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Ye X, Zhao Y, Li R, Li T, Zheng X, Xiong W, Zeng J, Xu M, Chen L. High Frequency Occult Hepatitis B Virus Infection Detected in Non-Resolved Donations Suggests the Requirement of Anti-HBc Test in Blood Donors in Southern China. Front Immunol 2021; 12:699217. [PMID: 34394093 PMCID: PMC8355616 DOI: 10.3389/fimmu.2021.699217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 07/12/2021] [Indexed: 02/04/2023] Open
Abstract
Background Most Chinese Blood Centers adopted mini pool (MP) nucleic acid testing (NAT) for HBV screening due to high cost of Individual donation (ID) NAT, and different proportions of MP-reactive but ID-non-reactive donations (MP+/ID-, defined as non-resolved donations) have been observed during daily donor screening process. Some of these non-resolved donations are occult HBV infections (OBIs), which pose potential risk of HBV transmission if they are not deferred. This study is aimed to further analyze these non-resolved donations. Methods The non-resolved plasma samples were further analyzed by serological tests and various HBV DNA amplification assays including quantitative PCR (qPCR) and nested PCR amplifying the basic core and pre-core promoter regions (BCP/PC; 295 base pairs) and HBsAg (S) region (496 base pairs). Molecular characterizations of HBV DNA+ non-resolved samples were determined by sequencing analysis. Results Of 17,226 MPs from 103,356 seronegative blood donations, 98 MPs were detected reactive for HBV. Fifty-six out of these 98 (57.1%) reactive MPs were resolved as HBV DNA+, but the remaining 42 pools (42.9%, 252 donations) were left non-resolved with a high rate (53.2%) of anti-HBc+. Surprisingly, among 42 non-resolved MPs, 17 contained one donation identified as OBIs by alternative NAT assays. Sequence analysis on HBV DNAs extracted from these OBI donations showed some key mutations in the S region that may lead to failure in HBsAg detection and vaccine escape. Conclusion A total of 53.2% of the non-resolved donations were anti-HBc+, and OBIs were identified in 40.5% of these non-resolved pools. Therefore, non-resolved donations with anti-HBc+ might pose potential risk for HBV transmission. Our present analysis indicates that anti-HBc testing in non-resolved donations should be used to identify OBIs in order to further increase blood safety in China.
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Affiliation(s)
- Xianlin Ye
- Department of Laboratory, Shenzhen Blood Center, Shenzhen, China
| | - Yu Zhao
- Department of Laboratory, Shenzhen Blood Center, Shenzhen, China
| | - Ran Li
- Department of Laboratory, Shenzhen Blood Center, Shenzhen, China
| | - Tong Li
- Department of Laboratory, Shenzhen Blood Center, Shenzhen, China
| | - Xin Zheng
- Department of Laboratory, Shenzhen Blood Center, Shenzhen, China
| | - Wen Xiong
- Department of Laboratory, Shenzhen Blood Center, Shenzhen, China
| | - Jinfeng Zeng
- Department of Laboratory, Shenzhen Blood Center, Shenzhen, China
| | - Min Xu
- Provincial Key Laboratory for Transfusion-Transmitted Infectious Diseases, Institute of Blood Transfusion, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Chengdu, China
| | - Limin Chen
- Provincial Key Laboratory for Transfusion-Transmitted Infectious Diseases, Institute of Blood Transfusion, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Chengdu, China.,The Joint Laboratory on Transfusion-Transmitted Diseases (TTD) Between Institute of Blood Transfusion, Nanning Blood Center, Chinese Academy of Medical Sciences and Nanning Blood Center, Nanning, China.,Toronto General Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada
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Kim J, Moon JH, Um SH. Short RNA Universal Coding for Topological Transformation Nano-barcoding Application. Chembiochem 2020; 22:392-397. [PMID: 32881235 DOI: 10.1002/cbic.202000477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 09/01/2020] [Indexed: 11/11/2022]
Abstract
With the advent of innovative genomic discovery toolkits such as RT-PCR, genetic information can be quickly decrypted, and this has resulted in significant progress in overcoming diseases. However, RT-PCR has the serious problem of frequent errors, and the demand for a new gene diagnostic system is emerging. Herein, we propose a universal coding system for the effective detection of short single-stranded DNA or RNA by using a topological transformation-based nano-barcoding technique (TNT). Our goal was to develop a dedicated diagnostic device that unifies the other gene groups, thus resulting in minimum testing. In a universal coding system consisting of two separate circulation structures, different gene groups become generalized into specific single genes with the same sequence by a strand-displacement reaction and are then amplified, eventually being quickly detected in one TNT system. Simple gene diagnostic systems like this make high-speed, point-of-care diagnostic technologies, and we are very confident that these will provide clinical gene detection in the near future.
