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Utility of cytomegalovirus (CMV) qualitative polymerase chain reaction from gastrointestinal biopsies in diagnosis of CMV gastrointestinal disease: A 10-year retrospective study 胃肠道活检巨细胞病毒(CMV)定性聚合酶链反应在巨细胞病毒胃肠道疾病诊断中的应用:一项10年回顾性研究
IF 3.4 3区 医学 Q2 VIROLOGY Pub Date : 2025-10-09 DOI: 10.1016/j.jcv.2025.105879
Cole Schonhofer , Calvin Ka-Fung Lo , Daniel R. Owen , Khuloud Aldhaheri , Nancy Matic , Christopher F. Lowe , David F. Schaeffer , Sara Belga , Alissa Wright

Background

Cytomegalovirus (CMV) gastrointestinal (GI) disease is traditionally diagnosed via histopathology of endoscopic tissue biopsies. The utility of tissue PCR for predicting CMV GI disease remains unclear. We conducted a 10-year retrospective single-center study comparing tissue PCR performance to histopathology for the diagnosis of CMV GI disease.

Methods

Adult patients with GI tissue biopsy between February 2014 and January 2024 were included. Qualitative tissue PCR was compared to histopathology (gold standard) to determine sensitivity, specificity, and receiver operating characteristic (ROC) curves. Log-binomial regression models were performed to evaluate potential predictors of CMV GI disease.

Results

Our study comprised 533 patients with 635 endoscopies. Underlying diagnoses included solid organ transplant, hematopoietic stem cell transplantation (HSCT), inflammatory bowel disease, and others. Histopathologic evidence of CMV disease was found in 41/635 biopsies and in 37/533 patients. Compared to histopathology, tissue PCR sensitivity was 100 % (95 % CI 91.4–100 %), and specificity was 71.7 % (67.9–75.3 %). Area under ROC curve (AUC) was 0.86 (0.84–0.88). Exclusion of specimens with cycle threshold >32 increased specificity to 82.7 % (79.4–85.6 %) but at the cost of decreased sensitivity (87.8 %, 73.8–95.9 %). Multivariable analyses demonstrated that plasma CMV DNAemia >1000 IU/mL increased risk of GI disease (risk ratio 10.9, 95 % CI 5.32–22.49) while HSCT was negatively associated (risk ratio 0.18, 95 % 0.05–0.78).

Conclusion

CMV tissue PCR correctly identified CMV GI disease in 100 % of histology-proven cases. Specificity was poor, likely reflecting detection of viral shedding. Overall, our study suggests that CMV tissue PCR should be reserved to rule out CMV GI disease in high pre-test probability settings (e.g. patients with known risk factors and compatible symptoms).
背景:巨细胞病毒(CMV)胃肠道(GI)疾病传统上是通过内镜组织活检的组织病理学诊断的。组织PCR预测CMV胃肠道疾病的效用尚不清楚。我们进行了一项为期10年的回顾性单中心研究,比较了组织PCR表现和组织病理学诊断巨细胞病毒胃肠道疾病的效果。方法:纳入2014年2月至2024年1月行胃肠组织活检的成年患者。将定性组织PCR与组织病理学(金标准)进行比较,以确定灵敏度、特异性和受试者工作特征(ROC)曲线。采用对数-二项回归模型评估CMV胃肠道疾病的潜在预测因素。结果:我们的研究包括533例患者,635例内窥镜检查。潜在的诊断包括实体器官移植、造血干细胞移植(HSCT)、炎症性肠病等。635例活检中有41例和533例患者中有37例发现巨细胞病毒疾病的组织病理学证据。与组织病理学比较,组织PCR敏感性为100 %(95 % CI 91.4 ~ 100 %),特异性为71.7 %(67.9 ~ 75.3 %)。ROC曲线下面积(AUC)为0.86(0.84 ~ 0.88)。排除周期阈值bbb32的标本可将特异性提高至82.7 %(77.4 -85.6 %),但代价是敏感性降低(87.8 %,73.8-95.9 %)。多变量分析表明,血浆CMV DNAemia >1000 IU/mL增加了胃肠道疾病的风险(风险比10.9,95 % CI 5.32-22.49),而HSCT呈负相关(风险比0.18,95 % 0.05-0.78)。结论:CMV组织PCR在100% %组织学证实的CMV胃肠道疾病中正确诊断。特异性较差,可能反映了病毒脱落的检测。总的来说,我们的研究表明,在检测前概率较高的情况下(例如,已知危险因素和相容症状的患者),应该保留CMV组织PCR来排除CMV胃肠道疾病。
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引用次数: 0
Some assembly required: Comparison of bioinformatic pipelines for analysis of viral metagenomic sequencing from nosocomial respiratory virus outbreaks 需要进行一些组装:比较用于分析医院呼吸道病毒暴发的病毒宏基因组测序的生物信息学管道
IF 3.4 3区 医学 Q2 VIROLOGY Pub Date : 2025-10-02 DOI: 10.1016/j.jcv.2025.105877
Assad Alhaboub , Natalie M. Deschenes , Xena X. Li , Victoria R. Williams , Kevin C. Katz , So Yeon Park , Patryk Aftanas , Henry Wong , Calvin Sjaarda , Kyla Tozer , Finlay Maguire , Jerome Leis , Prameet Sheth , Robert Kozak

Introduction

Metagenomic sequencing (mGS) is a useful tool for identifying pathogens in patient samples. During nosocomial outbreaks of respiratory viruses, mGS allows for the identification of viral strains and provides insight into their genetic relatedness. Multiple bioinformatics analysis assembler are available for processing data, but a comprehensive comparison of their performance in for respiratory virus outbreaks has not been conducted.

