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Diagnostics (Basel). 2019 Jul 30;9(3). pii: E86. doi: 10.3390/diagnostics9030086.

HIV Viral Load Estimation Using Hematocrit Corrected Dried Blood Spot Results on a BioMerieux NucliSENS® Platform.

Author information

1
National TB and HIV/AIDS Programme, Ministry of Health and Child Care, Harare P O Box CY1122 Causeway, 00263, Zimbabwe. nyagupecharles@gmail.com.
2
International Union against Tuberculosis and Lung Disease (The Union), 75006 Paris, France.
3
The Union South-East Asia, New Delhi 110016, India.
4
Karuna Trust, Bengaluru 560041, India.
5
Faculty of Medicine, Université de Parakou, Parakou BP:123, Benin.
6
National TB and HIV/AIDS Programme, Ministry of Health and Child Care, Harare P O Box CY1122 Causeway, 00263, Zimbabwe.
7
The Union Zimbabwe Office, Harare 00263, Zimbabwe.
8
Light-House Trust, Lilongwe 00265, Malawi.

Abstract

While reporting human immunodeficiency virus (HIV) viral load (VL) using dried blood spot (DBS) in the BioMerieux NucliSENS platform, application of the hematocrit correction factor has been suggested. In this cross-sectional study from the National Microbiology Reference Laboratory of Zimbabwe, we assessed whether hematocrit correction (individual and/or mean) in DBS results improved the correlation with plasma VL and prediction of VL non-suppression (≥1000 copies per ml in plasma). Of 517 specimens during August-December 2018, 65(12.6%) had non-suppressed plasma VL results. The hematocrit correction factor ranged from 1.3 to 2.0 with a mean of 1.6, standard deviation (SD: 1.5, 1.7). The intraclass correlation (ICC) for mean (0.859, 95% CI: 0.834, 0.880) and individual (0.809, 95% CI: 0.777, 0.837) hematocrit corrected DBS results were not significantly different. The uncorrected DBS results had a significantly lower ICC (0.640, 95% CI: 0.586, 0.688) when compared to corrected DBS results. There were no significant differences in validity, predictive values, and areas under the receiver operating characteristics curves for all three DBS results when predicting VL non-suppression. To conclude, hematocrit correction of DBS VL results improved agreement with the plasma results but did not improve prediction of VL non-suppression. The results were not significantly different for individual and mean corrected results.

KEYWORDS:

Antiretroviral therapy (ART) monitoring; dried blood spot; hematocrit; human immunodeficiency virus; viral load

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