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Affiliation(s)
- Jeonghun Kim
- Progeneer Incorporation, 12, Digital-ro 31-gil, Guro-gu, Seoul, 08380, South Korea
| | - Je Hun Moon
- School of Chemical Engineering, Sungkyunkwan University, 2066, Seobu-ro, Suwon, Gyeonggi-do, 16419, South Korea
| | - Soong Ho Um
- Progeneer Incorporation, 12, Digital-ro 31-gil, Guro-gu, Seoul, 08380, South Korea.,School of Chemical Engineering, Sungkyunkwan University, 2066, Seobu-ro, Suwon, Gyeonggi-do, 16419, South Korea.,SKKU Advanced Institute of Nanotechnology (SAINT), Sungkyunkwan University, 2066, Seobu-ro, Suwon, Gyeonggi-do, 16419, South Korea.,Biomedical Institute for Convergence at SKKU (BICS), Sungkyunkwan University, 2066, Seobu-ro, Suwon, Gyeonggi-do, 16419, South Korea.,Institute of Quantum Biophysics (IQB), Sungkyunkwan University, 2066, Seobu-ro, Suwon, Gyeonggi-do, 16419, South Korea
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Kim J, Yoo C, Moon JH, Um SH. EGFR Fragmentation for Topological Transformation Nanobarcoding. Chembiochem 2020; 21:2533-2539. [DOI: 10.1002/cbic.202000179] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 04/13/2020] [Indexed: 12/17/2022]
Affiliation(s)
- Jeonghun Kim
- Progeneer Incorporation 12, Digital-ro 31-gil, Guro-gu Seoul 08380 South Korea
| | - Changhoon Yoo
- Progeneer Incorporation 12, Digital-ro 31-gil, Guro-gu Seoul 08380 South Korea
| | - Je Hun Moon
- School of Chemical EngineeringSungkyunkwan University 2066 Seobu-ro Suwon Gyeonggi-do 16419 South Korea
| | - Soong Ho Um
- School of Chemical EngineeringSungkyunkwan University 2066 Seobu-ro Suwon Gyeonggi-do 16419 South Korea
- SKKU Advanced Institute of Nanotechnology (SAINT)Sungkyunkwan University 2066 Seobu-ro Suwon Gyeonggi-do 16419 South Korea
- Biomedical Institute for Convergence at SKKU (BICS)Sungkyunkwan University 2066 Seobu-ro Suwon Gyeonggi-do 16419 South Korea
- Progeneer Incorporation 12, Digital-ro 31-gil, Guro-gu Seoul 08380 South Korea
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Ramachandran S, Groves JA, Xia GL, Saá P, Notari EP, Drobeniuc J, Poe A, Khudyakov N, Schillie SF, Murphy TV, Kamili S, Teo CG, Dodd RY, Khudyakov YE, Stramer SL. Recent and occult hepatitis B virus infections among blood donors in the United States. Transfusion 2019; 59:601-611. [PMID: 30499591 PMCID: PMC8190636 DOI: 10.1111/trf.15057] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 09/28/2018] [Accepted: 10/02/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Characteristics of US blood donors with recent (RBI) or occult (OBI) hepatitis B virus (HBV) infection are not well defined. METHODS Donors with RBI and OBI were identified by nucleic acid and serologic testing among 34.4 million donations during 2009-2015. Consenting donors were interviewed and their HBV S-gene sequenced. RESULTS The overall rate of HBV-infected donors was 7.95 per 100,000; of these, 0.35 per 100,000 and 1.70 per 100,000 were RBI and OBI, respectively. RBI (n = 120) and OBI (n = 583) donors constituted 26% of all HBV-infected (n = 2735) donors. Detection of HBV DNA in 92% of OBI donors required individual donation nucleic acid testing. Donors with OBI compared to RBI were older (mean age, 48 vs 39 years; p < 0.0001) with lower median viral loads (9 vs. 529 IU/mL; p < 0.0001). A higher proportion of OBI than RBI donors were born or resided in an endemic country (39% vs. 5%; p = 0.0078). Seventy-seven percent of all RBI