Methods

This study sequenced samples from five separate nosocomial outbreaks of RNA respiratory viruses. RNA was extracted from the samples, and cDNA was synthesized using random hexamers, and then sequenced on an Illumina Miniseq following Nextera DNA Flex library preparation. The data from each outbreak were analyzed using four different assemblers: MEGAHIT, rnaSPAdes, rnaviralSPAdes, and coronaSPAdes, to evaluate their analytical performance.

Results

The mGS confirmed the viral identification and provided accurate strain identification for both coronavirus and parainfluenza virus samples. However, differences were observed between the assemblers in terms of the largest contigs produced and the proportion of the viral genome aligned with reference genomes. Notably, coronaSpades outperformed the other pipelines for analyzing seasonal coronaviruses, generating more complete data and covering a higher percentage of the viral genome.

Conclusion

Achieving a higher percentage of the viral genome sequence is crucial for a more detailed characterization, which is especially valuable for outbreak analysis where viral strains may only differ by a few genetic changes. Comparison of assemblers will allow for clinical laboratories to determine the bioinformatic pipeline that is optimal for helping clinicians better manage outbreaks.
宏基因组测序(metagenomics sequencing, mGS)是鉴定患者样本中病原体的一种有用工具。在医院内爆发呼吸道病毒时,mGS允许识别病毒株,并提供对其遗传相关性的见解。目前已有多个生物信息学分析汇编程序用于处理数据,但尚未对其在呼吸道病毒暴发中的性能进行全面比较。方法本研究对来自5个不同医院暴发的RNA呼吸道病毒样本进行测序。从样品中提取RNA,用随机六聚体合成cDNA,在Nextera DNA Flex文库制备后,在Illumina Miniseq上测序。使用四种不同的汇编程序(MEGAHIT、rnaSPAdes、rnaviralSPAdes和coronaSPAdes)分析每次爆发的数据,以评估它们的分析性能。结果mGS验证了病毒鉴定结果,对冠状病毒和副流感病毒样品进行了准确的毒株鉴定。然而,在产生的最大contigs和与参考基因组对齐的病毒基因组比例方面,组装者之间观察到差异。值得注意的是,coronaSpades在分析季节性冠状病毒方面优于其他管道,生成了更完整的数据,覆盖了更高比例的病毒基因组。获得更高百分比的病毒基因组序列对于更详细的特征描述至关重要,这对于病毒株可能只有少数遗传变化的爆发分析尤其有价值。组装体的比较将使临床实验室能够确定帮助临床医生更好地管理疫情的最佳生物信息管道。
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引用次数: 0
Pathogen surveillance of acute conjunctivitis reveals recent emergence of coxsackievirus A24 variants and high genotypic diversity of human adenoviruses in Shenzhen, China, 2018-2024. 2018-2024年深圳急性结膜炎病原监测显示近期出现柯萨奇病毒A24变异和人腺病毒高基因型多样性。
IF 3.4 3区 医学 Q2 VIROLOGY Pub Date : 2025-10-01 Epub Date: 2025-08-05 DOI: 10.1016/j.jcv.2025.105852
Long Chen, Hong Yang, Hai-Long Zhang, Xiao-Lu Shi, Bo Peng, Jun Meng

Objectives: To investigate the etiological characteristics of acute conjunctivitis in Shenzhen, China.

Methods: A total of 1234 conjunctival swabs collected between 2018 and 2024 were examined for coxsackievirus A24 variant (CVA24v), enterovirus D70 (EV-D70) and human adenovirus (HAdV). Complete VP1 sequences of CVA24v strains were determined and analyzed. HAdV was genotyped by PCR methods targeting the three genes (penton base, hexon and fiber) and sequencing. SPSS 22.0 software was used for statistical analysis.

Results: CVA24v was first detected in 2023, with a detection rate of 33.3 % (63/189). No EV-D70 was detected in 2018-2024. The annual distributions of HAdV-infected patients were 52.6 % (101/192), 62.7 % (111/177), 21.1 % (37/175), 9.0 % (14/155), 10.5 % (17/162), 15.9 % (30/189) and 21.7 % (40/184), respectively. CVA24v strains from this study clustered in a clade with significant temporal aggregation characteristic within the genotype GIV. Eight amino acid variation sites (T11A, I16L, K20I, L32P, K105R, A146T, R277G and P280S) were observed in VP1 sequences of CVA24v strains from this study when compared to the close strains. Conjunctivitis patients with one of the three symptoms (weakness, fever and blurred vision) had a higher detection rate of HAdV. Eleven known HAdV genotypes (HAdV-B3, -B14, -B21, HAdV-D8, -D37, -D42, -D53, -D64, -D85, -D115 and HAdV-E4) and 7 unknown genotypes were detected in 2020-2024, with HAdV-D37 (30.9 %), HAdV-D115 (21.1 %) and HAdV-B3 (17.1 %) being the three predominant genotypes.

Conclusions: The unique genetic characteristics were observed in Shenzhen CVA24v strains. HAdVs associated with conjunctivitis exhibited a high degree of genotypic diversity in Shenzhen, and HAdV-D115 related to conjunctivitis was first reported in this study.

