Evaluation of the Use of Plasma Preparation Tubes for HIV Viral Load Testing in Nigeria.

Abstract

Background: Routine viral load (VL) monitoring of persons living with HIV (PLWH) on antiretroviral therapy (ART) is imperative for improving the long-term success of treatment. Due to a limited number of PCR laboratories, VL testing is centralized, requiring cold chain storage while transporting samples from remote healthcare centers to referral PCR laboratories, which is a major challenge. The Becton Dickinson (BD) Vacutainer® Plasma Preparation Tube (PPT) was designed to mitigate cold chain transport needs and secondary tube storage of plasma.

Methods: This cross-sectional study assessed the suitability of PPTs for sample transportation in remote settings, in place of EDTA non-gel Vacutainers, eliminating the need for cold chain storage. Venous blood was collected from 115 PLWH into 3 Vacutainer tubes (1 EDTA and 2 PPT). The plasma obtained from the first PPT was assayed for HIV VL along with the plasma obtained from EDTA non-gel Vacutainer within 6 h on the COBAS 6800 (Roche Diagnostics) instrument. Samples from the second PPT were stored at room temperature (20 to 28°C) for 24 h before testing on the same instrument.

Results: The Wilcoxon signed rank test and W statistic (P value 0.91) showed that VL results obtained from the EDTA were comparable to the PPT on the collection day, and after 24 h at room temperature. Sensitivity and specificity for same-day and 24-hour testing were both 100%.

Conclusions: The BD Vacutainer PPT was shown to have similar VL results to the EDTA non-gel Vacutainer, and can therefore be deployed to remote settings for sample collection and transportation to PCR referral laboratories.