Estimating prevalence from dried blood spots without using biological cut-offs: application of a novel approach to hepatitis C virus in drug users in France (ANRS-Coquelicot survey)

Epidemiology and Infection
L LeonY LE Strat

Abstract

Seroprevalence estimation using cross-sectional serosurveys can be challenging due to inadequate or unknown biological cut-off limits of detection. In recent years, diagnostic assay cut-offs, fixed assay cut-offs and more flexible approaches as mixture modelling have been proposed to classify biological quantitative measurements into a positive or negative status. Our objective was to estimate the prevalence of anti-HCV antibodies among drug users (DU) in France in 2011 using a biological test performed on dried blood spots (DBS) collected during a cross-sectional serosurvey. However, in 2011, we did not have a cut-off value for DBS. We could not use the values for serum or plasma, knowing that the DBS value was not necessarily the same. Accordingly, we used a method which consisted of applying a two-component mixture model with age-dependent mixing proportions using penalised splines. The component densities were assumed to be log-normally distributed and were estimated in a Bayesian framework. Anti-HCV prevalence among DU was estimated at 43.3% in France and increased with age. Our method allowed us to provide estimates of age-dependent prevalence using DBS without having a specified biological cut-off value.

References

Feb 7, 2007·Public Health Reports·Holly HaganRichard S Garfein
Jul 1, 2008·Vaccine·Maria Cristina RotaMarta Luisa Ciofi degli Atti
Apr 21, 2009·Drug and Alcohol Review·Bethany WhiteLisa Maher
Jan 17, 2012·Antiviral Research·Ingrid J M SnijdewindRob A Gruters
Feb 18, 2014·Journal of Clinical Virology : the Official Publication of the Pan American Society for Clinical Virology·E Kainne DokuboKimberly Page
Jan 20, 2015·Biostatistics·Lucie LeonYann Le Strat
Aug 28, 2015·Epidemiology and Infection·G KafatosC P Farrington
Sep 4, 2015·The Journal of Infectious Diseases·Alexandre SoulierStéphane Chevaliez

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Citations

Sep 7, 2019·Mass Spectrometry Reviews·Benjamin S FreyAbraham K Badu-Tawiah

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Methods Mentioned

BETA
ELISA

Software Mentioned

R
Just another Gibbs Sampler ( JAGS )

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