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Dried Blood Spot (DBS) Testing

The Bloodborne Viruses Laboratory provides HIV rapid test confirmation on dried blood spot (DBS) specimens.  DBS submitted for HIV rapid test confirmation will be tested using an FDA approved HIV-1 Western blot.  For DBS with a negative or indeterminate HIV-1 Western blot result an HIV-1 RNA Qualitative assay may be performed as an additional supplemental test.  This service is available for HIV rapid testing sites that are unable to collect blood by venipuncture. 

GS HIV-1 Western blot (Bio-Rad): The GS HIV-1 Western blot is a qualitative assay for the detection of HIV-1 antibodies in human serum, plasma and dried blood spots.  The Western blot detects IgG antibodies produced against specific HIV-1 proteins.  Although the Western blot is no longer recommended for HIV confirmation of serum and plasma specimens, it is useful to confirm HIV-1 antibodies in dried blood spot specimens.  A positive HIV-1 Western blot confirms HIV-1 infection. 

HIV-1 RNA qualitative assay (modified FDA-approved test):  For DBS in which the HIV-1 Western blot result is negative or indeterminate, the Bloodborne Viruses Laboratory (BVL) may perform an HIV-1 qualitative RNA assay as an additional supplemental test. This assay utilizes an FDA-approved HIV-1 RNA qualitative assay kit under a modified protocol for detecting HIV-1 RNA in DBS specimens. This assay has been validated by the BVL and was approved by NYSDOH Clinical Laboratory Evaluation Program for clinical use*.  HIV-1 infection is confirmed when HIV-1 RNA is detected in a specimen following a reactive screening test.  If HIV-1 RNA is not detected in the DBS, we strongly recommend submission of a blood specimen collected by venipuncture to allow additional and more sensitive diagnostic tests to be performed.  

*The HIV-1 RNA qualitative assay has a limit of detection of 5000 copies/mL for DBS specimens.  The FDA-approved HIV-1 RNA qualitative assay has a limit of detection of 30 copies/mL for plasma and serum specimens. 

New York State HIV rapid testing sites that need access to DBS confirmatory testing services should contact Thomas Sullivan at the NYSDOH AIDS Institute to register for this service and to obtain training on specimen collection and submission.

Thomas Sullivan
Bureau of HIV/STD Field Services
Division of HIV/STD/Hepatitis C Prevention
AIDS Institute, New York State Department of Health
thomas.sullivan@health.ny.gov 
phone: (518) 474-3671