Cholette François, Périnet Simone, Neufeld Bronwyn, Bryson Maggie, Macri Jennifer, Sibley Kathryn M, Kim John, Driedger S Michelle, Becker Marissa L, Sandstrom Paul, Meyers Adrienne F A, Paquette Dana
National Sexually Transmitted and Blood Borne Infection Laboratory, National Microbiology Laboratory at the J. C. Wilt Infectious Diseases Research Centre, Public Health Agency of Canada, Winnipeg, Canada.
Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada.
PLOS Glob Public Health. 2024 Jun 14;4(6):e0003320. doi: 10.1371/journal.pgph.0003320. eCollection 2024.
Testing for human immunodeficiency virus (HIV) and hepatitis C virus (HCV) using dried blood spot (DBS) specimens has been an integral part of bio-behavioural surveillance in Canada for almost two decades, though less is known regarding the use of DBS in surveillance of other sexually transmitted and blood-borne infections (STBBI). A systematic review was conducted using a peer-reviewed search strategy to assess the current evidence regarding the validity of STBBI testing using DBS specimens. Eligibility criteria included studies reporting use of DBS specimens for STBBI testing with either commercially available or "in-house" tests in populations 15 years of age or older. Studies reporting a measure of validity such as sensitivity, specificity, positive and negative predictive values were eligible for inclusion. Quality of studies and risk of bias were assessed using the QUADAS-2 tool. A total of 7,132 records were identified. Of these, 174 met the criteria for inclusion. Among the studies that reported validity measures, a substantial proportion demonstrated high sensitivity (≥90%) in 62.5% of cases (N = 334/534 sensitivity measurements), and high specificity (≥90%) was observed in 84.9% of instances (N = 383/451 specificity measurements). However, the quality of the studies varied greatly. Our findings support the validity of the use of DBS specimens in STBBI testing where sufficient evidence was available, but validity is highly dependent on thorough method development and validation.
在加拿大，使用干血斑（DBS）样本检测人类免疫缺陷病毒（HIV）和丙型肝炎病毒（HCV）几乎已有二十年，一直是生物行为监测的重要组成部分，不过对于DBS在其他性传播和血源感染（STBBI）监测中的应用了解较少。我们采用同行评审的检索策略进行了一项系统综述，以评估目前关于使用DBS样本进行STBBI检测有效性的证据。纳入标准包括报告在15岁及以上人群中使用DBS样本通过市售或“内部”检测进行STBBI检测的研究。报告了诸如敏感性、特异性、阳性和阴性预测值等有效性指标的研究符合纳入条件。使用QUADAS - 2工具评估研究质量和偏倚风险。共识别出7132条记录。其中，174条符合纳入标准。在报告有效性指标的研究中，相当一部分在62.5%的案例中显示出高敏感性（≥90%）（N = 334/534次敏感性测量），在84.9%的情况下观察到高特异性（≥90%）（N = 383/451次特异性测量）。然而，研究质量差异很大。我们的研究结果支持在有充分证据的情况下使用DBS样本进行STBBI检测的有效性，但有效性高度依赖于全面的方法开发和验证。
