The plasma separation card as a novel solution for enhancing central laboratory capability for HIV-1 viral load monitoring in limited-access settings.

Measurement of HIV-1 viral load (VL) is essential for monitoring antiretroviral treatment (ART) efficacy. The preferred specimen type for VL is plasma, but in remote settings where collection and preservation of plasma many not be possible, dried blood spots (DBS) are often used instead. A new speci...

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Main Authors: Charles Kiyaga, Caroline Makoha, Ivan Nkugwa, Christopher Okiira, Richard Okwir, Sirak Zenebe Gebreab, Patricia Rodriguez-Ventosa Suarez, Benjamin LaBrot, Ana Carrasco Durán
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2023-01-01
Series:PLOS Global Public Health
Online Access:https://doi.org/10.1371/journal.pgph.0002099
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author Charles Kiyaga
Caroline Makoha
Ivan Nkugwa
Christopher Okiira
Richard Okwir
Sirak Zenebe Gebreab
Patricia Rodriguez-Ventosa Suarez
Benjamin LaBrot
Ana Carrasco Durán
author_facet Charles Kiyaga
Caroline Makoha
Ivan Nkugwa
Christopher Okiira
Richard Okwir
Sirak Zenebe Gebreab
Patricia Rodriguez-Ventosa Suarez
Benjamin LaBrot
Ana Carrasco Durán
author_sort Charles Kiyaga
collection DOAJ
description Measurement of HIV-1 viral load (VL) is essential for monitoring antiretroviral treatment (ART) efficacy. The preferred specimen type for VL is plasma, but in remote settings where collection and preservation of plasma many not be possible, dried blood spots (DBS) are often used instead. A new specimen collection matrix, the cobas plasma separation card (PSC, Roche Diagnostics Solutions), enables specimen preparation from a finger prick or venous blood, using a multi-layer absorption and filtration design that results in a specimen similar to dried plasma. We sought to confirm the correlation between VL results obtained using PSC prepared from venous blood to those from plasma or DBS, as well as PSC prepared with capillary blood from a finger prick. PSC, DBS and plasma were prepared with blood from HIV-1 infected persons attending a primary care clinic in Kampala, Uganda. VL in PSC and plasma was measured using cobas HIV-1 (Roche Diagnostics), while VL in DBS was measured with RealTime HIV-1 (Abbott Diagnostics). The correlation between VL from plasma and PSC made from capillary or venous blood was high (regression coefficient of determination r2 between 0.87 and 0.91), and there was good agreement based on mean bias (-0.14 to 0.24 log10 copies/mL) and classification of VL above or below 1000 copies/mL (91.4% agreement). In contrast, VL from DBS was lower than plasma or PSC (mean bias 0.51 to 0.63 log10 copies/mL) and not as well correlated (r2 0.78 to 0.81, 75.1-80.5% agreement). These results confirm the utility of PSC as an alternative specimen type for HIV-1 viral load measurement in areas where preparation and optimal storage or shipment of plasma is an obstacle to provision of treatment and care of HIV-1 infected people.
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spelling doaj.art-04f12281a401436ab29e6bd8601e75c72023-09-03T12:25:15ZengPublic Library of Science (PLoS)PLOS Global Public Health2767-33752023-01-0136e000209910.1371/journal.pgph.0002099The plasma separation card as a novel solution for enhancing central laboratory capability for HIV-1 viral load monitoring in limited-access settings.Charles KiyagaCaroline MakohaIvan NkugwaChristopher OkiiraRichard OkwirSirak Zenebe GebreabPatricia Rodriguez-Ventosa SuarezBenjamin LaBrotAna Carrasco DuránMeasurement of HIV-1 viral load (VL) is essential for monitoring antiretroviral treatment (ART) efficacy. The preferred specimen type for VL is plasma, but in remote settings where collection and preservation of plasma many not be possible, dried blood spots (DBS) are often used instead. A new specimen collection matrix, the cobas plasma separation card (PSC, Roche Diagnostics Solutions), enables specimen preparation from a finger prick or venous blood, using a multi-layer absorption and filtration design that results in a specimen similar to dried plasma. We sought to confirm the correlation between VL results obtained using PSC prepared from venous blood to those from plasma or DBS, as well as PSC prepared with capillary blood from a finger prick. PSC, DBS and plasma were prepared with blood from HIV-1 infected persons attending a primary care clinic in Kampala, Uganda. VL in PSC and plasma was measured using cobas HIV-1 (Roche Diagnostics), while VL in DBS was measured with RealTime HIV-1 (Abbott Diagnostics). The correlation between VL from plasma and PSC made from capillary or venous blood was high (regression coefficient of determination r2 between 0.87 and 0.91), and there was good agreement based on mean bias (-0.14 to 0.24 log10 copies/mL) and classification of VL above or below 1000 copies/mL (91.4% agreement). In contrast, VL from DBS was lower than plasma or PSC (mean bias 0.51 to 0.63 log10 copies/mL) and not as well correlated (r2 0.78 to 0.81, 75.1-80.5% agreement). These results confirm the utility of PSC as an alternative specimen type for HIV-1 viral load measurement in areas where preparation and optimal storage or shipment of plasma is an obstacle to provision of treatment and care of HIV-1 infected people.https://doi.org/10.1371/journal.pgph.0002099
spellingShingle Charles Kiyaga
Caroline Makoha
Ivan Nkugwa
Christopher Okiira
Richard Okwir
Sirak Zenebe Gebreab
Patricia Rodriguez-Ventosa Suarez
Benjamin LaBrot
Ana Carrasco Durán
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
title The plasma separation card as a novel solution for enhancing central laboratory capability for HIV-1 viral load monitoring in limited-access settings.
title_full The plasma separation card as a novel solution for enhancing central laboratory capability for HIV-1 viral load monitoring in limited-access settings.
title_fullStr The plasma separation card as a novel solution for enhancing central laboratory capability for HIV-1 viral load monitoring in limited-access settings.
title_full_unstemmed The plasma separation card as a novel solution for enhancing central laboratory capability for HIV-1 viral load monitoring in limited-access settings.
title_short The plasma separation card as a novel solution for enhancing central laboratory capability for HIV-1 viral load monitoring in limited-access settings.
title_sort plasma separation card as a novel solution for enhancing central laboratory capability for hiv 1 viral load monitoring in limited access settings
url https://doi.org/10.1371/journal.pgph.0002099
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