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Rodgers MA, Gomathi S, Vallari A, Saravanan S, Lucas GM, Mehta S, Solomon SS, Cloherty GA. Diverse HCV Strains And HIV URFS Identified Amongst People Who Inject Drugs In India. Sci Rep 2020; 10:7214. [PMID: 32350342 PMCID: PMC7190742 DOI: 10.1038/s41598-020-64309-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 02/27/2020] [Indexed: 12/22/2022] Open
Abstract
Although the prevalences of HIV and HCV are significantly higher amongst PWID in India compared to the general population, the strains circulating within this group have not been well-characterized. Through subgenomic sequencing of viruses present in residual plasma from an HIV/HCV prevalence study conducted amongst PWID across five cities in India in 2016-2017, a total of N = 498 HCV and N = 755 HIV strains were classified from N = 975 study participants. Considerable HCV diversity was identified, with different strains predominating in each region of the country. Overall, the most common strain was genotype 3a (39.0%), with genotypes 1a (26.9%), 1b (3.0%), 1c (0.2%), 3b (20.7%), 3i (2.0%), 4a (0.2%), 4d (1.0%), 6 (1.8%), 6n (4.8%), 6 v (0.2%) and one unclassifiable recombinant specimen (0.2%) also identified. The majority of the HIV specimens were subtype C (96.7%), although subtype A (0.4%), CRF01_AE (0.4%) and unique recombinant forms (URFs, 2.5%) were also detected. Notably, the geographical restriction of HIV subtype A and CRF01_AE, and HCV genotypes 4 and 6 to specific sites suggests distinct novel introductions of HIV and HCV into PWID populations, potentially via drug trafficking routes from neighboring countries where these strains are common.
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Affiliation(s)
- Mary A Rodgers
- Abbott Diagnostics, Infectious Disease Research, Abbott Park, USA.
| | | | - Ana Vallari
- Abbott Diagnostics, Infectious Disease Research, Abbott Park, USA
| | | | | | - Shruti Mehta
- Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Sunil S Solomon
- YR Gaitonde Centre for AIDS Research and Education, Chennai, India
- Johns Hopkins University School of Medicine, Baltimore, USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Gavin A Cloherty
- Abbott Diagnostics, Infectious Disease Research, Abbott Park, USA
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Schønning K, Pedersen MS, Johansen K, Landt B, Nielsen LG, Weis N, Westh H. Analytical and clinical performance of the Hologic Aptima HCV Quant Dx Assay for the quantification of HCV RNA in plasma samples. J Virol Methods 2017; 248:159-165. [PMID: 28732692 DOI: 10.1016/j.jviromet.2017.07.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2017] [Revised: 07/05/2017] [Accepted: 07/16/2017] [Indexed: 01/27/2023]
Abstract
BACKGROUND Chronic hepatitis C virus (HCV) infection can be effectively treated with directly acting antiviral (DAA) therapy. Measurement of HCV RNA is used to evaluate patient compliance and virological response during and after treatment. OBJECTIVES To compare the analytical performance of the Aptima HCV Quant Dx Assay (Aptima) and the COBAS Ampliprep/COBAS TaqMan HCV Test v2.0 (CAPCTMv2) for the quantification of HCV RNA in plasma samples, and compare the clinical utility of the two tests in patients undergoing treatment with DAA therapy. STUDY DESIGN Analytical performance was evaluated on two sets of plasma samples: 125 genotyped samples and 172 samples referred for quantification of HCV RNA. Furthermore, performance was evaluated using dilutions series of four samples containing HCV genotype 1a, 2b, 3a, and 4a, respectively. Clinical utility was evaluated on 118 plasma samples obtained from 13 patients undergoing treatment with DAAs. RESULTS Deming regression of results from 187 plasma samples with HCV RNA >2 Log IU/mL indicated that the Aptima assay quantified higher than the CAPCTMv2 test for HCV RNA >4.9 Log IU/mL. The linearity of the Aptima assay was excellent across dilution series of four HCV genotypes (slope of the regression line: 1.00-1.02). The Aptima assay detected significantly more replicates below targeted 2 Log IU/mL than the CAPCTMv2 test, and yielded clearly interpretable results when used to analyze samples from patients treated with DAAs. CONCLUSIONS The analytical performance of the Aptima assay makes it well suited for monitoring patients with chronic HCV infection undergoing antiviral treatment.
