Related Experiment Video
Updated: Feb 20, 2026
Dried Blood Spots - Preparing and Processing for Use in Immunoassays and in Molecular Techniques
Published on: March 13, 2015
Community-based screening of hepatitis C with a one-step RNA detection algorithm from dried-blood spots: Analysis of
V Saludes1,2, C Folch2,3, A Morales-Carmona4
1Microbiology Service, Germans Trias i Pujol University Hospital, Germans Trias i Pujol Health Sciences Research Institute (IGTP), Badalona, Spain.
Insights
A new one-step strategy using dried blood spot testing for hepatitis C virus (HCV) RNA in at-risk populations showed good performance but did not detect silent infections. Continued monitoring is recommended.
Area of Science:
- Infectious Diseases
- Hepatology
- Public Health
Background:
- Silent hepatitis C virus (HCV) infections pose a diagnostic challenge in key populations.
- Limited bio-behavioral data exists for HIV-negative men who have sex with men (MSM) and sex workers regarding HCV.
- Alternative diagnostic strategies are needed for these at-risk groups.
Purpose of the Study:
- To describe and evaluate a community-based, one-step HCV screening and confirmation strategy.
- To assess HCV prevalence and collect bio-behavioral data in HIV-negative MSM and sex workers in Barcelona.
- To determine the benefits of a real-time RT-PCR assay for HCV-RNA in dried blood spots (DBS).
Main Methods:
- Validated a real-time RT-PCR assay for HCV-RNA detection in DBS.
- Implemented DBS testing alongside an antibody point-of-care test in a community setting.
- Collected HCV prevalence and bio-behavioral data from 580 participants.
Main Results:
- The molecular assay demonstrated high precision, reproducibility, sensitivity, and specificity.
- HCV prevalence was 0.75% among HIV-negative MSM; no silent HCV cases were diagnosed.
- High-risk sexual practices and drug use for sex were frequently reported, with HIV prevalence at 4.7% in MSM and 10% in sex workers.
Conclusions:
- HCV-RNA testing in DBS performed well, but the one-step strategy showed limited benefit in this specific setting.
- Despite no silent HCV infections detected, high-risk behaviors and STI prevalence underscore the need for ongoing monitoring.
- Periodic behavioral surveillance, rapid antibody testing, and molecular DBS confirmation are recommended for HCV surveillance in these populations.
Abstract:
Alternative strategies are required to enhance the diagnosis of silent hepatitis C virus (HCV) infections in key populations at risk. Among them, HCV prevalence and bio-behavioural data are scarce for HIV-negative men who have sex with men (MSM) and men and trans-women sex workers. We sought to describe and assess the potential benefits of a community-based one-step HCV screening and confirmatory strategy for these populations in Barcelona. The screening strategy based on a real-time RT-PCR assay for HCV-RNA detection in dried-blood spots (DBS) was validated and implemented in addition to an antibody point-of-care test in a community centre. HCV prevalence was assessed, and bio-behavioural data were collected. The molecular assay was precise, reproducible, sensitive and specific. Four HIV-negative MSM reported being currently infected (0.75% HCV self-reported prevalence). Implementation of DBS testing was easy, and acceptability was >95%, but no silent HCV case was diagnosed (N = 580). High-risk sexual practices and drug use for sex were reported frequently. HIV prevalence was 4.7% in MSM and 10% in sex workers. Self-reported prevalence of other STIs ranged from 11.3% to 36.2%. In conclusion, HCV-RNA testing in DBS showed a good performance, but the assessed one-step strategy does not seem beneficial in this setting. Although no silent HCV infections were detected, the observed high-risk behaviours and prevalence of other STIs suggest that HCV spread should be periodically monitored among these populations in Barcelona by means of behavioural surveillance, rapid antibody testing and molecular confirmation in DBS.
