RESUMO
A high-risk patient was informed of a positive HIV antibody/antigen test. However, follow-up samples taken 2-3 months later for HIV RNA and anti-HIV antibodies were negative. Human DNA testing confirmed that all samples were from this patient, excluding a sample mix-up. Laboratory investigations revealed a likely splash-over contamination event.
Assuntos
Técnicas de Laboratório Clínico/métodos , Erros de Diagnóstico , Infecções por HIV/diagnóstico , Técnicas de Diagnóstico Molecular/métodos , Técnicas de Laboratório Clínico/normas , Anticorpos Anti-HIV/sangue , Antígenos HIV/sangue , Humanos , Imunoensaio/métodos , Masculino , RNA Viral/sangue , Adulto JovemRESUMO
BACKGROUND: Hepatitis C (HCV) genotyping is important for treatment planning. The Abbott m2000 RealTime HCV Genotype II assay is a PCR-based assay targeting specific regions of the 5'NCR gene for genotypes 1-6, and the NS5b gene for subgenotypes 1a/1b. However, not all genotypes can be resolved, with results being reported as: 'indeterminate', 'mixed', 'genotype X reactivity with Y', or just the major genotype 1 alone. OBJECTIVES AND STUDY DESIGN: To assess the supplementary testing required for these unresolved HCV genotypes, these samples were tested further using an in-house core/E1 sequencing assay. The resulting genotypes/subgenotypes were assigned using phylogenetic analysis with reference HCV genotype sequences. Additional testing was conducted using the INNO-LiPA HCV II assay for truly mixed genotypes. RESULTS: Out of 1052 samples tested, 89 (8.5%) underwent further sequencing to determine the HCV genotype: 16 that were 'indeterminate' on the m2000, were mostly genotype 2s and 3s by sequencing; 12 that were 'mixed', were mostly one of the genotypes reported in the mixture; 7 that were 'X reactivity with Y', were usually genotype X; 54 that gave just a major genotype 1 result were mostly 1a, with some 6 and 1b, and a few 1c. For three truly mixed genotypes, additional testing using the VERSANT(®) HCV Genotype Assay (LiPA) 2.0, showed two mixed 1 and 3, and one indistinguishable 6c-6l genotypes. CONCLUSIONS: The Abbott m2000 RealTime HCV Genotype II assay can resolve most (â¼90%) HCV genotypes. However in 9-10% of cases, to fully resolve the genotype, additional testing is required.