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Affiliation(s)
- Kristian Schønning
- Department of Clinical Microbiology, Copenhagen University Hospital, Hvidovre, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
| | - Martin Schou Pedersen
- Department of Clinical Microbiology, Copenhagen University Hospital, Hvidovre, Denmark; Copenhagen Hepatitis C Program (CO-HEP), Department of Infectious Diseases and Clinical Research Centre, Hvidovre Hospital and Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Kim Johansen
- Department of Clinical Microbiology, Copenhagen University Hospital, Hvidovre, Denmark
| | - Bodil Landt
- Department of Clinical Microbiology, Copenhagen University Hospital, Hvidovre, Denmark
| | - Lone Gilmor Nielsen
- Department of Clinical Microbiology, Copenhagen University Hospital, Hvidovre, Denmark
| | - Nina Weis
- Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Henrik Westh
- Department of Clinical Microbiology, Copenhagen University Hospital, Hvidovre, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
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Izquierdo L, Prégermain C, Hottelet C, Decombe G, Roque-Afonso AM. Clinical performance of the VERIS HCV assay for hepatitis C virus RNA quantification. J Clin Virol 2017; 93:1-7. [PMID: 28550721 DOI: 10.1016/j.jcv.2017.05.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 05/10/2017] [Accepted: 05/13/2017] [Indexed: 12/28/2022]
Abstract
BACKGROUND Diagnosis of hepatitis C virus (HCV) infection and treatment monitoring rely on detection/quantification of HCV RNA and real-time polymerase chain reaction (PCR) techniques are expected to equivalently quantify the different HCV genotypes. OBJECTIVE The clinical performance of the VERIS HCV assay for HCV RNA quantification was compared to that of the Abbott RealTime HCV assay. STUDY DESIGN Qualitative concordance and quantitative comparison were evaluated on a first panel of 286 clinical samples containing HCV genotypes 1-6. Forty additional genotype 4 samples were tested to explore genotype 4 HCV RNA underquantification. RESULTS Qualitative discrepancies were observed for low viral loads (<2 log10 IU/mL) in patients under antiviral therapy and would not have had any impact on patients' management with the current guidelines for the monitoring of patients on direct-acting antivirals (DAAs). Quantification results were well correlated (R2=0.89) with an overall minimal quantification bias (mean VERIS - Abbott difference) of -0.09 log10 IU/mL. Quantification agreement for genotypes 1, 2 and 3 samples was excellent, but reached -0.57 log10 IU/mL for 46 genotype 4 samples. A lower quantification bias of -0.24 log10 IU/mL was observed when testing 40 additional genotype 4 samples with a second reagent lot. Underquantification was not associated with 5' untranslated region (UTR) sequence polymorphisms but could be explained by 5' UTR RNA molecular modeling. CONCLUSION HCV RNA quantification by the VERIS HCV assay and the Abbott RealTime HCV assay was well correlated for all HCV genotypes, except genotype 4 where 5' UTR RNA folding may impact quantification. Nevertheless, this underestimation of HCV RNA levels had no impact on clinical use.
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Affiliation(s)
- Laure Izquierdo
- AP-HP, Hôpital Paul Brousse, Service de Virologie, Villejuif, France; Université Paris-Sud, INSERM U1193, Paris, France
| | | | - Corinne Hottelet
- AP-HP, Hôpital Paul Brousse, Service de Virologie, Villejuif, France
| | - Gwenaëlle Decombe
- AP-HP, Hôpital Paul Brousse, Service de Virologie, Villejuif, France
| | - Anne-Marie Roque-Afonso
- AP-HP, Hôpital Paul Brousse, Service de Virologie, Villejuif, France; Université Paris-Sud, INSERM U1193, Paris, France.
