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dc.contributor.authorZhang, G.
dc.contributor.authorDeVos, J.
dc.contributor.authorMedina-Moreno, S.
dc.date.accessioned2019-06-21T18:46:25Z
dc.date.available2019-06-21T18:46:25Z
dc.date.issued2018
dc.identifier.urihttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85053143137&doi=10.1371%2fjournal.pone.0203296&partnerID=40&md5=144ea9054c860abc2b862180efa64ec0
dc.identifier.urihttp://hdl.handle.net/10713/9673
dc.description.abstractIntroduction Surveillance of HIV drug resistance (HIVDR) is crucial to ensuring the continued success of antiretroviral therapy (ART) programs. With the concern of reduced genotyping sensitivity of HIV on dried blood spots (DBS), DBS for HIVDR surveillance have been limited to ART-naïve populations. To investigate if DBS under certain conditions may also be a feasible sample type for HIVDR testing in ART patients, we piloted nationwide surveys for HIVDR among ART patients using DBS in two African countries with rapid scale-up of ART. Methods EDTA-venous blood was collected to prepare DBS from adult and pediatric ART patients receiving treatment during the previous 12-36 months. DBS were stored at ambient temperature for two weeks and then at -80C until shipment at ambient temperature to the WHO-designated Specialized HIVDR Laboratory at CDC in Atlanta. Viral load (VL) was determined using NucliSENS ® HIV-1 v2.0 kits; HIVDR genotyping was performed using the ATCC HIV-1 Drug Resistance Genotyping kits. Results DBS were collected from 1,368 and 1,202 ART patients; 244 and 255 these specimens had VL 1,000 copies/mL in Kenya and Tanzania, respectively. The overall genotyping rate of those DBS with VL 1,000 copies/mL was 93.0% (95% CI: 89.1%-95.6%) in Kenya and 91.8% (87.7%-94.6%) in Tanzania. The turnaround times for the HIVDR surveys from the time of collecting DBS to completing laboratory testing were 6.5 months and 9.3 months for the Kenya and Tanzania surveys, respectively. Conclusions The study demonstrates a favorable outcome of using DBS for nationwide surveillance of HIVDR in ART patients. Our results confirm that DBS collected and stored at ambient temperature for two weeks, and shipped with routine courier services are a reliable sample type for large-scale surveillance of acquired HIVDR. This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.en_US
dc.description.urihttps://dx.doi.org/10.1371/journal.pone.0203296en_US
dc.language.isoen-USen_US
dc.publisherPublic Library of Scienceen_US
dc.relation.ispartofPLoS ONE
dc.subject.meshDrug Resistanceen_US
dc.subject.meshDried Blood Spot Testing--methodsen_US
dc.subject.meshHIVen_US
dc.subject.meshNucliSENS EasyQ HIV-1 kiten_US
dc.titleUtilization of dried blood spot specimens can expedite nationwide surveillance of HIV drug resistance in resource-limited settingsen_US
dc.typeArticleen_US
dc.identifier.doi10.1371/journal.pone.0203296
dc.identifier.pmid30192818


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