Analytical and Clinical Performance of the NeuMoDx™ Platform for Cytomegalovirus and Epstein-Barr Virus Viral Load Testing.

DNA assays for viral load (VL) monitoring are key tools in the management of immunocompromised patients with cytomegalovirus (CMV) or Epstein-Barr virus (EBV) infection. In this study, the analytical and clinical performances of the NeuMoDx™ CMV and EBV Quant Assays were compared with artus CMV and EBV QS-RGQ Kits in a primary hospital testing laboratory. Patient plasma samples previously tested using artus kits were randomly selected for testing by NeuMoDx assays. The NeuMoDx CMV Quant Assay and artus CMV QS-RGQ Kit limits of detection (LoDs) are 20.0 IU/mL and 69.7 IU/mL, respectively; 33/75 (44.0%) samples had CMV DNA levels above the LoD of both assays. The Pearson correlation coefficient was 0.9503; 20 samples (60.6%) had lower NeuMoDx CMV quantification values versus the artus kit. The LoD of the NeuMoDx EBV Quant Assay and artus EBV QS-RGQ Kit are 200 IU/mL and 22.29 IU/mL, respectively; 16/75 (21.3%) samples had EBV DNA levels above the LoD of both assays. The Pearson correlation coefficient was 0.8990. EBV quantification values with the NeuMoDx assay were higher versus the artus kit in 15 samples (93.8%). In conclusion, NeuMoDx CMV and EBV Quant Assays are sensitive and accurate tools for CMV and EBV DNA VL quantification.

Hepatitis C Virus (HCV) RNA screening and sequencing using dry plasma spots.

BACKGROUND: HCV RNA screening of large sample repositories provides data on HCV epidemic patterns that may help guide control policies. In resource-limited settings, shipment of frozen samples to molecular laboratory facilities and testing of individual samples may be prohibitively expensive. OBJECTIVE: Our aim was to detect and sequence HCV RNA in a large HIV-positive cohort from Kumasi, Ghana, using pooled and individual dried plasma spots (DPS) produced from samples stored at -80°C. STUDY DESIGN: In the validation phase, replicate DPS were prepared with six dilutions (500-10,000 IU/ml) of the 4th International Standard for HCV and tested in three independent experiments. In the testing phase, DPS prepared with plasma samples from 875 HIV-positive subjects were pooled for screening, followed by testing of individual DPS of positive pools. Input from individual DPS was two 6mm punches; pools comprised two punches from each of five DPS. Genotypes were determined by Sanger sequencing of HCV core and NS5B. RESULTS: With the dilution series, sensitivity of HCV RNA detection was ≥2500 IU/ml. Replicate DPS gave intra-assay and inter-assay coefficients of variation ≤1.4%. With the stored samples, HCV RNA was detected in 5/175 DPS pools and in one DPS from each positive pool, yielding a HCV RNA prevalence of 5/875 (0.57%; 95% confidence interval 0.07-1.07%). The five samples were sequenced as HCV genotypes 2l and 2r. DISCUSSION: DPS allowed reproducible HCV RNA detection, and pooling effectively contained the cost and labour of screening a previously untested, low-prevalence cohort. DPS were also suitable for HCV sequencing.

A European multicientre study on the comparison of HIV-1 viral loads between VERIS HIV-1 Assay and Roche COBAS® TAQMAN® HIV-1 test, Abbott RealTime HIV-1 Assay, and Siemens VERSANT HIV-1 Assay.

BACKGROUND: Viral load monitoring is essential for patients under treatment for HIV. Beckman Coulter has developed the VERIS HIV-1 Assay for use on the novel, automated DxN VERIS Molecular Diagnostics System.¥ OBJECTIVES: Evaluation of the clinical performance of the new quantitative VERIS HIV-1 Assay at multiple EU laboratories. STUDY DESIGN: Method comparison with the VERIS HIV-1 Assay was performed with 415 specimens at 5 sites tested with COBAS® AmpliPrep/COBAS® TaqMan® HIV-1 Test, v2.0, 169 specimens at 3 sites tested with RealTime HIV-1 Assay, and 202 specimens from 2 sites tested with VERSANT HIV-1 Assay. Patient monitoring sample results from 4 sites were also compared. RESULTS: Bland-Altman analysis showed the average bias between VERIS HIV-1 Assay and COBAS HIV-1 Test, RealTime HIV-1 Assay, and VERSANT HIV-1 Assay to be 0.28, 0.39, and 0.61 log10 cp/mL, respectively. Bias at low end levels below 1000cp/mL showed predicted bias to be <0.3 log10 cp/mL for VERIS HIV-1 Assay versus COBAS HIV-1 Test and RealTime HIV-1 Assay, and <0.5 log10cp/mL versus VERSANT HIV-1 Assay. Analysis on 174 specimens tested with the 0.175mL volume VERIS HIV-1 Assay and COBAS HIV-1 Test showed average bias of 0.39 log10cp/mL. Patient monitoring results using VERIS HIV-1 Assay demonstrated similar viral load trends over time to all comparators. CONCLUSIONS: The VERIS HIV-1 Assay for use on the DxN VERIS System demonstrated comparable clinical performance to COBAS® HIV-1 Test, RealTime HIV-1 Assay, and VERSANT HIV-1 Assay.