目的:了解深圳地区急性结膜炎的病原学特点。方法:对2018 - 2024年收集的1234份结膜拭子进行柯萨奇病毒A24变异(CVA24v)、肠道病毒D70 (EV-D70)和人腺病毒(hav)检测。测定并分析了CVA24v株VP1全序列。利用PCR方法对hav的3个基因(penton base、hexon和fiber)进行分型和测序。采用SPSS 22.0软件进行统计分析。结果:CVA24v于2023年首次检出,检出率为33.3%(63/189)。2018-2024年未检测到EV-D70。hadv感染者年分布分别为52.6%(101/192)、62.7%(111/177)、21.1%(37/175)、9.0%(14/155)、10.5%(17/162)、15.9%(30/189)和21.7%(40/184)。本研究的CVA24v株聚集在GIV基因型中具有显著的时间聚集特征的分支中。与相近菌株相比,本研究CVA24v菌株VP1序列存在8个氨基酸变异位点(T11A、I16L、K20I、L32P、K105R、A146T、R277G和P280S)。伴有虚弱、发热和视力模糊三种症状之一的结膜炎患者hav检出率较高。2020-2024年共检出已知hav基因型11种(hav - b3、-B14、-B21、hav - d8、-D37、-D42、-D53、-D64、-D85、-D115和hav - e4),未知基因型7种,其中hav -D37(30.9%)、hav -D115(21.1%)和hav - b3(17.1%)为优势基因型。结论:深圳CVA24v株具有独特的遗传特征。与结膜炎相关的hadv在深圳地区表现出高度的基因型多样性,本研究首次报道了与结膜炎相关的HAdV-D115。
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引用次数: 0
More aggressive initiation of antiviral treatment contributes to blocking mother-to-child transmission of HBV DNA & RNA in neonatal umbilical cord blood 更积极的抗病毒治疗有助于阻断新生儿脐带血中HBV DNA和RNA的母婴传播
IF 3.4 3区 医学 Q2 VIROLOGY Pub Date : 2025-10-01 DOI: 10.1016/j.jcv.2025.105875
Huimin Liu , Wenting Chen , Yongjie Liang , Jing Wang , Lijian Ran , Shilian Li , Yi Wu , Zixuan He , Xuemei Kuang , Jie Xia , Li Jiang , Xuqing Zhang , Qing Mao

Background and aims

This study aimed to evaluate the efficacy of expanding antiviral indications in preventing mother-to-child transmission (MTCT) by analyzing hepatitis B virus (HBV) markers in neonatal umbilical-cord-blood (UCB) samples.

Methods

We conducted a real-world study of pregnant women aged >30 years with chronic hepatitis B (CHB) who received antenatal care between January 2022 and June 2024. Maternal HBV markers at 24–28 weeks of gestation and serum biochemical parameters at delivery were obtained. For infants, HBV markers were measured in UCB at birth and in venous blood at 7–12 months of age. Logistic regression analysis was used to identify the maternal factors associated with UCB outcomes.

Results

A total of 171 pregnant women with CHB were included. Antiviral therapy had been started before conception in 31.0 % (53/171). At 24–28 weeks of gestation, 87.8 % (150/171) had HBV DNA <5.3 Log10 IU/mL, 56.1 % (96/171) had hepatitis B surface antigen (HBsAg) >3000 IU/mL and 32.7 % (56/171) were hepatitis B e antigen (HBeAg)-positive. At delivery, HBeAg-negative mothers had a median age of 33.4 ± 3.1 years, compared with 32.5 ± 2.9 years for those who were HBeAg-positive, respectively (t = 1.667, P = 0.970). 36 of 171 (21.1 %) infants were positive for HBsAg, including 12 of 115 born to HBeAg-negative mothers and 24 of 56 born to HBeAg-positive mothers (χ2 = 23.82, P < 0.001). 41 of 171 (24.0 %) infants were positive for HBeAg, and all were born to HBeAg-positive mothers. HBV DNA and RNA were undetectable in all UCB samples, whereas hepatitis B core antibody (HBcAb) was present in every specimen. Receiver operating characteristic curve (ROC) analysis identified maternal HBeAg levels (AUC=0.683, cut-off value=0.494 COI) and maternal HBV DNA load (AUC=0.645, cut-off value=0.311 Log10 IU/mL) as predictive of UCB HBsAg-positivity. No infants were infected with HBV, as confirmed by post-vaccination serologic testing (PVST).

