Detecting Antibodies to Hepatitis C in Injecting Drug Users: A Comparative Study Between Saliva, Serum, and Dried Blood Spot Tests

Addictive Disorders & Their Treatment , 06/01/2012

Testing for hepatitis C viral (HCV) infection using saliva although feasible has lower sensitivity and lower specificity compared with blood samples including dried blood spot (DBS). This study introduced the DBS to screen for HCV in clinical settings. The use of DBS removes a key obstacle for testing for HCV and is recommended for routine use in health settings and for large–scale community–based surveys of the prevalence and incidence of HCV in drug users.

Methods

  • IDUs attending drug services were screened for HCV antibodies using saliva or blood including DBS.

Results

  • There was poor acceptability of a routine blood test for HCV.
  • Introducing the DBS was associated with a 4.6-fold increase in HCV testing.
  • A total of 241 unique patients provided 323 DBS and/or saliva samples.
  • The prevalence of HCV antibodies ranged from 19.7% to 52.9% (mean 26.8%) in IDUs.
  • The prevalence of HCV infection detected by saliva was 28.5% compared with 27.6% detected by blood (DBS).
  • In 51 IDUs who were HCV seronegative and were tested for a second time by DBS, 4 were antibody positive indicating an incidence of 8 per 100 person-years.

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