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Abstract
INTRODUCTION Molecular assays for detection and accurate quantitation of hepatitis C virus (HCV) RNA have been important for identification and management of the hepatitis C. Furthermore, the HCV genotype should be assessed prior to treatment initiation. Recently, Roche developed the cobas® HCV tests for use on the cobas® 6800/8800 Systems and the cobas® 4800 System and the cobas® HCV genotyping (GT) test for use on the cobas® 4800 System. Areas covered: The analytic and clinical performance of the newly-developed tests is described according to the currently existing literature. Both tests for detection and quantitation of HCV RNA have been shown to be sensitive and linear, and correlate well with established Roche tests used in the routine diagnostic laboratory. The cobas® HCV GT test shows a good performance and is suitable for identification of HCV genotypes 1 to 6 and genotype 1 subtypes a and b in clinical specimens from individuals with chronic HCV infection. Expert commentary: The new tests are effective in screening for hepatitis C infection and in the management of patients with chronic HCV infection ensuring full HCV genotype coverage. They will replace the established Roche tests within the next few years.
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Affiliation(s)
- Harald H Kessler
- a Molecular Diagnostics Laboratory and Research Unit Molecular Diagnostics, IHMEM, Medical University of Graz , Graz , Austria
| | - Evelyn Stelzl
- a Molecular Diagnostics Laboratory and Research Unit Molecular Diagnostics, IHMEM, Medical University of Graz , Graz , Austria
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Rodgers MA, Vallari AS, Harris B, Yamaguchi J, Holzmayer V, Forberg K, Berg MG, Kenmenge J, Ngansop C, Awazi B, Mbanya D, Kaptue L, Brennan C, Cloherty G, Ndembi N. Identification of rare HIV-1 Group N, HBV AE, and HTLV-3 strains in rural South Cameroon. Virology 2017; 504:141-151. [PMID: 28193549 DOI: 10.1016/j.virol.2017.01.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 01/11/2017] [Accepted: 01/12/2017] [Indexed: 02/07/2023]
Abstract
Surveillance of emerging viral variants is critical to ensuring that blood screening and diagnostic tests detect all infections regardless of strain or geographic location. In this study, we conducted serological and molecular surveillance to monitor the prevalence and diversity of HIV, HBV, and HTLV in South Cameroon. The prevalence of HIV was 8.53%, HBV was 10.45%, and HTLV was 1.04% amongst study participants. Molecular characterization of 555 HIV-1 specimens identified incredible diversity, including 7 subtypes, 12 CRFs, 6 unclassified, 24 Group O and 2 Group N infections. Amongst 401 HBV sequences were found a rare HBV AE recombinant and two emerging sub-genotype A strains. In addition to HTLV-1 and HTLV-2 strains, sequencing confirmed the fifth known HTLV-3 infection to date. Continued HIV/HBV/HTLV surveillance and vigilance for newly emerging strains in South Cameroon will be essential to ensure diagnostic tests and research stay a step ahead of these rapidly evolving viruses.
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Affiliation(s)
| | | | - B Harris
- Abbott Laboratories, Abbott Park, IL, USA
| | | | | | - K Forberg
- Abbott Laboratories, Abbott Park, IL, USA
| | - M G Berg
- Abbott Laboratories, Abbott Park, IL, USA
| | - J Kenmenge
- Université de Yaoundé I, Yaoundé, Cameroon
| | - C Ngansop
- Université de Yaoundé I, Yaoundé, Cameroon
| | - B Awazi
- Université de Yaoundé I, Yaoundé, Cameroon
| | - D Mbanya
- Université de Yaoundé I, Yaoundé, Cameroon
| | - L Kaptue
- Université des Montagnes, Montagnes, Bangangté, Cameroon
| | - C Brennan
- Abbott Laboratories, Abbott Park, IL, USA
| | - G Cloherty
- Abbott Laboratories, Abbott Park, IL, USA
| | - N Ndembi
- Institute of Human Virology Nigeria, Abuja, Nigeria
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Pierce VM, Eversley JS, Tran TK, Rosenberg ES. Differences between quantification of genotype 3 hepatitis C virus RNA by Versions 1.0 and 2.0 of the COBAS AmpliPrep/COBAS TaqMan HCV Test. Clin Chem Lab Med 2017; 55:956-961. [DOI: 10.1515/cclm-2016-0799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 11/01/2016] [Indexed: 11/15/2022]
Abstract
AbstractBackground:Differences between the designs of hepatitis C virus (HCV) viral load assays can result in genotype-related variability in RNA quantification. We tested paired aliquots of plasma specimens from HCV-infected individuals using two versions (v1.0 and v2.0) of the Roche COBAS AmpliPrep/COBAS TaqMan HCV Test (CAP/CTM HCV) and noted variability between results for a subset of specimens; we then sought to determine whether discrepant results were more prevalent among specific HCV genotypes.Methods:Archived and prospectively-collected plasma samples from 114 unique patients were tested using CAP/CTM HCV v1.0 and v2.0. The HCV genotype result for each patient was determined by retrospectively reviewing laboratory records.Results:All (46/46) specimens with quantifiable viral loads from patients with genotype 1 or 2 infection had CAP/CTM HCV v1.0 and v2.0 results that were within 0.5 logConclusions:In patients infected with HCV genotype 3, sequential CAP/CTM HCV viral load results should be compared with caution and interpreted in the context of the specific assay version used.
