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. 2020 Apr 14;15(4):e0231385.
doi: 10.1371/journal.pone.0231385. eCollection 2020.

Dried blood spot self-sampling at home is a feasible technique for hepatitis C RNA detection

Tamara Prinsenberg  1   2 , Sjoerd Rebers  3 , Anders Boyd  1 , Freke Zuure  1 , Maria Prins  1   2 , Marc van der Valk  2 , Janke Schinkel  3
Affiliations

Dried blood spot self-sampling at home is a feasible technique for hepatitis C RNA detection

Tamara Prinsenberg et al. PLoS One. .

Abstract

To facilitate HCV diagnosis, we developed an HCV-RNA testing service, which involved home-sampled dried blood spots (DBS). The main objective of this study was to evaluate the feasibility of self-sampling at home. Furthermore, to optimise the processing of DBS samples for RNA detection, we evaluated two elution buffers: phosphate-buffered saline (PBS) and L6-buffer. 27 HCV-RNA and 12 HIV-1 RNA positive patients were included. Laboratory spotted DBS (LabDBS) were made by a technician from blood samples drawn at inclusion. Patients received a DBS home-sampling kit and were requested to return their self-sampled DBS (ssDBS) by mail. We compared the RNA load of PBS and L6-eluted labDBS, and of L6-eluted ssDBS, L6-eluted labDBS and plasma. LabDBS load measurements were repeated after 7-13 and 14-21 days to evaluate RNA stability. All 39 plasma samples provided quantifiable RNA loads. In 1/39 labDBS sample, RNA could not be detected (plasma HCV load: 2.98 log10 IU/ml). L6-eluted samples gave a 0.7 log10 and 0.6 log10 higher viral load for HCV and HIV-1 respectively, compared to PBS-eluted samples. Strong correlations were found between labDBS and ssDBS HCV RNA (r = 0.833; mean difference 0.3 log10 IU/mL) and HIV-1 RNA results (r = 0.857; mean difference 0.1 log10 copies/mL). Correlations between labDBS and plasma values were high for HCV (r = 0.958) and HIV-1 (r = 0.844). RNA loads in DBS remained stable over 21 days. Our study demonstrates that self-sampling dried blood spots at home is a feasible strategy for the detection of HCV and HIV-1 RNA. This could facilitate one-step diagnostics and treatment monitoring in communities with high HCV prevalence.

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Conflict of interest statement

I have read the journal's policy and the authors of this manuscript have the following competing interests:TP, FZ and MP report speaker fees and grants from: Gilead Sciences, MSD and AbbVie paid to their institute. AB reports grants from ANRS and SIDACTION, outside the submitted work. SR has no relevant conflicts of interest to report. MvdV’s institute received grants and speaker fees from: Abbvie, Gilead, Johnson & Johnson, MSD, ViiV, outside the submitted work. JS reports nonfinancial support from ROCHE Diagnostics, during the conduct of the study and grants from: Gilead Sciences, MSD, Abbvie, outside the submitted work. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Correlation between self-sampled dried blood spots (ssDBS) and lab-sampled dried blood spots (labDBS) viral load measurements.
Individual viral load measurements are plotted (gray dots). The solid line indicates the linear regression line between the two samples. (A) HCV loads. The linear relationship between the samples is defined as: log10 IU/mL labDBS HCV = 0.595 x (log10 IU/mL ssDBS) + 2.402. (B) HIV-1 loads. The linear relationship between the samples is defined as: log10 copies/mL labDBS HIV-1 = 0.833 x (log10 copies/mL ssDBS) +0.857.
Fig 2
Fig 2. Bland-Altman analysis comparing the labDBS and ssDBS viral load measurements to their mean.
The solid line in the middle represents the mean difference between labDBS (laboratory sampled dried blood spots) and ssDBS (self-sampled dried blood spots) viral loads, while the lower and upper lines are for the limits of agreement (± 2 standard deviations). (A)HCV loads: 2 values lie outside the limits of agreement; (B) HIV-1 loads: one value lies outside the limits of agreement.
Fig 3
Fig 3. Correlation between laboratory sampled dried blood spots (labDBS) and plasma viral load measurements.
Individual viral load measurements are plotted (gray dots). The solid line indicates the linear regression line between the two samples. (A) HCV loads. The linear relationship between the samples is defined as: log10 IU/mL plasma HCV = 1.119 x (log10 IU/mL labDBS) + 0.036. (B) HIV-1 loads. The linear relationship between the samples is defined as: log10 copies/mL plasma HIV-1 = 1.193 x (log10 copies/mL labDBS) - 0.738.
Fig 4
Fig 4. Correlation between viral load measurements of laboratory sampled DBS (labDBS) eluted in L6-buffer and PBS.
Individual viral load measurements are plotted (gray dots). The solid line indicates the linear regression line between the two samples. (A) HCV loads. The linear relationship between the samples is defined as: log10 IU/mL labDBS (PBS) = 0.978*log10 IU/mL labDBS (L6) –0.534. (B) HIV-1 loads. The linear relationship between the samples is defined as: log10 copies/mL labDBS (PBS) = 0.910*log10 copies/mL labDBS (L6)– 0.252. DBS (PBS) = DBS eluted in PBS, DBS (L6) = DBS eluted in L6.
Fig 5
Fig 5. Difference in viral load measurements between plasma and labDBS samples stored for up to 21 days.
Viral load measurements of labDBS are plotted over time (gray lines). The black dashed line represents the average difference over time. (A) HCV loads: The average change in difference over time is 0.002 log10 IU/mL (95% CI = -0.005, 0.009), p = 0.6. (B) HIV-1 loads: The average change in difference over time is 0.004 log10 copies/mL (95% CI = -0.018, 0.026), p = 0.7.
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References

    1. Grady BP, Vanhommerig JW, Schinkel J, Weegink CJ, Bruisten SM, Lindenburg CE, et al. Low incidence of reinfection with the hepatitis C virus following treatment in active drug users in Amsterdam. European journal of gastroenterology & hepatology. 2012;24(11):1302–7. - PubMed
    1. de Vos AS, van der Helm JJ, Matser A, Prins M, Kretzschmar ME. Decline in incidence of HIV and hepatitis C virus infection among injecting drug users in Amsterdam; evidence for harm reduction? Addiction (Abingdon, England). 2013;108(6):1070–81. - PubMed
    1. Slurink I, van Aar F, Op de Coul E, Heijne J, van Wees D, Hoenderboom B, et al. Sexually transmitted infections including HIV, in the Netherlands in 2018. Bilthoven: National Institute for Public Health and the Environment (RIVM) 2019. Report No.: 2019–0007.
    1. Hagan H, Jordan AE, Neurer J, Cleland CM. Incidence of sexually transmitted hepatitis C virus infection in HIV-positive men who have sex with men. AIDS (London, England). 2015;29(17):2335–45. - PMC - PubMed
    1. van de Laar TJ, Matthews GV, Prins M, Danta M. Acute hepatitis C in HIV-infected men who have sex with men: an emerging sexually transmitted infection. AIDS (London, England). 2010;24(12):1799–812. - PubMed

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