Comparison of cross-sectional HIV incidence assay results from dried blood spots and plasma.

BACKGROUND:Assays have been developed for cross-sectional HIV incidence estimation using plasma samples. Large scale surveillance programs are planned using dried blood spot (DBS) specimens for incidence assessment. However, limited information exists on the performance of HIV cross-sectional incide...

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Main Authors: Katherine E Schlusser, Christopher Pilcher, Esper G Kallas, Breno R Santos, Steven G Deeks, Shelley Facente, Sheila M Keating, Michael P Busch, Gary Murphy, Alex Welte, Thomas Quinn, Susan H Eshleman, Oliver Laeyendecker
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2017-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC5322916?pdf=render
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author Katherine E Schlusser
Christopher Pilcher
Esper G Kallas
Breno R Santos
Steven G Deeks
Shelley Facente
Sheila M Keating
Michael P Busch
Gary Murphy
Alex Welte
Thomas Quinn
Susan H Eshleman
Oliver Laeyendecker
author_facet Katherine E Schlusser
Christopher Pilcher
Esper G Kallas
Breno R Santos
Steven G Deeks
Shelley Facente
Sheila M Keating
Michael P Busch
Gary Murphy
Alex Welte
Thomas Quinn
Susan H Eshleman
Oliver Laeyendecker
author_sort Katherine E Schlusser
collection DOAJ
description BACKGROUND:Assays have been developed for cross-sectional HIV incidence estimation using plasma samples. Large scale surveillance programs are planned using dried blood spot (DBS) specimens for incidence assessment. However, limited information exists on the performance of HIV cross-sectional incidence assays using DBS. METHODS:The assays evaluated were: Maxim HIV-1 Limiting Antigen Avidity EIA (LAg-Avidity), Sedia HIV-1 BED-Capture EIA (BED-CEIA), and CDC modified BioRad HIV-1/2 Plus O Avidity-based Assay (CDC-BioRad Avidity) using pre-determined cutoff values. 100 matched HIV-1 positive plasma and DBS samples, with known duration of infection, from the Consortium for the Evaluation and Performance of HIV Incidence Assays repository were tested. All assays were run in duplicate. To examine the degree of variability within and between results for each sample type, both categorical and continuous results were analyzed. Associations were assessed with Bland Altman, R2 values and Cohen's kappa coefficient (ĸ). RESULTS:Intra-assay variability using the same sample type was similar for all assays (R2 0.96 to 1.00). The R2 values comparing DBS and plasma results for LAg-Avidity, BED-CEIA, and CDC-BioRad Avidity were 0.96, 0.94, and 0.84, respectively. The concordance and ĸ values between DBS and plasma for all three assays were >87% and >0.64, respectively. The Bland-Altman analysis showed significant differences between plasma and DBS samples. For all three assays, a higher number of samples were classified as recent infections using DBS samples. CONCLUSIONS:DBS and plasma sample results were highly correlated. However, when compared to plasma, each assay performed somewhat differently in DBS at the lower and higher ends of the dynamic range. DBS samples were more likely to be classified as recently infected by all three assays, which may lead to overestimation of incidence in surveys using performance criteria derived for plasma samples.
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spelling doaj.art-c8d8837d099f42939e6108262bf7bd6c2022-12-21T23:52:46ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01122e017228310.1371/journal.pone.0172283Comparison of cross-sectional HIV incidence assay results from dried blood spots and plasma.Katherine E SchlusserChristopher PilcherEsper G KallasBreno R SantosSteven G DeeksShelley FacenteSheila M KeatingMichael P BuschGary MurphyAlex WelteThomas QuinnSusan H EshlemanOliver LaeyendeckerBACKGROUND:Assays have been developed for cross-sectional HIV incidence estimation using plasma samples. Large scale surveillance programs are planned using dried blood spot (DBS) specimens for incidence assessment. However, limited information exists on the performance of HIV cross-sectional incidence assays using DBS. METHODS:The assays evaluated were: Maxim HIV-1 Limiting Antigen Avidity EIA (LAg-Avidity), Sedia HIV-1 BED-Capture EIA (BED-CEIA), and CDC modified BioRad HIV-1/2 Plus O Avidity-based Assay (CDC-BioRad Avidity) using pre-determined cutoff values. 100 matched HIV-1 positive plasma and DBS samples, with known duration of infection, from the Consortium for the Evaluation and Performance of HIV Incidence Assays repository were tested. All assays were run in duplicate. To examine the degree of variability within and between results for each sample type, both categorical and continuous results were analyzed. Associations were assessed with Bland Altman, R2 values and Cohen's kappa coefficient (ĸ). RESULTS:Intra-assay variability using the same sample type was similar for all assays (R2 0.96 to 1.00). The R2 values comparing DBS and plasma results for LAg-Avidity, BED-CEIA, and CDC-BioRad Avidity were 0.96, 0.94, and 0.84, respectively. The concordance and ĸ values between DBS and plasma for all three assays were >87% and >0.64, respectively. The Bland-Altman analysis showed significant differences between plasma and DBS samples. For all three assays, a higher number of samples were classified as recent infections using DBS samples. CONCLUSIONS:DBS and plasma sample results were highly correlated. However, when compared to plasma, each assay performed somewhat differently in DBS at the lower and higher ends of the dynamic range. DBS samples were more likely to be classified as recently infected by all three assays, which may lead to overestimation of incidence in surveys using performance criteria derived for plasma samples.http://europepmc.org/articles/PMC5322916?pdf=render
spellingShingle Katherine E Schlusser
Christopher Pilcher
Esper G Kallas
Breno R Santos
Steven G Deeks
Shelley Facente
Sheila M Keating
Michael P Busch
Gary Murphy
Alex Welte
Thomas Quinn
Susan H Eshleman
Oliver Laeyendecker
Comparison of cross-sectional HIV incidence assay results from dried blood spots and plasma.
PLoS ONE
title Comparison of cross-sectional HIV incidence assay results from dried blood spots and plasma.
title_full Comparison of cross-sectional HIV incidence assay results from dried blood spots and plasma.
title_fullStr Comparison of cross-sectional HIV incidence assay results from dried blood spots and plasma.
title_full_unstemmed Comparison of cross-sectional HIV incidence assay results from dried blood spots and plasma.
title_short Comparison of cross-sectional HIV incidence assay results from dried blood spots and plasma.
title_sort comparison of cross sectional hiv incidence assay results from dried blood spots and plasma
url http://europepmc.org/articles/PMC5322916?pdf=render
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