Conclusions

Following the expansion of antiviral therapy indications, administering therapy to pregnant women aged >30 years with detectable HBV DNA effectively reduced HBsAg, HBV DNA and even HBV RNA level in infants’ UCB. Maternal HBeAg status was significantly associated with both HBsAg and HBeAg positivity in UCB.
背景与目的本研究旨在通过分析新生儿脐带血(UCB)样本中的乙型肝炎病毒(HBV)标志物,评价扩大抗病毒适应症在预防母婴传播(MTCT)中的疗效。方法:我们对2022年1月至2024年6月期间接受产前护理的30岁慢性乙型肝炎(CHB)孕妇进行了一项现实世界研究。测定产妇妊娠24 ~ 28周时HBV标志物及分娩时血清生化指标。对于婴儿,出生时在UCB和7-12个月时在静脉血中测量HBV标志物。采用Logistic回归分析确定与UCB结局相关的母体因素。结果共纳入171例CHB孕妇。怀孕前开始抗病毒治疗的占31.0% %(53/171)。妊娠24-28周,87.8 % (150/171)HBV DNA检出5.3 Log10 IU/mL, 56.1% %(96/171)乙肝表面抗原(HBsAg)检出3000 IU/mL, 32.7% %(56/171)乙肝e抗原(HBeAg)检出阳性。分娩时,hbeag阴性母亲的中位年龄为33.4 ± 3.1岁,而hbeag阳性母亲的中位年龄为32.5 ± 2.9岁(t = 1.667,P = 0.970)。171例婴儿中有36例(21.1% %)HBsAg阳性,其中hbeag阴性母亲115例中有12例,hbeag阳性母亲56例中有24例(χ2 = 23.82,P <; 0.001)。171例婴儿中有41例(24.0 %)HBeAg阳性,所有婴儿的母亲均为HBeAg阳性。在所有UCB样本中均检测不到HBV DNA和RNA,而在每个样本中均存在乙型肝炎核心抗体(HBcAb)。受试者工作特征曲线(ROC)分析发现,母体HBeAg水平(AUC=0.683,临界值=0.494 COI)和母体HBV DNA负荷(AUC=0.645,临界值=0.311 Log10 IU/mL)可作为UCB hbsag阳性的预测指标。通过疫苗接种后血清学检测(PVST)证实,没有婴儿感染HBV。结论随着抗病毒治疗适应症的扩大,对30岁且HBV DNA可检测的孕妇进行抗病毒治疗可有效降低婴儿UCB中HBsAg、HBV DNA甚至HBV RNA水平。母亲HBeAg水平与UCB中HBsAg和HBeAg阳性均显著相关。
{"title":"More aggressive initiation of antiviral treatment contributes to blocking mother-to-child transmission of HBV DNA & RNA in neonatal umbilical cord blood","authors":"Huimin Liu ,&nbsp;Wenting Chen ,&nbsp;Yongjie Liang ,&nbsp;Jing Wang ,&nbsp;Lijian Ran ,&nbsp;Shilian Li ,&nbsp;Yi Wu ,&nbsp;Zixuan He ,&nbsp;Xuemei Kuang ,&nbsp;Jie Xia ,&nbsp;Li Jiang ,&nbsp;Xuqing Zhang ,&nbsp;Qing Mao","doi":"10.1016/j.jcv.2025.105875","DOIUrl":"10.1016/j.jcv.2025.105875","url":null,"abstract":"<div><h3>Background and aims</h3><div>This study aimed to evaluate the efficacy of expanding antiviral indications in preventing mother-to-child transmission (MTCT) by analyzing hepatitis B virus (HBV) markers in neonatal umbilical-cord-blood (UCB) samples.</div></div><div><h3>Methods</h3><div>We conducted a real-world study of pregnant women aged &gt;30 years with chronic hepatitis B (CHB) who received antenatal care between January 2022 and June 2024. Maternal HBV markers at 24–28 weeks of gestation and serum biochemical parameters at delivery were obtained. For infants, HBV markers were measured in UCB at birth and in venous blood at 7–12 months of age. Logistic regression analysis was used to identify the maternal factors associated with UCB outcomes.</div></div><div><h3>Results</h3><div>A total of 171 pregnant women with CHB were included. Antiviral therapy had been started before conception in 31.0 % (53/171). At 24–28 weeks of gestation, 87.8 % (150/171) had HBV DNA &lt;5.3 Log<sub>10</sub> IU/mL, 56.1 % (96/171) had hepatitis B surface antigen (HBsAg) &gt;3000 IU/mL and 32.7 % (56/171) were hepatitis B e antigen (HBeAg)-positive. At delivery, HBeAg-negative mothers had a median age of 33.4 ± 3.1 years, compared with 32.5 ± 2.9 years for those who were HBeAg-positive, respectively (t = 1.667, <em>P</em> = 0.970). 36 of 171 (21.1 %) infants were positive for HBsAg, including 12 of 115 born to HBeAg-negative mothers and 24 of 56 born to HBeAg-positive mothers (χ<sup>2</sup> = 23.82, <em>P</em> &lt; 0.001). 41 of 171 (24.0 %) infants were positive for HBeAg, and all were born to HBeAg-positive mothers. HBV DNA and RNA were undetectable in all UCB samples, whereas hepatitis B core antibody (HBcAb) was present in every specimen. Receiver operating characteristic curve (ROC) analysis identified maternal HBeAg levels (AUC=0.683, cut-off value=0.494 COI) and maternal HBV DNA load (AUC=0.645, cut-off value=0.311 Log<sub>10</sub> IU/mL) as predictive of UCB HBsAg-positivity. No infants were infected with HBV, as confirmed by post-vaccination serologic testing (PVST).</div></div><div><h3>Conclusions</h3><div>Following the expansion of antiviral therapy indications, administering therapy to pregnant women aged &gt;30 years with detectable HBV DNA effectively reduced HBsAg, HBV DNA and even HBV RNA level in infants’ UCB. Maternal HBeAg status was significantly associated with both HBsAg and HBeAg positivity in UCB.</div></div>","PeriodicalId":15517,"journal":{"name":"Journal of Clinical Virology","volume":"181 ","pages":"Article 105875"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145268018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Identifying people with chronic hepatitis B virus who are lost to clinical follow up: A retrospective case finding and re-engagement service improvement exercise 确定失去临床随访的慢性乙型肝炎病毒感染者:回顾性病例发现和再参与服务改进工作
IF 3.4 3区 医学 Q2 VIROLOGY Pub Date : 2025-10-01 DOI: 10.1016/j.jcv.2025.105876
Rachel Jackson , Adinah Marks , William L. Irving , Kathryn Jack

Background

Hepatitis B virus (HBV) infection is an important cause of liver disease-related mortality and morbidity. The World Health Organisation aims to eliminate this as a public health concern by 2030 and as such the key international guidelines recommend that all patients are reviewed regularly to observe for preventable signs of disease progression. This requires life-long engagement with specialist services, but some patients fall out of the care pathway and become lost to follow-up.