and OBI donors had multiple sex partners, an HBV-risk factor. Of 40 RBI and 10 OBI donors whose S gene was sequenced, 33 (83%) and 6 (60%), respectively, carried HBV subgenotype A2; 18 (55%) and 2 (33%), respectively, shared an identical sequence. Infection with 1 or more putative HBV-immune-escape mutants was identified in 5 (50%) of OBI but no RBI donors. CONCLUSION RBI and OBI continue to be identified at low rates, confirming the importance of comprehensive HBV DNA screening of US blood donations. HBV-infected donors require referral for care and evaluation and contact tracing; their HBV strains may provide important information on emergent genotypes.
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Affiliation(s)
- Sumathi Ramachandran
- Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jamel A. Groves
- Scientific Affairs, American Red Cross, Gaithersburg, Maryland
| | - Guo-liang Xia
- Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Paula Saá
- Scientific Affairs, American Red Cross, Gaithersburg, Maryland
| | | | - Jan Drobeniuc
- Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Amanda Poe
- Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Natasha Khudyakov
- Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sarah F. Schillie
- Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Trudy V. Murphy
- Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Saleem Kamili
- Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Chong-Gee Teo
- Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Roger Y. Dodd
- Scientific Affairs, American Red Cross, Gaithersburg, Maryland
| | - Yury E. Khudyakov
- Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia
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Granade TC, Kodani M, Wells SK, Youngpairoj AS, Masciotra S, Curtis KA, Kamili S, Owen SM. Characterization of real-time microarrays for simultaneous detection of HIV-1, HIV-2, and hepatitis viruses. J Virol Methods 2018; 259:60-65. [PMID: 29874550 DOI: 10.1016/j.jviromet.2018.06.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 06/01/2018] [Accepted: 06/02/2018] [Indexed: 01/07/2023]
Abstract
Real-time PCR assays for nucleic acid testing (NAT) of hepatitis viruses A-E and for HIV-1 and HIV-2 have been developed; however, a multiplex assay that can simultaneously detect all of these agents is not yet available. Standardized TaqMan assays for detection of hepatitis viruses A-E have been described and applied to TaqMan Array Cards (TAC) which are capable of multiple pathogen detection using a single set of optimized PCR conditions. Assays for three gene regions of HIV-1 (long-terminal repeat (LTR), gag, and polymerase) and HIV-2 (overlap of LTR and gag, protease and integrase) were designed using the hepatitis assay conditions. Nucleic acid extracts of HIV-1-infected samples (44 plasma, 41 whole blood, 20 HIV-1 viral stocks) were tested on the TAC cards; 98 were reactive (92%) with 70 in multiple gene regions. Twenty-four of the 27 (89%) HIV-2 specimens (10 plasma, 1 PBMC lysate, 6 whole blood and 10 plasmids containing HIV-2 polymerase) were detected on TAC. No HIV or hepatitis virus sequences were detected in 30 HIV-negative samples (specificity 100%). Three HBV and 18 HCV co-infections were identified in the HIV-1-infected specimens. Multi-pathogen detection using TAC could provide a rapid, sensitive and more efficient method of surveying for a variety of infectious disease nucleic acids.
