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Improving estimates of HIV-1 seroprevalence among childbearing women: Use of smaller blood spots

Author

Listed:
  • Hoxie, N.J.
  • Vergeront, J.M.
  • Pfister, J.R.
  • Hoffman, G.L.
  • Markwardt-Elmer, P.A.
  • Davis, J.P.

Abstract

Objectives. Nationwide, human immunodeficiency virus type 1 (HIV-1) seroprevalence surveys using dried neonatal blood specimens are critical to estimating HIV-1 seroprevalence among childbearing women. However, the noninclusion of blood specimens deemed 'quantity not sufficient' (QNS) for HIV-1 antibody testing potentially introduces bias. In Wisconsin beginning in 1990, we modified the survey protocol to reduce QNS rates and assess bias introduced by QNS specimens. Methods. The HIV-1 antibody assay was modified to use four 1/8-in blood spots when a single 1/4 -in blood spot could not be obtained. Both methods obtain identical blood volumes for testing. Results. During a 27-month period, 7396 (4.8%) of 154 683 specimens were deemed QNS using 1/4 -in blood spots. Of these, 6590 (89%) were of sufficient quantity to be tested using four 1/8-in blood spots; 6 (0.09%) specimens tested with 1/8- in blood spots were HIV-1 Western blot assay positive compared with 44 (0.03%) of 147 287 1/4 -in specimens (odds ratio = 3.0; 95% confidence interval = 1.2, 7.4). Conclusions. Because noninclusion of QNS specimens potentially introduces bias, incorporating the results of HIV-1 antibody testing of QNS specimens using four 1/8-in blood spots can improve the accuracy of HIV-1 seroprevalence estimates in these serologic surveys.

Suggested Citation

  • Hoxie, N.J. & Vergeront, J.M. & Pfister, J.R. & Hoffman, G.L. & Markwardt-Elmer, P.A. & Davis, J.P., 1992. "Improving estimates of HIV-1 seroprevalence among childbearing women: Use of smaller blood spots," American Journal of Public Health, American Public Health Association, vol. 82(10), pages 1370-1373.
    • Handle: RePEc:aph:ajpbhl:1992:82:10:1370-1373_1
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