Comparative evaluation of three FDA-approved HIV Ag/Ab combination tests using a genetically diverse HIV panel and diagnostic specimens.

BACKGROUND: HIV Ag/Ab combination assays are recommended by CDC for routine screening and several HIV Ag/Ab combination tests are now FDA-approved. Maintaining high specificity and consistent sensitivity across diverse HIV strains is critical for these assays to accurately detect HIV infection and expedite delivery of patient results. OBJECTIVES: To evaluate performance of three FDA-approved HIV tests: ARCHITECT HIV Combo (Abbott), ADVIA Centaur HIV Combo (Siemens) and BioPlex HIV Ag-Ab (Bio-Rad). STUDY DESIGN: Sensitivity and specificity were evaluated using an extensive panel of 28 HIV infected human specimens and 17 cultured virus isolates representing multiple genotypes, 6 seroconversion panels, 4 human samples with acute infection, WHO p24 standard and 4020 clinical specimens. RESULTS: The p24 limit of detection (LOD) for the WHO standard was 0.19IU/ml, 0.70IU/ml, and 1.77IU/ml in BioPlex, ARCHITECT, and Centaur respectively. The distribution of LODs across 15 HIV-1 isolates was substantially narrower in ARCHITECT (5-33pg/ml) than in BioPlex (11-198pg/ml) and Centaur (6-384pg/ml). All assays detected antibodies to the majority of HIV-1 and HIV-2 variants. However, reduced sensitivity was observed for Centaur in detection of antibodies to HIV-1 group M (CRF02_AG), O and N variants. BioPlex and ARCHITECT showed better seroconversion sensitivity than Centaur, detecting one bleed (3-7 days) earlier in 4 (BioPlex) and 3 (ARCHITECT) of 6 seroconversion panels. ARCHITECT demonstrated the highest specificity (99.90-100%) compared to BioPlex (99.80%) and Centaur (99.42%). CONCLUSIONS: The overall performance of ARCHITECT and BioPlex was superior to Centaur, especially for detection of acute HIV infection.

Development of double-generation gold nanoparticle chip-based dengue virus detection system combining fluorescence turn-on probes.

A sensing platform, combined amino acid labeling kit and a double-generation gold nanoparticle (DG-AuNP) chip, was designed to prove the existence of weak but crucial binding between the DV (dengue virus) and its CLEC5A receptor. At first, we have designed a kit combining the novel fluorescence turn-on sensors for lysine, arginine and cysteine amino acids. Advantages of this kit are that emission on-off switching can increase the signal-to-noise ratio and the virus must be fluorescently labelled with sufficient numbers of fluorophores because the lysine, arginine and cysteine residues of viral proteins are labelled simultaneously. Consequently, this kit can be used to light-on single DV spot both in solution and in cell under fluorescence microscopy. Second, the labeling kit was used to examine the DV binding to the CLEC5A-coated DG-AuNP chip. Based on our study, the double-generation gold nanoparticle construction of chip can support more coating areas for receptor CLEC5A and then, support more binding opportunities for DV. Meanwhile, the grooves between nanohemispheres will provide the extra driving force for DV stacking. We try to give a proof that this sensing platform is very useful for detection of weak binding mechanism.

Comparative investigations for adenovirus recognition and quantification: Plastic or natural antibodies?

Comparative and comprehensive investigations for adenovirus recognition and detection were conducted using plastic and natural antibodies to compare three different strategies. The implementation of molecularly imprinted polymer (MIP) technology for specific and sensitive recognition of viruses with the combination of biosensors was reported. Plastic antibodies (MIPs nanoparticles) were produced for adenovirus by employing a novel solid phase synthesis method. MIP receptors were then characterised using dynamic light scattering (DLS) and transmission electron microscopy (TEM) techniques prior to immobilisation on a surface plasmon resonance (SPR) sensor as affinity receptor for adenovirus detection. Two different templates were also imprinted as control MIPs (vancomycin-MIP and MS2-MIP). The specific recognition of adenovirus was investigated in the concentration range of 0.01-20 pM and the limit of detection was achieved as 0.02 pM. As an alternative to MIP receptors, direct and sandwich assays were developed for adenovirus quantification using natural antibodies. The detection limit of direct and sandwich assays were found as 0.3 pM and 0.008 pM, respectively. The kinetic data analyses were performed for three different adenovirus recognition methods and cross-reactivity studies were also conducted using MS2 phage as control virus and an excellent specificity was achieved with all assays types. This work confirmed the suitability of the MIPs SPR sensor for the detection of viruses.

