Low prevalence of hepatitis C virus infection in Amerindians from Western Venezuela

Previous studies have not found hepatitis C virus (HCV) infection in Amerindians from Western Venezuela. A survey of 254 Bari and Yukpa natives aged 10-60 years (mean +/- SD age = 35 +/- 5.4 years) from four communities, two Bari and two Yukpa, in this area were studied to assess the prevalence of antibodies to HCV (anti-HCV) and HCV RNA among these indigenous populations. Serum samples were examined initially for anti-HCV by a four generation enzyme-linked immunosorbent assay (ELISA). Reactive samples were then tested using a third generation recombinant immunoblot assay (RIBA-3). Viral RNA was investigated in all immunoblot-reactive samples by a nested polymerase chain reaction (PCR) method. Six (2.3%) of 254 natives were positive by ELISA, one (2.2%) of these reactive samples were positive by RIBA, and four (1.5%) were indeterminate. Only two (0.8%) were positive by PCR, corresponding to 1 (2.1%) of 47 inhabitants of a Yukpa community and to 1 (2.2%) of 45 subjects of a Bari community. Iatrogenic is thought to play a role in acquisition of the infection. The findings indicate a HCV focus of low endemicity and are compatible with a low degree of exposures of the natives to the virus. Studies are necessary to assess the risk factors for infection in these Amerindians.     

Hepatitis C virus infection from blood and blood products

Abstract: The addition of second-generation HCV epitopes in antibody detection assays has increased the sensitivity and specificity of blood donor testing, to prevent post-transfusion hepatitis non-A, non-B (PTH-NANB), later characterized as Hepatitis C. However, it is not clear whether all HCV infectious donors are detected by second generation anti-HCV testing. Prospective studies on PTH-NANB were left with some unresolved cases. The use of second-generation anti-HCV assays in blood banks presented a problem with a relatively large number of indeterminate reactivities in supplemental assays such as RIBA-2. These indeterminate reactivities may be solved by the use of polymerase chain reaction (PCR). PCR is more and more used as an extra confirmatory assay to resolve RIBA indeterminate results on blood donors. However, a European study on the proficiency of HCV PCR in different countries revealed that only a minority of the reference laboratories perform this test faultness. Lately, third generation RIBA was developed, which was originally designed to resolve RIBA-2 indeterminate cases. RIBA-3 was shown to be more sensitive and specific in early HCV infection and blood donors than RIBA-2. Third generation anti-HCV testing will become standard practice. Some questions, however, remain unanswered. Do we miss any rare HCV infectious donors, of other genotypes, with third-generation assays, based only on the type 1 sequence of HCV? Can we improve HCV detection in the early phase of infection? What is the role of sporadic HCV transmission? How can we standardize HCV nucleic acid detection methods?     

丙型肝炎病毒分片段抗体检测蛋白质芯片质控参比品的建立及质量验证

建立能同时检测丙型肝炎病毒(HCV)嵌合抗体、核心抗体和NS3、NS4、NS5抗体的蛋白质芯片质控参比品,对质控合格的芯片进行质量验证。用3种HCV EIA试剂分别检测从3家医院收集的丙型肝炎病毒感染患血清及其他非HCV感染患血清,从3种EIA试剂同时阴性或阳性的血样中挑取阳性和阴性血清,然后用RNA hyb PCR试剂进行检测,从中再选取部分样本用RIBA3．0进行检测,确定HCV分片段抗体检测蛋白质芯片质控参比品。经质检合格的芯片用中国药品生物制品检定所的HCV参比品进行检定。通过490例临床标本的检测对芯片的质量进行进一步的验证。从收集的240份丙型肝炎病毒感染患血清及其他非HCV感染患血清筛选出30份血样(15份阳性,15份阴性)作为HCV分片段抗体检测蛋白芯片质控参比品。中国药品生物制品检定所的80份HCV参比品检定结果表明,混合抗体阳性检出率为39／40,阴性符合率为40／40,总符合率为98．7％;核心抗体阳性检出率为27／40,阴性符合率为40／40;NS3抗体阳性检出率为26／40,阴性符合率为39／40;NS4抗体阳性检出率为19／40,阴性符合率为40／40;NS5抗体阳性检出率2／40,阴性符合率为40／40。490例临床标本的检测结果表明,对于194例HCV阳性标本,蛋白质芯片混合抗体与ELISA的符合率达99．5％,分片段抗体符合率达97．4％,两种方法检测结果不符的标本经RIBA试剂确认,蛋白质芯片与RIBA试剂的符合率高度一致。对于296例各种HCV抗体阴性标本,蛋白质芯片检测结果全部为阴性。以上结果表明,制备的丙型肝炎病毒分片段抗体检测蛋白质芯片质控参比品可用于芯片生产的质量控制,经质控合格的芯片符合国家标准的要求,可用于临床检测。     

Performance characteristics of a microsphere immunoassay using recombinant HCV proteins as a confirmatory assay for the detection of antibodies to the hepatitis C virus.

