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Pooled HIV-1 Viral Load Testing Using Dried Blood Spots to Reduce the Cost of Monitoring Antiretroviral Treatment in a Resource-Limited Setting

Pannus, Pieter MSc*; Fajardo, Emmanuel BSc*; Metcalf, Carol MBChB, MPH*; Coulborn, Rebecca M. MPH; Durán, Laura T. MBChB; Bygrave, Helen MA, MBChB*; Ellman, Tom BSc, MBChB, MSc*; Garone, Daniela MBChB, BSc (ID); Murowa, Michael MBBS; Mwenda, Reuben MSc§; Reid, Tony MD; Preiser, Wolfgang MD, PhD

JAIDS Journal of Acquired Immune Deficiency Syndromes: October 1st, 2013 - Volume 64 - Issue 2 - p 134–137
doi: 10.1097/QAI.0b013e3182a61e63
Rapid Communication

Abstract: Rollout of routine HIV-1 viral load monitoring is hampered by high costs and logistical difficulties associated with sample collection and transport. New strategies are needed to overcome these constraints. Dried blood spots from finger pricks have been shown to be more practical than the use of plasma specimens, and pooling strategies using plasma specimens have been demonstrated to be an efficient method to reduce costs. This study found that combination of finger-prick dried blood spots and a pooling strategy is a feasible and efficient option to reduce costs, while maintaining accuracy in the context of a district hospital in Malawi.

*Médecins Sans Frontières, Southern Africa Medical Unit, Cape Town, South Africa;

Médecins Sans Frontières, Thyolo, Malawi;

Ministry of Health, Health Technical Support Services, Diagnostics, District Management Office, Thyolo, Malawi;

§Ministry of Health, Lilongwe, Malawi;

Médecins Sans Frontières, Operational Research Unit, Brussels, Belgium; and

Division of Medical Virology, Stellenbosch University, and National Health Laboratory Service, Tygerberg, South Africa.

Correspondence to: Emmanuel Fajardo, BSc, Médecins Sans Frontières, Southern Africa Medical Unit, Cape Town, Mowbray, 7925, Wyecroft Road, South Africa (e-mail: emmanuel.fajardo@joburg.msf.org).

Supported by Médecins Sans Frontières, Brussels Operational Centre.

Presented as Poster 612 at 20th Conference on Retroviruses and Opportunistic Infections March 3–6, 2013, Atlanta, GA.

The authors have no conflicts of interest to disclose.

This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivitives 3.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially. http://creativecommons.org/licenses/by-nc-nd/3.0.

Unauthorized reproduction of this article is prohibited. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially.

Received May 03, 2013

Accepted July 22, 2013

© 2013 by Lippincott Williams & Wilkins