The feasibility of modified HIV and antiretroviral drug testing using self-collected dried blood spots from men who have sex with men

Abstract

Background In the US, one in six men who have sex with men (MSM) with HIV are unaware of their HIV infection. In certain circumstances, access to HIV testing and viral load (VL) monitoring is challenging. The objective of this study was to evaluate the feasibility of conducting laboratory-based HIV and antiretroviral (ARV) drug testing, and VL monitoring as part of two studies on self-collected dried blood spots (DBS). Methods Participants were instructed to collect DBS by self-fingerstick in studies that enrolled MSM online. DBS from the first study (N = 1444) were tested with HIV serological assays approved by the Food and Drug Administration (FDA). A subset was further tested with laboratory-modified serological and VL assays, and ARV levels were measured by mass spectrometry. DBS from the second study (N = 74) were only tested to assess VL monitoring. Results In the first study, the mail back rate of self-collected DBS cards was 62.9%. Ninety percent of DBS cards were received at the laboratory within 2 weeks from the day of collection, and 98% of the cards had sufficient spots for one assay. Concordance between FDA-approved and laboratory-modified protocols was high. The samples with undetectable ARV had higher VL than samples with at least one ARV drug. In the second study, 70.3% participants returned self-collected DBS cards, and all had sufficient spots for VL assay. High VL was observed in samples from participants who reported low ARV adherence. Conclusions In these studies, MSM were able to collect and provide adequate DBS for HIV testing. The FDA-approved and laboratory-modified testing algorithms performed similarly. DBS collected at home may be feasible for HIV testing, ARV measurement, and monitoring viral suppression.

Use of Self-Collected Dried Blood Spots and a Multiplex Microsphere Immunoassay to Measure IgG Antibody Response to COVID-19 Vaccines

“…Therefore, this high rate of success in DBS collection may not occur in the general population. Similar studies using at-home self-collected DBS reported lower return rates than this study ( 10 , 14 – 16 ) but the proportion of samples that were unsuitable for testing upon arriving at the lab were comparable ( 14 – 16 ). It is of note that while our study demonstrates an effective use of self-collected DBS as a sample type, rather than more invasive and labor-intensive plasma and serum samples, the test still requires trained laboratory staff, specialized equipment, and time to perform.…”

I was like sh*t this is gonna hurt’: Implementing Self-Sampling of Dried Blood Spots to Measure HIV Viral Load

“…Self-sampling devices for dried blood spots (DBS) are feasible in this population such that participants describe this approach as convenient because it eliminates the need for in-person venipuncture (8,9). In fact, self-sampling of DBS for laboratory-based VL testing is a medically effective measure to reduce AIDS-related mortality in Africa, and has contributed to the surveillance of HIV drug resistance (10)(11)(12). Although it has the potential to optimize HIV treatment as prevention, further research is needed to optimize procedures for implementing self-sampling of DBS in high priority populations with HIV such as people who use stimulants.…”