BACKGROUND: The detection of antibody to hepatitis C virus (HCV) is an important assay for the identification of individuals infected with this virus. However, the confirmation of antibody positivity remains problematic. Currently none of the screening or confirmatory assays provide quantitation of the antibodies present. A microsphere assay was designed to provide improved confirmation. METHODS: Microspheres of 3.6 mum in diameter coated with NeutraAvidin were used to capture biotinylated HCV recombinant proteins. A phycoerythrin goat anti-human immunoglobulin G (IgG) was used to detect specific antibody captured to the microsphere. A human IgG calibrator was designed that was internal to each sample in the microsphere assay. RESULTS: Detection of HCV-specific antibody using these microspheres was straightforward in most samples, with the lower detection limit set at 0.01 microg equivalents of human IgG per milliliter. In antibody-positive samples, the HCV antibody levels ranged from 0.09 to 55 microg equivalents of IgG per milliliter. Forty-nine of the 54 samples (91%) previously identified as having an indeterminate serologic pattern were negative in the microsphere assay. CONCLUSIONS: The microspheres and biotinylated HCV proteins were stable for longer than 8 months when stored at 2 degrees C to 8 degrees C and coating of the microspheres was reproducible with an interassay coefficient of variation less than 10%. Avidin-coated microspheres provide an easy solid support on which to design an assay provided the capture reagent being used can be biotinylated effectively. Confirmation of antibody to HCV can be performed using this assay format.     

Development of Hepatitis C Virus Genotyping by Real-Time PCR Based on the NS5B Region

Background

Hepatitis C virus (HCV) genotyping is the most significant predictor of the response to antiviral therapy. The aim of this study was to develop and evaluate a novel real-time PCR method for HCV genotyping based on the NS5B region.

Methodology/Principal Findings

Two triplex reaction sets were designed, one to detect genotypes 1a, 1b and 3a; and another to detect genotypes 2a, 2b, and 2c. This approach had an overall sensitivity of 97.0%, detecting 295 of the 304 tested samples. All samples genotyped by real-time PCR had the same type that was assigned using LiPA version 1 (Line in Probe Assay). Although LiPA v. 1 was not able to subtype 68 of the 295 samples (23.0%) and rendered different subtype results from those assigned by real-time PCR for 12/295 samples (4.0%), NS5B sequencing and real-time PCR results agreed in all 146 tested cases. Analytical sensitivity of the real-time PCR assay was determined by end-point dilution of the 5000 IU/ml member of the OptiQuant HCV RNA panel. The lower limit of detection was estimated to be 125 IU/ml for genotype 3a, 250 IU/ml for genotypes 1b and 2b, and 500 IU/ml for genotype 1a.

Conclusions/Significance

The total time required for performing this assay was two hours, compared to four hours required for LiPA v. 1 after PCR-amplification. Furthermore, the estimated reaction cost was nine times lower than that of available commercial methods in Brazil. Thus, we have developed an efficient, feasible, and affordable method for HCV genotype identification.     

A Novel Multiplex Real-Time PCR Assay for the Concurrent Detection of Hepatitis A,B and C Viruses in Patients with Acute Hepatitis

A novel multiplex real-time PCR assay for concurrent detection of hepatitis viruses was evaluated for its clinical performance in screening patients with acute hepatitis. A total of 648 serum samples were collected from patients with acute symptoms of hepatitis. Concurrent detection of nucleic acids of HAV, HBV and HCV was performed using the Magicplex™ HepaTrio Real-time Detection test. Serum nucleic acid levels of HBV and HCV were also quantified by the Cobas® AmpliPrep/Cobas® TaqMan® (CAP/CTM) HBV and HCV tests. Patients’ medical records were also reviewed. Concordance rates between the results from the HepaTrio and the CAP/CTM tests for the detection of HBV and HCV were 94.9% (k = 0.88) and 99.2% (k = 0.98), respectively. The cycle threshold values with the HepaTrio test were also correlated well with the levels of HBV DNA (r = −0.9230) and HCV RNA (r = −0.8458). The sensitivity and specificity of the HepaTrio test were 93.8% and 98.2%, respectively, for detecting HBV infection, and 99.1% and 100.0%, respectively, for HCV infection. For the HepaTrio test, 21 (3.2%) cases were positive for both HBV and HCV. Among the positive cases, 6 (0.9%) were true coinfections. This test also detected 18 (2.8%) HAV positives. The HepaTrio test demonstrated good clinical performance and produced results that agreed well with those of the CAP/CTM assays, especially for the detection of HCV. This assay was also able to detect HAV RNA from anti-HAV IgM-positive individuals. Therefore, this new multiplex PCR assay could be useful for the concurrent detection of the three hepatitis viruses.     