Objectives

This study sought to identify and re-engage patients with HBV who were lost to follow up (LTFU), defined as any HBsAg positive patient who had not been seen in the hepatology outpatient service since 31st December 2021, excluding those with acute infection.

Study design

A retrospective case finding and re-engagement healthcare service improvement exercise was conducted to identify and contact individuals with HBV diagnosed between June 2007 and the end of December 2021 who were lost-to-follow-up.

Results

One third of the HBsAg positive cohort were lost to follow-up (32.9 %, n = 506/1539). Of this group, 145 people were still living in the hospital’s catchment area, yet only 60 people could be contacted by telephone of whom 50 returned to clinic. More than 12 % of patients were HBeAg positive at their last clinic visit, and almost one quarter (23.2 %) had an abnormally raised ALT. There was extensive ethnic heterogeneity with 65 languages spoken among 474 people. We successfully re-engaged 10.07 % (51/506) back into care.

Conclusions

Patients with potentially progressive HBV-related liver disease are falling out of the care pathway with the attendant long-term problems that failure to control their infection may have.
背景乙型肝炎病毒(HBV)感染是肝脏疾病相关死亡率和发病率的重要原因。世界卫生组织的目标是到2030年消除这一公共卫生问题,因此,主要的国际指南建议定期对所有患者进行检查,以观察可预防的疾病进展迹象。这需要终生接受专业服务,但有些患者脱离了护理途径,无法随访。本研究旨在确定并重新参与失访(LTFU)的HBV患者,定义为自2021年12月31日以来未在肝病科门诊就诊的任何HBsAg阳性患者,不包括急性感染患者。研究设计进行了一项回顾性病例发现和再参与医疗保健服务改进活动,以确定和联系2007年6月至2021年12月底期间诊断为乙型肝炎病毒的失踪者。结果1 / 3的HBsAg阳性队列失访(32.9% %,n = 506/1539)。在这一群体中,145人仍然住在医院的集水区,但只有60人可以通过电话联系,其中50人返回诊所。超过12% %的患者在最后一次就诊时HBeAg呈阳性,几乎四分之一(23.2% %)的患者ALT异常升高。474人中有65种语言,存在广泛的种族异质性。我们成功地将10.07 %(51/506)重新纳入护理。具有潜在进行性hbv相关肝病的患者正在脱离护理途径,随之而来的是未能控制其感染可能产生的长期问题。
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引用次数: 0
Heterogeneity of false reactivity profiles of HIV assays while optimizing national HIV testing algorithms: Findings from a multi-country analysis. 优化国家HIV检测算法时HIV检测错误反应性的异质性:来自多国分析的发现。
IF 3.4 3区 医学 Q2 VIROLOGY Pub Date : 2025-10-01 Epub Date: 2025-07-22 DOI: 10.1016/j.jcv.2025.105843
Manfred Accrombessi, Cheryl Johnson, Alaleh Abadpour, Jean De Dieu Anoubissi, Joseph Fokam, Araz Chiloyan, Iryna Andrianova, Hamakwa Mantina, Agai Kherbino Akec, Fatou Ousmane Sall, Abdelaye Keita, Elizabeth Telan, Adoum Fouda Abderrazzack, Chatté Adawaye, Rose Wafula, Stephen Ayisi-Addo, Monkoe S Leqheka, Jacob Lusekelo Mwambeta, Jeremie Muwonga Masidi, Dramane Kania, Anita Sands, Rachel Baggaley, Jean-François Etard, Céline Lastrucci

This study highlights the importance of verifying HIV testing algorithms to reduce the risk of misdiagnoses caused by common false reactivity. Between 2020 and 2023, WHO supported 14 countries to assess rates of false reactivity and shared false reactivity across HIV rapid diagnostic tests (RDTs) used in HIV testing services. The study involved 26,278 results from 22 different RDT products, with sample sizes ranging from 100 to 302 results per country. The number of RDT products assessed varied between 4 and 13 per country. False reactivity rates ranged from 0 % to 3.32 %, with one country reporting a high false reactivity rate of over 4 % for one RDT. Five countries have no shared false reactivity between RDTs, while the remaining eight countries shared false reactivity across one to six pairs of RDT products. These findings were used to inform national policy, with more than 90 % of countries introducing new RDT products into their HIV testing algorithm based on these results. The study concludes that rates of false reactivity and shared false reactivity between RDT products vary across countries. Therefore, conducting verification studies is crucial for updating national HIV testing algorithms and ensuring accurate diagnosis while also facilitating the market entry of new HIV testing products.