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Affiliation(s)
- Timothy C Granade
- Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, GA, 30333, United States.
| | - Maja Kodani
- Centers for Disease Control and Prevention, Division of Viral Hepatitis, Atlanta, GA, 30333, United States
| | - Susan K Wells
- Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, GA, 30333, United States
| | - Ae S Youngpairoj
- Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, GA, 30333, United States
| | - Silvina Masciotra
- Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, GA, 30333, United States
| | - Kelly A Curtis
- Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, GA, 30333, United States
| | - Saleem Kamili
- Centers for Disease Control and Prevention, Division of Viral Hepatitis, Atlanta, GA, 30333, United States
| | - S Michele Owen
- Centers for Disease Control and Prevention, National Center for HIV, Hepatitis, STD and TB Prevention, Atlanta, GA, 30333, United States
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Hou P, Tebbs JM, Bilder CR, McMahan CS. Hierarchical group testing for multiple infections. Biometrics 2016; 73:656-665. [PMID: 27657666 DOI: 10.1111/biom.12589] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 06/01/2016] [Accepted: 08/01/2016] [Indexed: 11/30/2022]
Abstract
Group testing, where individuals are tested initially in pools, is widely used to screen a large number of individuals for rare diseases. Triggered by the recent development of assays that detect multiple infections at once, screening programs now involve testing individuals in pools for multiple infections simultaneously. Tebbs, McMahan, and Bilder (2013, Biometrics) recently evaluated the performance of a two-stage hierarchical algorithm used to screen for chlamydia and gonorrhea as part of the Infertility Prevention Project in the United States. In this article, we generalize this work to accommodate a larger number of stages. To derive the operating characteristics of higher-stage hierarchical algorithms with more than one infection, we view the pool decoding process as a time-inhomogeneous, finite-state Markov chain. Taking this conceptualization enables us to derive closed-form expressions for the expected number of tests and classification accuracy rates in terms of transition probability matrices. When applied to chlamydia and gonorrhea testing data from four states (Region X of the United States Department of Health and Human Services), higher-stage hierarchical algorithms provide, on average, an estimated 11% reduction in the number of tests when compared to two-stage algorithms. For applications with rarer infections, we show theoretically that this percentage reduction can be much larger.
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Affiliation(s)
- Peijie Hou
- Department of Statistics, University of South Carolina, Columbia, South Carolina 29208, U.S.A
| | - Joshua M Tebbs
- Department of Statistics, University of South Carolina, Columbia, South Carolina 29208, U.S.A
| | - Christopher R Bilder
- Department of Statistics, University of Nebraska-Lincoln, Lincoln, Nebraska 68583, U.S.A
| | - Christopher S McMahan
- Department of Mathematical Sciences, Clemson University, Clemson, South Carolina 29634, U.S.A
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Duncan R, Kourout M, Grigorenko E, Fisher C, Dong M. Advances in multiplex nucleic acid diagnostics for blood-borne pathogens: promises and pitfalls. Expert Rev Mol Diagn 2015; 16:83-95. [PMID: 26581018 DOI: 10.1586/14737159.2016.1112272] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The large number of blood-borne viruses, bacteria and parasites currently of concern, as well as many newly emerging pathogens, presents a daunting challenge to protection of the safety of blood for transfusion and diagnosing infectious diseases. Focusing on nucleic acid diagnostic tests, multiplex devices are coming into use with many more in various developmental stages that promise to offer solutions to the clinical need. The characteristics, advantages and disadvantages of platforms in clinical use and at the research and development stage are examined here. The presence of multiple assays and associated reagents operating simultaneously on one platform, implementation in traditional clinical laboratories and regulatory review will present special challenges. Fortunately, clinical laboratories have made dramatic technical progress in the last two decades and regulatory agencies have publicly expressed support for development of multiplex devices.