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Wiesmann F, Braun P. Significance of HCV RNA monitoring in the era of new potent therapies. Expert Rev Anti Infect Ther 2016; 14:837-44. [PMID: 27424603 DOI: 10.1080/14787210.2016.1214355] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
INTRODUCTION The development and approval of direct-acting-antivirals (DAA) has revolutionized the treatment of hepatitis C within a few years and opened the door to a new era of shorter, well-tolerated but also highly expensive treatment options. AREAS COVERED Nowadays, reductions of viral load below quantification limits may often be achieved within the first weeks of therapy. Viral breakthroughs during treatment are rarely observed and unfavourable viral genotypes or an advanced liver disease do not necessarily lower the prospect of eradication. For this reason, pan-genotypic DAA-only therapies are about to replace interferon/ribavirin-regimens as the standard of care worldwide. Expert commentary: Consequently, it has become essential to reevaluate the utility of HCV RNA quantification in predicting treatment outcomes and to guide clinical decisions. Is there still a need for a close-meshed monitoring or is it reasonable to limit HCV RNA monitoring to baseline and post-treatment results? This review discusses the pro- and contra arguments in this regard.
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Affiliation(s)
- F Wiesmann
- a PZB Aachen , HIV&Hepatitis Research Group , Aachen , Germany
| | - P Braun
- a PZB Aachen , HIV&Hepatitis Research Group , Aachen , Germany
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Huang X, Deng Z, Long L, Chen J, Tan D, Zhu L, Fan X, Shen T, Lu F. Traceability, reproducibility and clinical evaluation of Sansure Realtime HCV RNA assay. BMC Infect Dis 2016; 16:47. [PMID: 26832356 PMCID: PMC4736550 DOI: 10.1186/s12879-016-1390-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 01/27/2016] [Indexed: 02/08/2023] Open
Abstract
Background Accurate quantitative detection of hepatitis C virus (HCV) RNA is critical for diagnosis of acute or chronic HCV infection, and for follow-up of virologic response during HCV targeted therapy. In the present study, traceability and reproducibility of a novel China-certified domestic Sansure HCV RNA diagnostic assay (Sansure, Changsha, Hunan, China) was evaluated and the clinical performance of this assay was also analyzed. Methods Traceability of the Sansure HCV RNA assay to the WHO international standard for HCV (genotype 1a) was detected across multiple centers. Reproducibility, accuracy (the differences of observed average concentrations and expected concentrations) and precision were assessed using series dilutions of World HCV RNA performance panel WWHV303-02 (HCV-1b), WWHV303-04(HCV-2a), WWHV303-11(HCV-3a) and WWHV303-19 (HCV-6a). In addition, both Sansure HCV RNA and CAP/CTM HCV (Roche, Branchburg, NJ, USA) assays were used to detect HCV RNA in 346 EDTA anti-coagulated plasma samples from previous HCV-infected patients, during and after antiviral therapy. Results The Sansure assay showed good traceability by agreeing with the HCV-1a WHO standard across all five concentrations tested (25, 50, 100, 1000, 10000 IU/ml). The differences between observed average concentrations and expected concentrations were all within 0.2 log10 IU/ml. HCV WWHV303 standards across 4 HCV genotypes (1b, 2a, 3a and 6a) were used for evaluation of reproducibility and the accuracy of the test were all within 0.2 log10 IU/ml. The inter-assay variations across the above 4 HCV genotypes were all less than 0.03 on each evaluated concentration, indicating good precision of Sansure HCV RNA assay. In clinical practice, concordant results were determined in 99.42 % (344/346) samples (215 positive and 129 negative samples). Two specimens with negative HCV RNA results by Sansure assay were detected positive by CAP/CTM HCV test. Correlation analysis indicated a significantly positive correlation in detected HCV RNA concentrations (r = 0.9439, P < 0.0001). HCV RNA levels in 95.35 % (205/215) specimens were within mean difference ± 1.96 SD as tested by both assays. Conclusions With the advantages of traceability, reproducibility and lower price, Sansure HCV RNA assay represented an alternative option for HCV RNA detection in hospital and medical institution in China.