这项研究强调了验证HIV检测算法的重要性,以减少由常见的假反应引起的误诊风险。2020年至2023年期间,世卫组织支持14个国家评估艾滋病毒检测服务中使用的艾滋病毒快速诊断试剂盒的假反应率和共享假反应率。该研究涉及22种不同RDT产品的26278个结果,每个国家的样本量从100到302个结果不等。每个国家评估的RDT产品数量在4到13种之间。假反应率从0%到3.32%不等,有一个国家报告一种RDT的假反应率超过4%。五个国家在RDT产品之间没有共同的假反应性,而其余八个国家在一到六对RDT产品之间存在共同的假反应性。这些发现被用来为国家政策提供信息,90%以上的国家根据这些结果在其艾滋病毒检测算法中引入了新的RDT产品。该研究得出结论,RDT产品之间的假反应性和共享假反应性的比率因国家而异。因此,开展验证研究对于更新国家艾滋病毒检测算法和确保准确诊断,同时促进新的艾滋病毒检测产品进入市场至关重要。
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引用次数: 0
The Allplex HPV HR Detection assay fulfils international guideline requirements for primary cervical screening on SurePath samples and qualifies as a second-generation HPV comparator test. Allplex HPV HR检测法符合SurePath样本的初级宫颈筛查的国际指南要求,并有资格作为第二代HPV比较试验。
IF 3.4 3区 医学 Q2 VIROLOGY Pub Date : 2025-10-01 Epub Date: 2025-08-06 DOI: 10.1016/j.jcv.2025.105853
Anja Oštrbenk, Helle Pedersen, Mario Poljak, Jesper Bonde

A key parameter for the continued success of cervical cancer screening is quality-controlled use of human papillomavirus (HPV) tests that are clinically validated according to international guidelines. The clinical accuracy for cervical screening of the Allplex HPV HR Detection (Allplex), which concurrently detects and distinguishes 12 high-risk HPV types (16,18,31,33,35,39,45,51,52,56,58,59) and HPV66 and HPV68 was assessed on SurePath samples by comparing its performance to the second-generation comparator BD Onclarity HPV assay (Onclarity). The absolute clinical sensitivity, assessed on 76 samples derived from a screening population with underlying CIN2+, of Allplex and Onclarity was 98.7 % (95 % CI, 92.9-100.0 %) and 100.0 % (95 % CI, 95.2-100.0 %), respectively, with relative sensitivity of Allplex of 0.99 (95 % CI; 0.96-1.01). The absolute clinical specificity, assessed on 801 consecutive clinician-collected cervical samples obtained from women 30 to 59 years old attending the routine Danish cervical screening program, for Allplex and Onclarity was 92.5 % (95 % CI, 90.4-94.2 %) and 92.5 % (95 % CI, 90.4-94.2 %), respectively, with relative specificity of Allplex of 1.00 (95 % CI; 0.99-1.01). With thresholds mandated by international guidelines of ≥90 % for relative clinical sensitivity (p = 0.001) and ≥98 % for relative clinical specificity (p = 0.0018), Allplex was non-inferior to Onclarity. Excellent intra- and inter-laboratory agreement of Allplex was observed, both overall (99.2 % and 99.6 %) and at the genotype level (range: 99.6-100.0 %). By fulfilling all guideline requirements for clinical sensitivity, specificity, and reproducibility, Allplex can be considered clinically validated for primary cervical screening using clinician-collected SurePath samples. With this study, Allplex also meets the criteria for a second-generation HPV comparator test.

宫颈癌筛查继续取得成功的一个关键参数是,根据国际准则进行临床验证的人乳头瘤病毒(HPV)检测的使用受到质量控制。Allplex HPV HR Detection (Allplex)同时检测和区分12种高危HPV类型(16、18、31、33、35、39、45、51、52、56、58、59)和HPV66和HPV68,通过与第二代比较器BD Onclarity HPV assay (Onclarity)的性能比较,在SurePath样本上评估Allplex HPV HR Detection (Allplex)宫颈筛查的临床准确性。对来自潜在CIN2+筛查人群的76份样本进行评估,Allplex和Onclarity的绝对临床敏感性分别为98.7% (95% CI, 92.9- 100.0%)和100.0% (95% CI, 95.2- 100.0%), Allplex的相对敏感性为0.99 (95% CI;0.96 - -1.01)。对801例连续临床采集的参加丹麦宫颈常规筛查项目的30 - 59岁女性宫颈样本进行评估,Allplex和Onclarity的绝对临床特异性分别为92.5% (95% CI, 90.4- 94.2%)和92.5% (95% CI, 90.4- 94.2%), Allplex的相对特异性为1.00 (95% CI;0.99 - -1.01)。根据国际指南规定的相对临床敏感性≥90% (p = 0.001)和相对临床特异性≥98% (p = 0.0018)的阈值,Allplex并不逊于Onclarity。Allplex在实验室内和实验室间的总体(99.2%和99.6%)和基因型水平(范围:99.6- 100.0%)上的一致性都很好。通过满足临床敏感性、特异性和可重复性的所有指南要求,Allplex可以被认为是临床验证的,可以使用临床收集的SurePath样本进行初步宫颈筛查。在这项研究中,Allplex也符合第二代HPV比较试验的标准。
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引用次数: 0
Performance of a commercial assay for detecting JC Polyomavirus DNA in human samples. 用于检测人类样本中JC多瘤病毒DNA的商业试验的性能。
IF 3.4 3区 医学 Q2 VIROLOGY Pub Date : 2025-10-01 Epub Date: 2025-08-05 DOI: 10.1016/j.jcv.2025.105849
Sébastien Lhomme, Isabelle Da Silva, Oriane Cabanel, Estelle Raguin, Guillaume Martin-Blondel, Nassim Kamar, Jacques Izopet, Florence Abravanel

Introduction: We evaluated the performance of the automated AltoStar JCV PCR platform for detecting and quantifying JC Polyomavirus (JCPyV) DNA in samples including urine, plasma and cerebrospinal fluid.