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Affiliation(s)
- Robert Duncan
- a Center for Biologics Evaluation and Research , US FDA , Silver Spring , MD , USA
| | - Moussa Kourout
- a Center for Biologics Evaluation and Research , US FDA , Silver Spring , MD , USA
| | | | - Carolyn Fisher
- a Center for Biologics Evaluation and Research , US FDA , Silver Spring , MD , USA
| | - Ming Dong
- a Center for Biologics Evaluation and Research , US FDA , Silver Spring , MD , USA
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Wang L, Chang L, Xie Y, Huang C, Xu L, Qian R, Zhu H, He Y, Li J, Huang H, Li W, Zhang K, Zhang R, Xie J, Sun Y, Li J. What is the meaning of a nonresolved viral nucleic acid test-reactive minipool? Transfusion 2014; 55:395-404. [PMID: 25125223 DOI: 10.1111/trf.12818] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Revised: 07/02/2014] [Accepted: 07/07/2014] [Indexed: 12/14/2022]
Abstract
BACKGROUND This study aimed at analyzing the prevalence of hepatitis B virus (HBV) DNA among hepatitis B surface antigen (HBsAg)-negative donations by cobas TaqScreen MPX test (Roche Molecular Systems) and discussing the meaning of a reactive minipool (MP) that does not resolve to an individual donation (ID)-reactive result. STUDY DESIGN AND METHODS Nucleic acid amplification testing (NAT) was performed in 12 Chinese blood centers on 826,044 serologic negative donations in MPs of six. MP-reactive pools that were resolved to ID-reactive donations were confirmed by Roche TaqMan viral load assays. Antibody to hepatitis B surface antigen and antibody to hepatitis B core antigen (anti-HBc) results were also analyzed. Cycle threshold (Ct) values of reactive MPs were analyzed in relation to the probability of pool resolution. RESULTS A total of 1267 of 137,674 pools were reactive, of which 839 donations were reactive by ID-NAT. The MP6 HBV NAT-yield rate lay between 1 in 1600 and 1 in 1000. At MP Ct values equal or below 37, the probability of pool resolution was approximately 80%. The prevalence of anti-HBc in ID-reactive donations was 81%. The proportion of reactive pools that could not be resolved was 36%. The prevalence of anti-HBc in donations implicated in nonresolved MPs was significantly higher than those in nonreactive MPs (48% vs. 37%, p = 0.016). CONCLUSION The anti-HBc data suggest that approximately 10% of nonresolved MPs contain HBV DNA from a low-viral-load occult carrier. We consider ID-NAT resolution testing in duplicate to minimize HBV transmission risk associated with transfusing nonreactive donations implicated in reactive MPs.
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Affiliation(s)
- Lunan Wang
- National Center for Clinical Laboratories, Beijing Hospital, Beijing, China
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A Simple and Rapid Method for the Detection of HIV-1/HCV in Co-Infected Patients. IRANIAN JOURNAL OF BIOTECHNOLOGY 2013. [DOI: 10.5812/ijb.10717] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Comparative evaluation of a triplex nucleic acid test for detection of HBV DNA, HCV RNA, and HIV-1 RNA, with the Procleix Tigris System. J Virol Methods 2013; 187:357-61. [DOI: 10.1016/j.jviromet.2012.10.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2012] [Revised: 10/24/2012] [Accepted: 10/30/2012] [Indexed: 12/15/2022]
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Detección de hepatitis B oculta en donantes de bancos sangre, Colombia 2008-2009. BIOMEDICA 2011. [DOI: 10.7705/biomedica.v31i4.446] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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