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Affiliation(s)
- Xiangbo Huang
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Zhongping Deng
- Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, 100871, China
| | - Lu Long
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Jinjun Chen
- Department of Infectious Diseases, Nanfang Hospital of Southern Medical University, Guangzhou, 510515, China
| | - Deming Tan
- Department of Infectious Diseases, Xiangya Hospital of Central South University, Changsha, 410008, China
| | - Liyan Zhu
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Xueying Fan
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Tao Shen
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China.
| | - Fengmin Lu
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
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Grüner N, Viazov S, Korn K, Knöll A, Trippler M, Schlaak JF, Gerken G, Roggendorf M, Ross RS. Performance characteristics of the VERSANT hepatitis C virus RNA 1.0 (kPCR) assay. Int J Med Microbiol 2015; 305:627-35. [PMID: 26384868 DOI: 10.1016/j.ijmm.2015.08.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
HCV RNA assays are of central importance for virological diagnostics and for clinical planning and monitoring of an antiviral combination treatment of chronic HCV infections. The objective of the pre-market evaluation of the VERSANT HCV RNA 1.0 Assay (kPCR) was to collect analytical performance data for this new method of HCV RNA quantification and to compare them with the high standards that exist in this context. The assay exhibited a specificity of 100%. The mean intra- and inter-assay imprecision was 14.1% and 14.6%, respectively. The detection limit was determined to be 16IU/ml (95% confidence interval: 11.9-30.6IU/ml) and consequently corresponded to the manufacturer's claims (i.e. 15IU/ml). The test exhibited linearity for all HCV genotypes in a broad range from 15 to 10(8)IU HCV RNA/ml. Hence, the kPCR assay in general is well suitable for HCV RNA determinations in clinical practice. However, in a methodological comparison, a considerable under-quantification of the concentrations of HCV genotype 2 and 3 isolates was detected. Provided that the assay's manufacturer will quickly remedy this shortcoming, the VERSANT HCV RNA 1.0 (kPCR) can be called a completely reliable technique for HCV RNA quantification in routine virological diagnostics.
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Affiliation(s)
- Nico Grüner
- Institute of Virology, National Reference Centre for Hepatitis C, Essen University Hospital, University of Duisburg-Essen, Hufelandstr., D-45122 Essen, Germany
| | - S Viazov
- Institute of Virology, National Reference Centre for Hepatitis C, Essen University Hospital, University of Duisburg-Essen, Hufelandstr., D-45122 Essen, Germany
| | - K Korn
- Institute of Clinical and Molecular Virology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Schlossgarten 4, D-91054 Erlangen, Germany
| | - A Knöll
- Institute of Clinical and Molecular Virology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Schlossgarten 4, D-91054 Erlangen, Germany
| | - M Trippler
- Department of Gastroenterology and Hepatology, Essen University Hospital, University of Duisburg-Essen, Hufelandstr., D-45122 Essen, Germany
| | - J F Schlaak
- Department of Gastroenterology and Hepatology, Essen University Hospital, University of Duisburg-Essen, Hufelandstr., D-45122 Essen, Germany
| | - G Gerken
- Department of Gastroenterology and Hepatology, Essen University Hospital, University of Duisburg-Essen, Hufelandstr., D-45122 Essen, Germany
| | - M Roggendorf
- Institute of Virology, National Reference Centre for Hepatitis C, Essen University Hospital, University of Duisburg-Essen, Hufelandstr., D-45122 Essen, Germany
| | - R Stefan Ross
- Institute of Virology, National Reference Centre for Hepatitis C, Essen University Hospital, University of Duisburg-Essen, Hufelandstr., D-45122 Essen, Germany.