Methods and results: Using the NIBSC JCPyV DNA standard, the assay was linear from 1 to 6 log IU/mL standard and the limit of detection determined by Probit analysis corresponded to 9.3 [95 % CI: 7.0-16.5] IU/mL. Specificity was accessed by testing urines containing a high concentration of BK Polyomavirus; none tested positive for JCPyV. The intra-run and inter-run standard deviations were 0.02 IU/mL and 0.35 IU/mL, respectively. Lastly, clinical performance was determined by testing 45 samples quantified previously with a laboratory-developed test (LDT). The assays were concordant for 42/45 samples. One of the 3 samples that tested negative with the AltoStar assay had a low JCpyV DNA concentration. We were unable to re-test the 3 negative samples due to insufficient volume. A conservation problem could not be ruled out for the 3 samples with discordant results.

Conclusions: The AltoStar platform enables highly accurate testing for the detection and quantification of JCPyV DNA with very low limit of detection. This allowed us to shorten turnaround times and save time for technical staff.

简介:我们评估了自动化AltoStar JCV PCR平台检测和定量尿样、血浆和脑脊液中JC多瘤病毒(JCPyV) DNA的性能。方法与结果:采用NIBSC JCPyV DNA标准,在1 ~ 6 log IU/mL标准范围内呈线性关系,Probit分析的检出限为9.3 [95% CI: 7.0 ~ 16.5] IU/mL。通过检测含有高浓度BK多瘤病毒的尿液获得特异性;没有人对JCPyV呈阳性反应。组内和组间标准差分别为0.02 IU/mL和0.35 IU/mL。最后,通过测试45个样品来确定临床表现,这些样品之前是用实验室开发的测试(LDT)量化的。45份样品中有42份检测结果一致。AltoStar检测阴性的3个样本中有一个jpyv DNA浓度较低。由于容量不足,我们无法重新测试3个阴性样品。结果不一致的3个样品不能排除守恒问题。结论:AltoStar平台对JCPyV DNA的检测和定量具有较高的准确性,检测限极低。这使我们能够缩短周转时间,节省技术人员的时间。
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引用次数: 0
Comparison of diagnostic performances of HDV-RNA quantification assays used in clinical practice: Results from a national quality control multicenter study. 临床实践中使用的HDV-RNA定量分析诊断性能的比较:来自一项国家质量控制多中心研究的结果。
IF 3.4 3区 医学 Q2 VIROLOGY Pub Date : 2025-10-01 Epub Date: 2025-08-06 DOI: 10.1016/j.jcv.2025.105850
Romina Salpini, Lorenzo Piermatteo, Gian Paolo Caviglia, Ada Bertoli, Maurizia Rossana Brunetto, Bianca Bruzzone, Annapaola Callegaro, Cinzia Caudai, Daniela Cavallone, Luchino Chessa, Fernando Coghe, Nicola Coppola, Nunzia Cuomo, Stefano D'Anna, Mariantonietta Di Stefano, Floriana Facchetti, Claudio Farina, Donatella Ferraro, Elisa Franchin, Daniela Francisci, Silvia Galli, Anna Rosa Garbuglia, William Gennari, Valeria Ghisetti, Pietro Lampertico, Sergio Lo Caputo, Nadia Marascio, Stefano Menzo, Valeria Micheli, Grazia Anna Niro, Antonella Olivero, Pierpaolo Paba, Concetta Ilenia Palermo, Orazio Palmieri, Stefania Paolucci, Mariantonietta Pisaturo, Teresa Pollicino, Giuseppina Raffa, Teresa Santantonio, Giulia Torre, Ombretta Turriziani, Sergio Uzzau, Sara Colonia Uceda Renteria, Marialinda Vatteroni, Maurizio Zazzi, Antonio Craxì, Francesca Ceccherini-Silberstein, Valentina Svicher, Marco Arosio, Sabrina Bastianelli, Annamaria Gentile, Federica A M Giardina, Anna Gidari, Rosalba Govoni, Gabriele Ibba, Alessandro Loglio, Alessandra Lombardi, Chiara Mascarella, Fabrizio Maggi, Giovanni Matera, Chiara Mazzei, Maria Grazia Milia, Angela Quirino, Adriana Raddi, Rosetta Scioscia, Sara Tagliazucchi, Michele Totaro, Rea Valaperta

Introduction: A reliable quantification of hepatitis D virus (HDV) RNA is of paramount importance for monitoring patients under antiviral therapy. This quality control study compares the diagnostic performances of quantitative HDV-RNA assays used in clinical practice.

Methods: Two HDV-RNA sample panels were quantified in 30 centers by RoboGene (N = 9 laboratories), EurobioPlex (N = 7), RealStar (N = 4), AltoStar (N = 1), Bosphore (N = 3), Bosphore-on-InGenius (N = 1), Dia.Pro (N = 2), Nuclear-Laser-Medicine (N = 1) and 3 in-house assays. Panel A and B comprised 8 serial dilutions of WHO/HDV standard (range: 0.5-5.0 log10 IU/ml) and 20 clinical samples (range: 0.5-6.0 log10 IU/ml), respectively. The following parameters were determined: sensitivity by 95 % LOD (limit of detection), precision by intra- and inter-run CV (coefficient of variation), accuracy by the differences between expected-observed HDV-RNA, linearity by linear regression analysis.