Electrochemical aptasensors for microbial and viral pathogens.

Aptamers are DNA and RNA oligonucleotides that can bind to a variety of nonnucleic acid targets with high affinity and specificity. Pathogen detection is a promising area in aptamer research. One of its major advantages is the ability of the aptamers to target and specifically differentiate microbial and viral strains without previous knowledge of the membrane-associated antigenic determinants or molecular biomarkers present in that particular microorganism. Electrochemical sensors emerged as a promising field in the area of aptamer research and pathogen detection. An electrochemical sensor is a device that combines a recognition element and an electrochemical transduction unit, where aptamers represent the latest addition to the large catalog of recognition elements. This chapter summarizes and evaluates recent developments of electrochemical aptamer-based sensors for microbial and viral pathogen detection, viability assessment of microorganisms, bacterial typing, identification of epitope-specific aptamers, affinity measurement between aptamers and their respective targets, and estimation of the degree of aptamer protection of oncolytic viruses for therapeutic purposes.

A Rat Basophilic Leukaemia cell sensor for the detection of pathogenic viruses.

A Rat Basophilic Leukemia (RBL) cell sensor is developed for the detection and identification of pathogenic viruses. Recombinant sdAb-Fc antibodies were constructed by linking virus-specific single domain antibody to mouse IgE-Fc fragment. The sdAb-Fc can bind to FcεRI receptors on RBL cells and can be cross-linked by target viruses leading to cell activation and Ca(2+) influx reflected by the increase of intracellular fluorescence. The responses of RBL cells to viruses in real time could be observed using fluorescence microscopy. 10(3) TCID50 of H5N1 viruses and 10 LD50 of rabies viruses could be detected in less than three minutes. An excess quantity of non-relevant viruses did not interfere with the recognition of target viruses.

Real-time optical detection of single human and bacterial viruses based on dark-field interferometry.

The rapid and sensitive detection and characterization of human viruses and bacteriophage is extremely important in a variety of fields, such as medical diagnostics, immunology and vaccine research, and environmental contamination and quality control. We introduce an optical detection scheme for real-time and label-free detection of human viruses and bacteriophage as small as ~24 nm in radius. Combining the advantages of heterodyne interferometry and dark-field microscopy, this label-free method enables us to detect and characterize various biological nanoparticles with unsurpassed sensitivity and selectivity. We demonstrate the high sensitivity and precision of the method by analyzing a mixture containing HIV virus and bacteriophage. The method also resolves the distribution of small nano-impurities (~20-30 nm) in clinically relevant virus samples.

Rapid enumeration of respiratory viruses.

Virus detection and enumeration has become increasingly important in fields ranging from medicine and biotechnology to environmental science. Although there are a wide variety of techniques that can be used to count viruses, there is demand for a rapid and more accurate means for virus enumeration. In this work, the performance of a flow cytometer that was designed and custom-built specifically for rapid detection of single viruses was evaluated. The instrument, designated a single nanometric particle enumerator (SNaPE), was characterized and calibrated using fluorescent polystyrene nanospheres. The reliability of the instrument with respect to virus enumeration was demonstrated for three medically relevant viruses, adenovirus-5, respiratory syncytial virus, and influenza A, treated with a fluorescent nucleotide stain. In each case, the SNaPE yielded a virus particle concentration consistent with, but slightly lower than, transmission electron microscopy (TEM) results, as expected. In addition, on the basis of calibration of signal intensity, the average peak height for a given virus was correlated with genome size, as expected. In contrast to time-consuming analyses such as TEM and plaque titers, SNaPE analysis of pure virus samples (including sample handling, data collection, and data processing) can be completed within 1 h.

Cuantificación de la carga viral

Para las infecciones causadas por agentes virales como el virus de la inmunodeficiencia humana (VIH), las pruebas más utilizadas se basan en la determinación de anticuerpos especificos producidos por el sistema inmune del paciente como respuesta al agente infeccioso. Estas pruebas que determinan anticuerpos tienen utilidad para estudios de tamización y como herramienta diagnóstica, pero sólo permiten una medida indirecta de la infección viral. De otra parte, el recuento de linfocitos CD4+, que se utiliza para la profilaxis de infecciones oportunistas y seguimiento de los pacientes con VIH, ha demostrado ser poco efectivo para la evaluación de la respuesta al tratamiento. El desarrollo de nuevas técnicas moleculares como la prueba de ADN- ramificado -bDNA- para la cuantificaión del ARN del VIH-1 -carga viral- en plasma, finalmente ha permitido el estudio individualizado de la progresión clínica de la enfermedad y de la respuesta a la terapia antiviral. Se describe paso a paso el proseso de esta técnica, al igual que sus ventajas y desventajas ante a las otras pruebas utilizadas para la evaluación de los pacientes infectados por el VIH.