Author information
1 Toronto Centre for Liver Disease, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON M5G 2C4, Canada. mia.biondi@mail.mcgill.ca.
2 Viral Hepatitis Care Network (VIRCAN) Study Group, Toronto Centre for Liver Disease, Toronto, ON M5G 2C4 Canada. mia.biondi@mail.mcgill.ca.
3 Arthur Labatt Family School of Nursing, Western University, London, ON N6A 3K7, Canada. mia.biondi@mail.mcgill.ca.
4 Toronto Centre for Liver Disease, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON M5G 2C4, Canada. m.vantilborg@erasmusmc.nl.
5 Gastroenterology and Hepatology, Erasmus MC University Medical Center Rotterdam, Rotterdam 3015 GD, The Netherlands. m.vantilborg@erasmusmc.nl.
6 Toronto Centre for Liver Disease, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON M5G 2C4, Canada. david@vircan.ca.
7 Viral Hepatitis Care Network (VIRCAN) Study Group, Toronto Centre for Liver Disease, Toronto, ON M5G 2C4 Canada. david@vircan.ca.
8 Toronto Centre for Liver Disease, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON M5G 2C4, Canada. gregory.heymann@mail.utoronto.ca.
9 Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada. aaquino@mtsinai.on.ca.
10 Public Health Ontario Laboratories, Toronto, ON M5G 1M1, Canada. stephen.perusini@oahpp.ca.
11 Toronto Centre for Liver Disease, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON M5G 2C4, Canada. erin.mandel@uhnresearch.ca.
12 Viral Hepatitis Care Network (VIRCAN) Study Group, Toronto Centre for Liver Disease, Toronto, ON M5G 2C4 Canada. erin.mandel@uhnresearch.ca.
13 Department of Microbiology, Sunnybrook Health Sciences, Toronto, ON M4N 3M5, Canada. rob.kozak@sunnybrook.ca.
14 Toronto Centre for Liver Disease, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON M5G 2C4, Canada. vera.a.ch@gmail.com.
15 Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada. matt.kowgier@gmail.com.
16 Toronto Centre for Liver Disease, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON M5G 2C4, Canada. bettina.hansen@utoronto.ca.
17 Viral Hepatitis Care Network (VIRCAN) Study Group, Toronto Centre for Liver Disease, Toronto, ON M5G 2C4 Canada. bettina.hansen@utoronto.ca.
18 Public Health Ontario Laboratories, Toronto, ON M5G 1M1, Canada. lee.goneau@gmail.com.
19 Toronto Centre for Liver Disease, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON M5G 2C4, Canada.
20 Viral Hepatitis Care Network (VIRCAN) Study Group, Toronto Centre for Liver Disease, Toronto, ON M5G 2C4 Canada.
21 Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada. tony.mazzulli@sinaihealthsystem.ca.
22 Public Health Ontario Laboratories, Toronto, ON M5G 1M1, Canada. tony.mazzulli@sinaihealthsystem.ca.
23 Abbott Molecular, Des Plaines, IL 60018, USA. gavin.cloherty@abbott.com.
24 Gastroenterology and Hepatology, Erasmus MC University Medical Center Rotterdam, Rotterdam 3015 GD, The Netherlands. r.deknegt@erasmusmc.nl.
25 Toronto Centre for Liver Disease, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON M5G 2C4, Canada. jordan.feld@uhn.ca.
26 Viral Hepatitis Care Network (VIRCAN) Study Group, Toronto Centre for Liver Disease, Toronto, ON M5G 2C4 Canada. jordan.feld@uhn.ca.
27 Institute of Medical Sciences, University of Toronto, Toronto, ON M5S 1A8, Canada. jordan.feld@uhn.ca.
Abstract
In order to expand hepatitis C virus (HCV) screening, a change in the diagnostic paradigm is warranted to improve accessibility and decrease costs, such as utilizing dried blood spot (DBS) collection. In our study, blood from 68 patients with chronic HCV infection was spotted onto DBS cards and stored at the following temperatures for one week: -80 °C, 4 °C, 21 °C, 37 °C, and alternating 37 °C and 4 °C; to assess whether temperature change during transportation would affect sensitivity. Sample was eluted from the DBS cards and tested for HCV antibodies (HCV-Ab) and HCV core antigen (core-Ag). HCV-Abs were detected from 68/68 DBS samples at -80 °C, 4 °C, 21 °C, and 67/68 at 37 °C and alternating 37 °C and 4 °C. Sensitivity of core-Ag was as follows: 94% (-80 °C), 94% (4 °C), 91% (21 °C), 93% (37 °C), and 93% (37 °C/4 °C). Not only did temperature not greatly affect sensitivity, but sensitivities are higher than previously reported, and support the use of this assay as an alternative to HCV RNA. We then completed a head-to-head comparison (n = 49) of venous versus capillary samples, and one versus two DBS. No difference in core-Ag sensitivity was observed by sample type, but there was an improvement when using two spots. We conclude that HCV-Abs and core-Ag testing from DBS cards has high diagnostic accuracy and could be considered as an alternative to HCV RNA in certain settings.