In situ hybridization of hepatitis C virus RNA in liver cells of an experimentally infected rhesus macaque

The liver tissue of a rhesus macaque inoculated with hepatitis C virus (HCV) has been analyzed for the presence of HCV RNA using the technique of in situ hybridization, both at light and electron microscopy levels. The animal was inoculated by the intrasplenic route using a HCV infected autogenic hepatocyte transplant. The serum sample used to infect the hepatocyte cells was characterized by polymerase chain reaction technique and shown to be positive for HCV RNA, genotype 3 with 10(7) RNA copies/ml. In situ hybridization was performed using a complementary negative strand probe made with the specific primer. We were able to detect and localize viral RNA in altered membranes of the rough endoplasmic reticulum of infected liver cells, showing evidence of virus replication in vivo.     

环介导逆转录等温扩增技术(RT-LAMP)在丙型肝炎病毒基因检测中的应用

该文介绍了一种便捷、灵敏而又特异的环介导逆转录等温扩增基因检测技术,该技术分别使用特异对应于靶序列中8个基因区段的3对特殊引物,并在反转录酶和Bst-DNA聚合酶的作用下对靶序列进行等温核酸扩增反应,整个检测反应只需1~2h。利用这种技术成功检测了丙型肝炎病毒基因,对60份经Real-time PCR或RT-PCR验证阳性的血清样品检测,阳性符合率为98%。同时,对扩增终产物进一步进行酶切分析,并与HIV、HBV和不同亚型流感病毒RNA进行交叉反应和特异性测试,均与预期结果吻合。将Real-time PCR定量后的RNA系列稀释后对检测方法的灵敏度进行了测试。结果显示,该技术的检测灵敏度在理论上可达到10个拷贝的RNA分子。以上结果证明,RT-LAMP扩增技术是一种检测程序简单、灵敏度和特异性较高的基因检测手段,在丙型肝炎病毒的快速检测方面具有一定的开发潜力。     

WSSV和IHHNV二重实时荧光PCR检测方法的建立

根据基因库中对虾白斑综合征病毒WSSV(AF369029)和传染性皮下及造血器官坏死病毒IHHNV(AF218226)基因序列,设计了WSSV和IHHNV的两对特异性引物和两条用不同荧光基团标记的TaqMan探针。对反应条件和试剂浓度进行优化,建立了能够同时检测WSSV和IHHNV的二重实时荧光PCR方法。该方法特异性好,对WSSV和IHHNV的检测敏感性分别达到2和20个模板拷贝数;此外抗干扰能力强,对WSSV和IHHNV不同模板浓度进行组合,仍可有效地同时检测这二个病毒。对保存的30份经常规PCR检测仅为WSSV或IHHNV阳性的样品进行二重实时荧光PCR检测,结果都为阳性,其中1份为WSSV和IHHNV混合感染。本研究建立的二重实时荧光PCR方法用于WSSV和IHHNV的检测具有特异、敏感、快速、定量等优点。     

Hepatitis C virus and Epstein-Barr virus: dual infection or atypical antibody response

Positive serological reactions against hepatitis C virus (HCV) appeared in the course of Epstein-Barr virus (EBV) infectious mononucleosis. In 429 consecutive patients with high levels of transaminases, 28 patients with EBV primary infection were found. The presence of anti-HCV antibodies and HCV RNA was studied in these subjects. In seven patients anti-HCV antibodies (C33 and C22c RIBA bands) were detected, but all were polymerase chain reaction (PCR) negative. These results may have been due solely to a HCV infection or were an atypical response to HCV in the course of infectious mononucleosis.     

应用循环逆转录PCR技术检测丙型肝炎病毒RNA

循环逆转录（ｃｉｒｃｕｌａｔｏｒｙ ｒｅｖｅｒｓｅ ｔｒａｎｓｃｒｉｐｔｉｏｎ,ＣＲＴ）是线性增长逆转录ｃＤＮＡ产量的一种新技术。为了将该技术用于检测ＨＣＶ ＲＮＡ,通过改变ＣＲＴ的循环次数,结合竞争ＰＣＲ,作出标准曲线。采用１６次ＣＲＴ加３４次循环ＰＣＲ检测了１３６例ＨＣＶ ＥＬＩＳＡ阳性、５４例ＨＣＶ ＥＬＩＳＡ阴性和１０８例临床可疑病人全血标本,并与逆转录ＰＣＲ（ＲＴ－ＰＣＲ）和巢式ＰＣＲ（     

