Shyamala Venkatakrishna, Arcangel Phillip, Cottrell Joshua, Coit Doris, Medina-Selby Angelica, McCoin Colin, Madriaga Dennis, Chien David, Phelps Bruce
Blood Testing Division, Chiron Corporation, Emeryville, CA 94608, USA.
J Clin Microbiol. 2004 Nov;42(11):5199-204. doi: 10.1128/JCM.42.11.5199-5204.2004.
Recent clinical studies suggest that hepatitis B virus (HBV) load and genotype may be independent predictors of responses to antiviral therapies. However, it is difficult for clinicians to accurately determine viral loads in patient samples because results--both the values and the units of measure--can vary greatly among different tests. Accordingly, the World Health Organization (WHO) has produced the first international standard for HBV DNA for nucleic acid amplification technology (NAT) assays. In the present study, we describe the performance of the target-capture PCR HBV DNA quantitative assay for the quantitation of HBV DNA in clinical samples and reference panels. The range of quantitation was between 50 and 10(10) IU/ml. The sensitivity and accuracy of the target-capture PCR assay were demonstrated by using the HBV panel from Quality Control for Medical Diagnostics (QCMD) and the WHO HBV DNA standard. The target-capture PCR assay quantitated the six genotype A members of the QCMD panel and dilutions of the WHO HBV DNA standard within an accuracy of 74 to 142%. Compared to current serological methods, the assay offers window period reductions of 19 days prior to HBV surface antigen and 26 days prior to HBV e antigen detection. The target-capture PCR assay was also compared with four commercially available NAT assays, and the various units of measure were standardized with respect to the international units of the WHO HBV DNA standard. The target-capture PCR assay is a sensitive, accurate, high-throughput, rapid, and reproducible assay for the determination of HBV loads.
近期临床研究表明,乙肝病毒(HBV)载量和基因型可能是抗病毒治疗反应的独立预测指标。然而,临床医生很难准确测定患者样本中的病毒载量,因为不同检测方法的结果——包括数值和测量单位——可能差异很大。因此,世界卫生组织(WHO)制定了首个用于核酸扩增技术(NAT)检测的HBV DNA国际标准。在本研究中,我们描述了用于定量临床样本和参考品中HBV DNA的靶向捕获PCR HBV DNA定量检测方法的性能。定量范围为50至10(10)IU/ml。通过使用医学诊断质量控制(QCMD)的HBV参考品和WHO HBV DNA标准品,证明了靶向捕获PCR检测方法的灵敏度和准确性。靶向捕获PCR检测方法对QCMD参考品中的6个A型基因型成员和WHO HBV DNA标准品的稀释液进行定量,准确度在74%至142%之间。与目前的血清学方法相比,该检测方法可将HBV表面抗原检测前的窗口期缩短19天,将HBV e抗原检测前的窗口期缩短26天。还将靶向捕获PCR检测方法与4种市售NAT检测方法进行了比较,并根据WHO HBV DNA标准品的国际单位对各种测量单位进行了标准化。靶向捕获PCR检测方法是一种用于测定HBV载量的灵敏、准确、高通量、快速且可重复的检测方法。