Dried blood spot samples for seroepidemiology of infections with human papillomaviruses, Helicobacter pylori, Hepatitis C Virus, and JC Virus

Cancer Epidemiol Biomarkers Prev. 2012 Feb;21(2):287-93. doi: 10.1158/1055-9965.EPI-11-1001. Epub 2011 Dec 6.

Abstract

Background: To establish antibody analysis from dried blood spots (DBS) on filter paper for seroepidemiologic infection and cancer association studies, we analyzed data from a population-based study in Mongolia.

Methods: Using multiplex serology, we analyzed 985 paired DBS and serum samples from the same donors for antibodies to 12 different proteins from four groups of infectious agents: human papillomaviruses (HPV), Helicobacter pylori (H. pylori), hepatitis C virus (HCV), and JC polyomavirus (JCV).

Results: Quantitative antibody reactivities in serum and DBS showed good correlation, with median correlation coefficients (Pearson R(2)) of 0.88 (range, 0.80-0.90) for high-titer (i.e., H. pylori, HCV, JCV) and 0.79 (range, 0.72-0.85) for low-titer antibodies (i.e., HPV). For high-titer antibodies, serum and DBS data were comparable (median slope of linear trend line, 1.14; range, 1.09-1.21), whereas for low-titer antibodies, DBS reactivities were lower than in serum (median slope, 0.54; range, 0.50-0.80). By extrapolating seropositivity cutoff points previously defined for serum to DBS, we found high agreement (>89% for all antigens) of dichotomized DBS and serum results and median kappa values for high- and low-titer antibodies of 0.86 and 0.78 (range, 0.78-0.92 and 0.55-0.86), respectively. Epidemiologic associations with known risk factors for HPV antibodies were as strong for DBS as for serum.

Conclusions: DBS provide a reliable alternative to serum or plasma for detection of antibodies against various pathogens by multiplex serology.

Impact: DBS do not require blood centrifugation and allow storage and shipment at ambient temperature, thus facilitating field work for seroepidemiologic studies especially in environments with limited technical infrastructure.

MeSH terms

  • Adolescent
  • Adult
  • Cross-Sectional Studies
  • Dried Blood Spot Testing
  • Female
  • Helicobacter Infections / blood
  • Helicobacter Infections / virology
  • Helicobacter pylori / isolation & purification*
  • Hepacivirus / isolation & purification*
  • Hepatitis C / blood
  • Hepatitis C / virology
  • Humans
  • JC Virus / isolation & purification*
  • Middle Aged
  • Mongolia / epidemiology
  • Papillomaviridae / isolation & purification*
  • Papillomavirus Infections / blood
  • Papillomavirus Infections / virology
  • Polyomavirus Infections / blood
  • Polyomavirus Infections / virology
  • Seroepidemiologic Studies
  • Specimen Handling / methods*
  • Surveys and Questionnaires
  • Virus Diseases / blood*
  • Virus Diseases / epidemiology*
  • Virus Diseases / virology
  • Young Adult