Immuno-enzymatic evaluation of the recombinant TSSA-II protein of Trypanosoma cruzi in dogs and human sera: a tool for epidemiological studies

The rTSSA-II (recombinant Trypomastigote Small Surface II) antigen was evaluated by ELISA to detect anti-Trypanosoma cruzi antibodies in sera from naturally infected dogs and humans. For this evaluation ELISA-rTSSA-II was standardized and groups were classified according to the results obtained through xenodiagnosis, ELISA and PCR. Sensitivity (Se), Specificity (Sp), Kappa index (KI) and area under curve (AUC) were determined. The Se was determined by using 14 sera from dogs infected with T. cruzi VI (TcVI) whereas Sp was determined by using 95 non-chagasic sera by xenodiagnosis, ELISA-Homogenate and PCR. The performance of ELISA-rTSSA-II in dog sera was high (AUC=0·93 and KI=0·91). The Se was 92·85% (1 false negative) and Sp was 100%. Two sera from dogs infected with TcI and 1 with TcIII were negative. For patients infected with T. cruzi, reactivity was 87·8% (36/41), there was only 1 indeterminate, and Sp was 100%. Fifty-four sera from non-chagasic and 68 sera from patients with cutaneous leishmaniasis did not react with rTSS-II. ELISA-rTSSA-II showed a high performance when studying sera from naturally infected dogs and it also presented 100% Sp. This assay could be an important tool to carry out sero-epidemiological surveys on the prevalence of T. cruzi circulating lineages in the region.     

RT套式PCR检测血浆HCV RNA及与抗HCV检测的比较

应用微量血清热变性法提取核酸,逆转录套式聚合酶链反应(RT-nest PCR)检测血浆HCV RNA,并与抗HCV ELISA检测结果比较,对HCV RNA阳性标本进行HGV RNA的筛查.结果在32例抗HCV阳性和20例抗HCV阴性血浆中,HCV RNA分别检出18例和2例,总符合率为70%,20例HCV RNA阳性者中有2例合并感染HBV,1例合并感染HGV.证明血浆样本中抗HCV与HCV RNA间存在很大的相关性.     

Characterization of a candidate Trypanosoma rangeli small nucleolar RNA gene and its application in a PCR-based parasite detection

In this study, we report the isolation and characterization of a candidate Trypanosoma rangeli small nucleolar RNA (snoRNA) gene, and the development of a PCR assay for detection of the parasite based on its nucleotide sequence. This gene, isolated from a T. rangeli genomic sub-library, was named snoRNA-cl1 and is encoded by a multi-copy gene of 801bp in length. Computer sequence analysis of snoRNA-cl1 showed the presence of two sequence motifs, box C and box D, as well as of two long stretches that perfectly complement the universal core region of the mature rRNA 28S, suggesting that cl1 encodes for a Box C/D snoRNA from the parasite. Hybridization analysis using cl1 as probe, showed a weak hybridization signal with Trypanosoma cruzi DNA, demonstrating the existence of differences in this locus between these two species. Two oligonucleotide primers from this gene, which specifically amplified a 620-bp fragment in KP1 (+) and KP1 (-) strains of T. rangeli, were used in a PCR assay. The amplification allowed the detection of 1pg of DNA in the presence of heterologous DNA and no amplification was observed with different T. cruzi strains (groups I and II). In addition, the PCR assay reported here is able to detect T. rangeli in the presence of T. cruzi DNA, and is useful for detection of the parasite in samples from infected vectors.     

A reliable multiplex genotyping assay for HCV using a suspension bead array

The genotyping of the hepatitis C virus (HCV) plays an important role in the treatment of HCV because genotype determination has recently been incorporated into the treatment guidelines for HCV infections. Most current genotyping methods are unable to detect mixed genotypes from two or more HCV infections. We therefore developed a multiplex genotyping assay to determine HCV genotypes using a bead array. Synthetic plasmids, genotype panels and standards were used to verify the target‐specific primer (TSP) design in the assay, and the results indicated that discrimination efforts using 10 TSPs in a single reaction were extremely successful. Thirty‐five specimens were then tested to evaluate the assay performance, and the results were highly consistent with those of direct sequencing, supporting the reliability of the assay. Moreover, the results from samples with mixed HCV genotypes revealed that the method is capable of detecting two different genotypes within a sample. Furthermore, the specificity evaluation results suggested that the assay could correctly identify HCV in HCV/human immunodeficiency virus (HIV) co‐infected patients. This genotyping platform enables the simultaneous detection and identification of more than one genotype in a same sample and is able to test 96 samples simultaneously. It could therefore provide a rapid, efficient and reliable method of determining HCV genotypes in the future.