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Wiesmann F, Naeth G, Sarrazin C, Berger A, Kaiser R, Ehret R, Knechten H, Braun P. Variation analysis of six HCV viral load assays using low viremic HCV samples in the range of the clinical decision points for HCV protease inhibitors. Med Microbiol Immunol 2015; 204:515-25. [PMID: 25398515 PMCID: PMC4514908 DOI: 10.1007/s00430-014-0364-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Accepted: 10/30/2014] [Indexed: 12/11/2022]
Abstract
In the range of clinical decision points for response-guided therapy of HCV, there is still insufficient data concerning the conformity of quantification results obtained by different assays and their correlation with the HPS/CTM v2 assay which was used for initial clinical studies. In a head-to-head comparison, assay accuracy and detection rates of six quantitative assays [artus HCV QS-RGQ, COBAS Ampliprep/COBAS TaqMan HCV v1/v2, High Pure System/COBAS TaqMan (HPS), RealTime HCV, and Versant HCV1.0] were assessed by measuring WHO and PEI standards at dilution steps near clinical decision points. Detection rates and mean differences between assays were evaluated by analyzing twenty clinical samples at 10, 100, and 1,000 IU/mL. Ten replicates from specimens with different HCV genotypes were used to analyze pan-genotypic intra-assay variation. At ≤ 25 IU/mL, RealTime demonstrated the highest detection rates. With 0.1 log difference when testing clinical samples, results obtained from the Versant and RealTime assays matched best with results from HPS. Mean difference analysis across all assay results revealed wide differences between 0.01 and 0.75 log IU/mL. RealTime showed the lowest intra-assay variation across genotypes 1-4 (25, 100, 1,000 IU/mL). There are substantial analytical differences between viral load assays clinicians should be aware of. These variations may have impact on clinical decisions for patients on HCV triple therapy and may argue for assay-specific decision points equivalent to reference values established in studies using HPS. A comparison of quantification is recommended prior to a switch of assays during ongoing therapy.
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Affiliation(s)
- F Wiesmann
- HIV and Hepatitis Research Group, PZB Aachen, Blondelstr. 9, 52062, Aachen, Germany,
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11
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HIV-1 variability and viral load technique could lead to false positive HIV-1 detection and to erroneous viral quantification in infected specimens. J Infect 2015; 71:368-76. [PMID: 26033694 DOI: 10.1016/j.jinf.2015.05.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Revised: 05/12/2015] [Accepted: 05/25/2015] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Viral load (VL) testing is used for early HIV diagnosis in infants (EID) and for detecting early therapeutic failure events, but can be affected by HIV genetic variability. Dried blood samples (DBS) increase VL access and EID in remote settings and when low blood volume is available. METHODS This study compares VL values using Siemens VERSANT HIV-1 RNA 1.0 kPCR assay (kPCR) and Roche CAP/CTM Quantitative test v2.0 (CAP/CTM v2.0) in 176 DBS carrying different HIV-1 variants collected from 69 Equatoguinean mothers and their infants with known HIV-1 status (71 infected, 105 uninfected). RESULTS CAP/CTM v2.0 provided false positive VLs in 11 (10.5%) cases. VL differences above 0.5 log10 were observed in 42/49 (87.5%) DBS, and were above 1 log10 in 18 cases. CAP/CTM v2.0 quantified all the 41 specimens with previously inferred HIV-1 variant by phylogenetic analysis (68.3% recombinants) whereas kPCR only identified 90.2% of them, and was unable to detect 14.3% of 21 CRF02_AG viruses. CAP/CTM v2.0 showed higher sensitivity than kPCR (95.8% vs. 70.1%), quantifying a higher rate of viruses in infected DBS from subjects under antiretroviral exposure at sampling time compared to kPCR (94.7% vs. 96.2%, p-value<0.001). kPCR showed maximum specificity (100%) whereas for CAP/CTM v2.0 was 89.5%. CONCLUSIONS VL assays should increase their sensitivity and specificity to avoid overestimated HIV-1 quantifications, which could be interpreted as virological failure events, or false negative diagnostic results due to genetic variability. We recommend using the same VL technique for each patient during antiretroviral therapy monitoring.
