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Updated: Sep 1, 2026
Dried Blood Spot Collection of Health Biomarkers to Maximize Participation in Population Studies
Published on: January 28, 2014
Validation of mailed via postal service dried blood spot cards on commercially available HIV testing systems
Tsunefusa Hayashida1, Misao Takano1, Kiyoto Tsuchiya1
1AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan.
Insights
Dried blood spot (DBS) testing offers a convenient method for HIV testing, even when mailed. This study validates DBS for HIV detection, showing high accuracy for screening purposes.
Area of Science:
- Virology
- Clinical Diagnostics
- Public Health
Background:
- Dried blood spot (DBS) samples are increasingly used for HIV testing.
- DBS is not yet an approved sample type for HIV diagnostics in Japan.
- Validation is needed to assess DBS performance for HIV detection.
Purpose of the Study:
- To validate HIV testing using dried blood spots (DBS).
- To assess the feasibility of using DBS prepared in the lab or mailed via postal service.
- To determine the diagnostic accuracy of DBS for HIV detection in Japan.
Main Methods:
- DBS samples were prepared and eluted in phosphate buffered saline.
- HIV testing was performed using the Lumipulse S HIVAg/Ab assay.
- The study included 50 HIV-positive and 50 HIV-negative individuals.
Main Results:
- DBS testing showed a sensitivity of 98% and a specificity of 100%.
- Storage time up to one month minimally impacted LUM counts.
- A single false negative result occurred in a patient with undetectable viral load.
Conclusions:
- DBS testing is a potentially valuable screening tool for HIV detection.
- DBS allows for self-collection and postal submission, increasing accessibility.
- While slightly less sensitive than plasma, DBS offers a viable alternative for remote HIV testing.
Abstract:
The demand for HIV testing using dried blood spots (DBS) has increased recently. However, DBS is not an approved sample for HIV testing in Japan. This study examined the validation of HIV testing with DBS, prepared at the laboratory or remotely and mailed via postal service to the laboratory. DBS were punched out from a 5.5 mm diameter circle on filter paper, then eluted with 600 μL of phosphate buffered saline overnight at 4℃, and analyzed by Lumipulse S HIVAg/Ab (LUM). The mean LUM count of DBS was 237.4-times diluted compared to titrated plasma. Repeated sample testing showed that although LUM count of DBS decreased slightly with increase in sample storage time (up to one month), it did not affect the result of HIV testing with DBS. Based on testing of 50 HIV+ confirmed cases and 50 HIV- persons, the estimated sensitivity was 98% (49/50) with a specificity of 100% when the cut-off value is 0.5. The single false negative case was a patient with undetectable viral load over the last 10 years, resulting in a decrease of antibody titer below the cut-off level. In conclusion, although DBS cannot completely replace plasma in HIV testing because the sensitivity was a little lower than that of plasma, it can be potentially useful for a screening test by self-finger-prick and postal service use. This will allow people to receive HIV testing without visiting public health centers.
