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Updated: Aug 18, 2026
Dried Blood Spots - Preparing and Processing for Use in Immunoassays and in Molecular Techniques
Published on: March 13, 2015
Dried blood spots improve access to HIV diagnosis and care for infants in low-resource settings
Gayle G Sherman1, Gwynneth Stevens, Stephanie A Jones
1Department of Molecular Medicine and Haematology, National Health Laboratory Service and University of the Witwatersrand, Johannesburg, South Africa. gayle.sherman@nhls.ac.za
Insights
Dried blood spot testing offers accurate infant HIV diagnosis in low-resource settings. This approach enhances healthcare for HIV-exposed infants, improving access to crucial early detection services.
Area of Science:
- Virology
- Public Health
- Diagnostics
Background:
- Infant HIV diagnosis is crucial for effective healthcare delivery, especially in mother-to-child transmission prevention programs.
- Limited access to infant HIV testing hinders care for perinatally exposed infants globally.
- Dried blood spot (DBS) collection offers a viable alternative for HIV testing in resource-limited settings.
Purpose of the Study:
- To assess the accuracy of the Roche Amplicor HIV-1 DNA test (version 1.5) using dried blood spots for infant HIV diagnosis.
- To evaluate the feasibility of DBS collection and centralized PCR testing in a low-resource setting.
Main Methods:
- Prospective collection of dried blood spots from 300 infants born to HIV-infected mothers in Johannesburg, South Africa.
- Analysis of DBS using the Roche Amplicor HIV-1 DNA test in a routine diagnostic laboratory.
- Comparison of DBS results with HIV DNA/RNA PCR tests on liquid blood and infant HIV status.
Main Results:
- Dried blood spots were available for 288 infants (96%); 25 (8.7%) were HIV infected.
- The Roche Amplicor assay on DBS demonstrated high accuracy: 100% sensitivity and 99.6% specificity.
- The method proved effective for HIV diagnosis in a real-world, low-resource laboratory setting.
Conclusions:
- Dried blood spot HIV DNA PCR testing is a highly accurate and feasible method for infant diagnosis in low-resource settings.
- This approach has the potential to significantly improve healthcare delivery for HIV-affected children.
- Implementing DBS testing can enhance early detection and management of HIV in infants globally.
Abstract:
Effective health care delivery to the majority of perinatally exposed infants worldwide, including those enrolled in prevention of mother-to-child transmission programs, is hampered by lack of access to an HIV diagnosis in infancy. Dried blood spot collection from young infants for centralized HIV polymerase chain reaction (PCR) testing is attainable in low-resource settings, provided PCR methodology suitable for routine laboratory service is available. The accuracy of the Roche Amplicor HIV-1 DNA test version 1.5 (Branchburg, NJ) performed on dried blood spots collected prospectively on ordinary Whatman filter paper from a cohort of 300 6-week-old infants born to HIV-infected women in Johannesburg, South Africa, was assessed. Anonymous analysis of the blood spots using a unique DNA extraction procedure was performed in a routine diagnostic laboratory and the results compared with HIV DNA and RNA PCR liquid blood tests at age 6 weeks, and the HIV status of the infant. Dried blood spots were available for 288 infants (96%) of whom 25 (8.7%) were HIV infected. The Roche Amplicor assay yielded a sensitivity of 100% and a specificity of 99.6%. HIV DNA PCR tests on dried blood spots have the potential to improve health care delivery to HIV-affected children in low-resource settings right now.