Results: 95 % LOD varied across assays and centers underlining heterogeneous sensitivities: AltoStar had the lowest 95 % LOD (3 IU/ml) followed by RealStar (10 [min-max: 3-316] IU/ml), Bosphore-on-InGenius (10 IU/ml), RoboGene (31 [3-316] IU/ml), Nuclear-Laser-Medicine (31 IU/ml) and EuroBioplex (100 [100-316] IU/ml). Moreover, 6 assays (RoboGene, EurobioPlex, RealStar, AltoStar, Nuclear-Laser-Medicine and In-house) showed <0.5 log10 IU/ml differences between expected and observed HDV-RNA for all dilutions while other assays had >1 log10 IU/ml underestimations. RealStar, Bosphore-on-InGenius and EurobioPlex had the highest precision (mean intra-run CV < 20 %). Inter-run CV was higher for all assays, with CVs < 25 % for RealStar, AltoStar, Nuclear-Laser-Medicine and EurobioPlex. Seven assays (RoboGene/AltoStar/RealStar/EurobioPlex/Nuclear-Laser-Medicine/In-house) showed a good linearity (R2 > 0.90), but for HDV-RNA < 1000 IU/ml only Bosphore-on-InGenius, AltoStar, RealStar and Robogene showed a R2 > 0.85.

Conclusions: This study underlines heterogeneous sensitivities (inter- and intraassays), that could hamper proper HDV-RNA quantification, particularly at low viral loads. This raises the need to improve the diagnostic performance of most assays for properly identifying virological response to anti-HDV drugs.

一种可靠的丁型肝炎病毒(HDV) RNA定量检测对于监测接受抗病毒治疗的患者至关重要。本质量控制研究比较了临床实践中使用的定量HDV-RNA检测的诊断性能。方法:采用RoboGene (N = 9)、EurobioPlex (N = 7)、RealStar (N = 4)、AltoStar (N = 1)、Bosphore (N = 3)、Bosphore-on- ingenius (N = 1)、Dia,在30个中心对2个HDV-RNA样品板进行定量分析。Pro (N = 2),核激光医学(N = 1)和3个内部分析。A组和B组分别包括8组WHO/HDV标准品(范围:0.5-5.0 log10 IU/ml)和20组临床样品(范围:0.5-6.0 log10 IU/ml)。测定以下参数:灵敏度为95%检出限(LOD),精密度为组内和组间变异系数(CV),准确度为预期观察到的HDV-RNA之间的差异,线性为线性回归分析。结果:95%的LOD在不同的检测方法和中心存在差异,强调了异质性敏感性:AltoStar的95% LOD最低(3 IU/ml),其次是RealStar (10 [min-max: 3-316] IU/ml), bospore -on- ingenius (10 IU/ml), RoboGene (31 [3-316] IU/ml), Nuclear-Laser-Medicine (31 IU/ml)和EuroBioplex (100 [100-316] IU/ml)。此外,6项检测(RoboGene、EurobioPlex、RealStar、AltoStar、Nuclear-Laser-Medicine和internal)显示低估1 log10 IU/ml。RealStar, Bosphore-on-InGenius和EurobioPlex具有最高的精度(平均运行内CV 2 > 0.90),但HDV-RNA 2 > 0.85。结论:本研究强调了异质性敏感性(分析间和分析内),这可能妨碍适当的HDV-RNA定量,特别是在低病毒载量时。这就提出需要改进大多数检测方法的诊断性能,以便正确识别对抗艾滋病毒药物的病毒学反应。
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引用次数: 0
Design and performance of a real-time RT-PCR assay for detection of influenza C viruses C型流感病毒实时RT-PCR检测方法的设计与性能
IF 3.4 3区 医学 Q2 VIROLOGY Pub Date : 2025-09-25 DOI: 10.1016/j.jcv.2025.105874
Bo Shu , William G. Davis , Ji Liu , Beth K. Thielen , Sarah Bistodeau , Brian Lynch , Christine M. Warnes , Jimma Liddell , Anna K. Strain , Jaime Christensen , Phili Wong , Natasha Burnett , Todd C. Davis , Marie K. Kirby
Influenza C virus (ICV) usually causes a mild upper respiratory tract infection in children and those infected are frequently co-infected with other respiratory viruses. However, there have only been a few hundred documented cases of ICV infection in humans as of the end of 2024. To better understand the epidemiology and clinical impact of ICVs, we developed an influenza C real-time RT-PCR (InfC rRT-PCR) assay that targets a highly conserved region of the matrix gene segment of ICVs. The analytical sensitivity evaluation demonstrated that the InfC rRT-PCR assay was highly sensitive, as it was able to detect as few as five RNA copies per PCR reaction and had robust reactivity over a range of viral RNAs from historical and recent ICVs. The analytical specificity evaluation confirmed the assay did not cross-react with any influenza A or B viruses tested, including several animal-origin viruses, or other common non-influenza respiratory viruses. The performance evaluation on clinical specimens demonstrated the assay was highly sensitive and specific for the detection of ICVs.
丙型流感病毒(ICV)通常在儿童中引起轻度上呼吸道感染,受感染者经常与其他呼吸道病毒合并感染。然而,截至2024年底,只有几百例记录在案的人类感染ICV病例。为了更好地了解icv的流行病学和临床影响,我们开发了一种针对icv基质基因片段高度保守区域的流感C实时RT-PCR (InfC rRT-PCR)检测。分析敏感性评估表明,InfC rRT-PCR检测是高度敏感的,因为它能够在每次PCR反应中检测到5个RNA拷贝,并且对来自历史和近期icv的一系列病毒RNA具有强大的反应性。分析特异性评价证实,该检测方法与测试的任何甲型或乙型流感病毒(包括几种动物源性病毒或其他常见的非流感呼吸道病毒)均无交叉反应。对临床标本的性能评价表明,该方法对ICVs的检测具有高度的敏感性和特异性。
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引用次数: 0
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Journal of Clinical Virology
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