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Sarrazin C, Dierynck I, Cloherty G, Ghys A, Janssen K, Luo D, Witek J, Buti M, Picchio G, De Meyer S. An OPTIMIZE study retrospective analysis for management of telaprevir-treated hepatitis C virus (HCV)-infected patients by use of the Abbott RealTime HCV RNA assay. J Clin Microbiol 2015; 53:1264-9. [PMID: 25653396 PMCID: PMC4365219 DOI: 10.1128/jcm.03030-14] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Accepted: 01/28/2015] [Indexed: 12/17/2022] Open
Abstract
Protease inhibitor (PI)-based response-guided triple therapies for hepatitis C virus (HCV) infection are still widely used. Noncirrhotic treatment-naive and prior relapser patients receiving telaprevir-based treatment are eligible for shorter, 24-week total therapy if HCV RNA is undetectable at both weeks 4 and 12. In this study, the concordance in HCV RNA assessments between the Roche High Pure System/Cobas TaqMan and Abbott RealTime HCV RNA assays and the impacts of different HCV RNA cutoffs on treatment outcome were evaluated. A total of 2,629 samples from 663 HCV genotype 1 patients receiving telaprevir/pegylated interferon/ribavirin in OPTIMIZE were analyzed using the High Pure System and reanalyzed using Abbott RealTime (limits of detection, 15.1 IU/ml versus 8.3 IU/ml; limits of quantification, 25 IU/ml versus 12 IU/ml, respectively). Overall, good concordance was observed between the assays. Using undetectable HCV RNA at week 4, 34% of the patients would be eligible for shorter treatment duration with Abbott RealTime versus 72% with the High Pure System. However, using <12 IU/ml for Abbott RealTime, a similar proportion (74%) would be eligible. Of the patients receiving 24-week total therapy, 87% achieved a sustained virologic response with undetectable HCV RNA by the High Pure System or <12 IU/ml by Abbott RealTime; however, 92% of the patients with undetectable HCV RNA by Abbott RealTime achieved a sustained virologic response. Using undetectable HCV RNA as the cutoff, the more sensitive Abbott RealTime assay would identify fewer patients eligible for shorter treatment than the High Pure System. Our data confirm the <12-IU/ml cutoff, as previously established in other studies of the Abbott RealTime assay, to determine eligibility for shortened PI-based HCV treatment. (The study was registered with ClinicalTrials.gov under registration no. NCT01241760.).
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Affiliation(s)
| | | | | | - Anne Ghys
- Janssen Infectious Diseases BVBA, Beerse, Belgium
| | | | - Donghan Luo
- Janssen Research and Development, LLC, Titusville, New Jersey, USA
| | - James Witek
- Janssen Research and Development, LLC, Titusville, New Jersey, USA
| | - Maria Buti
- Hospital Valle Hebron and Ciberehd del Institute Carlos III, Barcelona, Spain
| | - Gaston Picchio
- Janssen Research and Development, LLC, Titusville, New Jersey, USA
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Mukherjee R, Burns A, Rodden D, Chang F, Chaum M, Garcia N, Bollipalli N, Niemz A. Diagnosis and Management of Hepatitis C Virus Infection. ACTA ACUST UNITED AC 2015; 20:519-38. [PMID: 25609256 DOI: 10.1177/2211068214563794] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Indexed: 01/03/2023]
Abstract
The hepatitis C virus (HCV) infects more than 200 million people globally, with increasing incidence, especially in developing countries. HCV infection frequently progresses to chronic liver disease, creating a heavy economic burden on resource-poor countries and lowering patient quality of life. Effective HCV diagnosis, treatment selection, and treatment monitoring are important in stopping disease progression. Serological assays, which detect anti-HCV antibodies in the patient after seroconversion, are used for initial HCV diagnosis. Qualitative and quantitative molecular assays are used to confirm initial diagnosis, determine viral load, and genotype the dominant strain. Viral load and genotype information are used to guide appropriate treatment. Various other biomarker assays are performed to assess liver function and enable disease staging. Most of these diagnostic methods are mature and routinely used in high-resource countries with well-developed laboratory infrastructure. Few technologies, however, are available that address the needs of low-resource areas with high HCV prevalence, such as Africa and Southeast Asia.
