Feasibility, Accuracy, and Acceptability of Self-Collected Dried Blood Spots for Hepatitis C Virus, Hepatitis B Virus, and SARS-CoV-2 Testing.
8 affiliations
- 1Toronto Centre for Liver Disease/Viral Hepatitis Care Network, University Health Network, Toronto, Ontario, Canada.
- 2Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada.
- 3Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada.
- 4Mount Sinai Hospital/University Health Network, University of Toronto, Toronto, Ontario, Canada.
- 5Public Health Ontario Laboratory, Toronto, Ontario, Canada.
- 6National Microbiology Laboratory, Winnipeg, Manitoba, Canada.
- 7Toronto Western Family Health Team, University Health Network, Toronto, Ontario, Canada.
- 8School of Nursing, York University, Toronto, Ontario, Canada.
Abstract
Background
Screening, diagnosis, and treatment for hepatitis C and hepatitis B can be limited due to challenges in accessing in-person health care. This study explored the alternative method of dried blood spot (DBS) collection, specifically through mail-based self-collection.Methods
A total of 388 patients were recruited by phone from the Toronto Centre for Liver Disease and the Toronto Western Family Health Team, who were seropositive for hepatitis C virus (HCV), hepatitis B virus, and/or SARS-CoV-2 or had unknown serostatus. Participants were mailed a collection kit, paper instructions/QR code for video instructions, demographic/acceptability questionnaires, a return envelope, and laboratory requisition. DBS cards and phlebotomy were tested for hepatitis B surface antigen, HCV antibody, and SARS-CoV-2 antibody. DBS results were compared against conventional phlebotomy as the gold standard.Results
Of the 388 recruited participants, 110 completed the study by returning their DBS cards and completing conventional phlebotomy and questionnaires. For hepatitis B surface antigen, self-collection DBS testing showed 100% sensitivity and specificity, with 31 true positives and 79 true negatives. For HCV antibody, self-collection DBS testing showed 96.2% (25/26) sensitivity and 96.4% specificity (81/84), with 25 true positives, 81 true negatives, 3 false positives, and 1 false negative. SARS-CoV-2 testing also showed 100% sensitivity and specificity, with 108 true positives and 2 true negatives. Acceptability was high with 78.3% (101/129) participants rating the process easy or very easy.Conclusions
Mail-based self-collected DBS enables remote testing by allowing nonmedically trained individuals to reliably collect their own samples. High concordance and acceptability indicate that this method is viable for addressing health care access challenges, particularly in populations motivated to seek testing.
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BibTeX
@article{tran2026feasibility,
title = {{Feasibility, Accuracy, and Acceptability of Self-Collected Dried Blood Spots for Hepatitis C Virus, Hepatitis B Virus, and SARS-CoV-2 Testing.}},
author = {Sarah S Tran and Aaron Vanderhoff and Ahreni Saunthar and Agustina Crespi and Bethany Barber and Andrew B Mendlowitz and Anne-Claude Gingras and Karen Colwill and Freda Qi and Melanie Delgado-Brand and Tony Mazzulli and John Kim and Nikolina Mizdrak and Camelia Capraru and Mia J Biondi and Jordan J Feld},
journal = {Open forum infectious diseases},
year = {2026},
month = oct,
doi = {10.1093/ofid/ofag645},
url = {https://europepmc.org/article/MED/42921465},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Feasibility, Accuracy, and Acceptability of Self-Collected Dried Blood Spots for Hepatitis C Virus, Hepatitis B Virus, and SARS-CoV-2 Testing.
AU - Sarah S Tran
AU - Aaron Vanderhoff
AU - Ahreni Saunthar
AU - Agustina Crespi
AU - Bethany Barber
AU - Andrew B Mendlowitz
AU - Anne-Claude Gingras
AU - Karen Colwill
AU - Freda Qi
AU - Melanie Delgado-Brand
AU - Tony Mazzulli
AU - John Kim
AU - Nikolina Mizdrak
AU - Camelia Capraru
AU - Mia J Biondi
AU - Jordan J Feld
PY - 2026
DA - 2026/10/23
JO - Open forum infectious diseases
DO - 10.1093/ofid/ofag645
UR - https://europepmc.org/article/MED/42921465
AB - Background Screening, diagnosis, and treatment for hepatitis C and hepatitis B can be limited due to challenges in accessing in-person health care. This study explored the alternative method of dried blood spot (DBS) collection, specifically through mail-based self-collection.Methods A total of 388 patients were recruited by phone from the Toronto Centre for Liver Disease and the Toronto Western Family Health Team, who were seropositive for hepatitis C virus (HCV), hepatitis B virus, and/or SARS-CoV-2 or had unknown serostatus. Participants were mailed a collection kit, paper instructions/QR code for video instructions, demographic/acceptability questionnaires, a return envelope, and laboratory requisition. DBS cards and phlebotomy were tested for hepatitis B surface antigen, HCV antibody, and SARS-CoV-2 antibody. DBS results were compared against conventional phlebotomy as the gold standard.Results Of the 388 recruited participants, 110 completed the study by returning their DBS cards and completing conventional phlebotomy and questionnaires. For hepatitis B surface antigen, self-collection DBS testing showed 100% sensitivity and specificity, with 31 true positives and 79 true negatives. For HCV antibody, self-collection DBS testing showed 96.2% (25/26) sensitivity and 96.4% specificity (81/84), with 25 true positives, 81 true negatives, 3 false positives, and 1 false negative. SARS-CoV-2 testing also showed 100% sensitivity and specificity, with 108 true positives and 2 true negatives. Acceptability was high with 78.3% (101/129) participants rating the process easy or very easy.Conclusions Mail-based self-collected DBS enables remote testing by allowing nonmedically trained individuals to reliably collect their own samples. High concordance and acceptability indicate that this method is viable for addressing health care access challenges, particularly in populations motivated to seek testing.
SN - 2328-8957
ER -