The stability of HIV-1 nucleic acid in whole blood and improved detection of HIV-1 in alternative specimen types when compared to Dried Blood Spot (DBS) specimens

•HIV-1 nucleic acids are stable in refrigerated whole blood for 10 days.•Whole blood can be frozen or processed into alternative specimen types that improve HIV-1 detection over DBS.•Modified Roche TaqMan HIV-1 RNA assay can be used to quantify total HIV-1 nucleic acids in whole blood. Commercially-available kits for HIV-1 detection include instructions for detecting HIV-1 in plasma and DBS, but don’t support other specimen types. Show quantitative stability of HIV-1 total nucleic acid (TNA) in blood and improved HIV-1 detection in alternative specimen types. Whole blood and DBS specimens, tested as part of an external quality assurance program for qualitative HIV-1 detection, were used to evaluated error rates (false negative [FN], false positive [FP] and indeterminant [IND] results) across assays (internally developed [IH], Roche Amplicor [RA], and Roche TaqMan Qual [TQ]) and specimen types (frozen whole blood [BLD], DBS and cell pellets [PEL]). A modified Roche TaqMan HIV-1 assay was used to quantify HIV-1 TNA. Significantly higher error rates were noted in DBS across all of the assays (4% vs. 0% for DBS and PEL, IH, p = 0.005; 4% vs. 0.1% for DBS and PEL, RA, p