A cost-effective particle agglutination assay to detect viral antibodies in dried blood spots--a simple solution to HIV and HCV screening.

OBJECTIVES To conduct a serological survey of human immunodeficiency virus (HIV) and hepatitis C virus (HCV) in Gabon and Ga-Rankuwa, South Africa. A secondary objective was to test a novel, simple, inexpensive agglutination assay for anti-HIV IgG and anti-HCV IgG from blood samples stored as spots dried onto filter paper. DESIGN Blood from heel pricks was dried onto filter paper and stored. Blood was eluted from the spots and serum antibody was then assayed using a modified agglutination assay--blood was added to gelatin agglutination beads that had been sensitised with viral antigen. A positive result showed as an agglutination pattern while a negative result appeared as a tight bead. SUBJECT This was a hospital-based study involving 271 neonates at Ga-Rankuwa Hospital, South Africa, and 856 patients ranging in age from three months to over 50 years who attended clinics in Gabon. RESULTS Seroprevalence to HIV was determined in Ga-Rankuwa to be just under 14% (13.8%). Antibodies to HCV were not detected. In Gabon, the prevalence to HIV was just under 1% (0.82%) with a relatively high incidence of HCV, nearing 4% (3.79%). CONCLUSION The sensitivity of the agglutination assay compared favourably to enzyme immune assay (EIA) with respect to sensitivity, simplicity and cost. This assay may be useful in sero-epidemilogical assays in developing countries.