform well at the failure threshold of 5000 copies/ml. Fingerstick specimen source may improve access to virologic treatment monitoring in resource-limited settings given task-shifting in high-volume, low-resource facilities.
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