Cost and impact of dried blood spot versus plasma separation card for scale-up of viral load testing in resource limited settings

By  Brooke Nichols  Sarah Girdwood  Aaron Shibemba, Sharper Sikota, Christopher J Gill, Lawrence Mwananyanda, Lara Noble, Lynsey Stewart-Isherwood, Lesley Scott, Sergio Carmona  Sydney Rosen  Wendy Stevens  |  | 

Routine plasma viral load (VL) testing is the WHO-recommended method for monitoring HIV-infected patients on antiretroviral therapy (ART). In Zambia, VL scale-up is limited due to significant logistical obstacles around plasma specimen collection, storage, and transport to centralized laboratories. Dried blood spot (DBS) technology could circumvent many logistical challenges at the cost of reduced sensitivity and/or specificity. Recently, plasma separation cards (PSC) have become available and, though more expensive, have lower total misclassification than DBS. Adopting the partial use of dried specimens will help achieve improved VL access for patients at the lowest cost/correct result.

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Oxford University Press for the Clinical Infectious Diseases Society of America