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Affiliation(s)
- Ronita Mukherjee
- Keck Graduate Institute of Applied Life Sciences, Claremont, CA, USA
| | - Andrew Burns
- Keck Graduate Institute of Applied Life Sciences, Claremont, CA, USA
| | - Diane Rodden
- Keck Graduate Institute of Applied Life Sciences, Claremont, CA, USA
| | - Frances Chang
- Keck Graduate Institute of Applied Life Sciences, Claremont, CA, USA
| | - Manita Chaum
- Keck Graduate Institute of Applied Life Sciences, Claremont, CA, USA
| | - Nancy Garcia
- Keck Graduate Institute of Applied Life Sciences, Claremont, CA, USA
| | | | - Angelika Niemz
- Keck Graduate Institute of Applied Life Sciences, Claremont, CA, USA
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14
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Ansaldi F, Orsi A, Sticchi L, Bruzzone B, Icardi G. Hepatitis C virus in the new era: Perspectives in epidemiology, prevention, diagnostics and predictors of response to therapy. World J Gastroenterol 2014; 20:9633-9652. [PMID: 25110404 PMCID: PMC4123355 DOI: 10.3748/wjg.v20.i29.9633] [Citation(s) in RCA: 104] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Revised: 04/18/2014] [Accepted: 05/19/2014] [Indexed: 02/06/2023] Open
Abstract
Despite the great successes achieved in the fields of virology and diagnostics, several difficulties affect improvements in hepatitis C virus (HCV) infection control and eradication in the new era. New HCV infections still occur, especially in some of the poorest regions of the world, where HCV is endemic and long-term sequelae have a growing economic and health burden. An HCV vaccine is still no available, despite years of researches and discoveries about the natural history of infection and host-virus interactions: several HCV vaccine candidates have been developed in the last years, targeting different HCV antigens or using alternative delivery systems, but viral variability and adaption ability constitute major challenges for vaccine development. Many new antiviral drugs for HCV therapy are in preclinical or early clinical development, but different limitations affect treatment validity. Treatment predictors are important tools, as they provide some guidance for the management of therapy in patients with chronic HCV infection: in particular, the role of host genomics in HCV infection outcomes in the new era of direct-acting antivirals may evolve for new therapeutic targets, representing a chance for modulated and personalized treatment management, when also very potent therapies will be available. In the present review we discuss the most recent data about HCV epidemiology, the new perspectives for the prevention of HCV infection and the most recent evidence regarding HCV diagnosis, therapy and predictors of response to it.
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Schønning K. Comparison of the QIAGEN artus HCV QS-RGQ test with the Roche COBAS Ampliprep/COBAS TaqMan HCV test v2.0 for the quantification of HCV-RNA in plasma samples. J Clin Virol 2014; 60:323-7. [PMID: 24894603 DOI: 10.1016/j.jcv.2014.05.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Revised: 04/24/2014] [Accepted: 05/01/2014] [Indexed: 12/16/2022]
Abstract
BACKGROUND Quantification of Hepatitis C Virus (HCV)-RNA is important for the clinical management of patients undergoing antiviral therapy. OBJECTIVES To compare the quantification of clinical plasma samples by the Roche COBAS AmpliPrep/COBAS TaqMan HCV test v2.0 and the artus HCV QS-RGQ test. STUDY DESIGN HCV-RNA viral load in 155 plasma samples from HCV-seropositive individuals was determined using the COBAS test and retrospectively with the artus. Furthermore, a dilution series of an Acrometrix standard was tested with both tests in replicates of five to assess differences in limit of detection and precision. RESULTS Two clinical samples showed inhibition using the artus test and were excluded from analysis. Of the clinical samples, 20 tested negative in both tests, 7 tested positive in the COBAS test and negative in the artus test, and 126 samples were quantified by both tests. The mean overall difference between tests (artus-COBAS) was 0.27 log IU/mL. The mean difference of quantification varied little across genotype 1a, 1b, 2b and 3a (range: +0.15 to +0.35 log IU/mL). Both tests were precise (%CV at 1000 IU/mL 1.1 and 1.8 for the COBAS and artus test, respectively). CONCLUSIONS The limit of detection appeared lower in the COBAS test than the artus test when analyzed from a limited number of replicates. Both tests were precise with the artus test quantifying higher than the COBAS test on average. It is therefore recommended to monitor individual patients with the same test throughout treatment.
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Affiliation(s)
- Kristian Schønning
- Department of Clinical Microbiology, 445, Copenhagen University Hospital, Hvidovre, Kettegård Alle 30, DK-2650 Hvidovre, Denmark.
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