The feasibility of fingerstick blood collection for point-of-care HIV-1 viral load monitoring in rural Zambia

Viral load monitoring for HIV treatment is recommended but not feasible in many settings. A point-of-care test using capillary blood would increase access butmay require up to 200 ?Lof blood to achieve a lower limit of detection of 1000 copies/mL.This cross-sectional study evaluated the feasibility of collecting 200 ?L of capillary blood as well as blood collection preferences among adults in rural Zambia. Adults seeking HIV counseling and testing at Macha Hospital were recruited in 2015. Capillary blood was collected in four 50 ?L tubes. Blood collection was categorized as complete (200 ?L collected), partial (all tubes filled but <200 ?L obtained due to collection techniques), or incomplete (1-4 tubes attempted;<200?Lobtained due to insufficient blood flow).One fingerstickwas required for 90%of the 201 participants.Amedian blood volume of 196 ?L was collected. Complete, partial and incomplete collection was achieved in 34%, 59% and 6% of participants. The majority of participants (95%) preferred fingerstick over venous blood collection. A point-of-care viral load test requiring up to 200 ?L of blood is feasible in a rural setting but would require training and supervision to ensure that sufficient blood was collected.