Abstract
Many of the current reverse transcription (RT)-PCR assays for the detection of hepatitis C virus (HCV) RNA are multistep processes which use multiple enzymes and buffers. The assays are also often suboptimal, requiring nested amplification to achieve the desired levels of sensitivity. As a result, these assays are cumbersome and prone to false-positive results. The susceptibility to contamination is further aggravated by the lack of carryover controls. We have previously reported the development of a combined RT-PCR assay for HCV RNA detection which is sensitive and simple to perform. We have since successfully integrated dUTP-uracil-N-glycosylase carryover prevention into the combined assay. Restriction of as much as 0.5 microliter of deoxyuridine-containing amplification products has been achieved. The performance of the improved combined assay was compared directly with conventional nested RT-PCR and antibody detection. The combined assay was found to have sensitivity similar to that of nested RT-PCR in detecting HCV RNA from HCV antibody-positive specimens. In an analysis of hepatitis B virus antibody-positive specimens, nested amplification had false-positive rates ranging from 8 to 31%, while no false-positive results were seen with the combined assay. In comparison with serological methods, the combined assay had specificity and sensitivity of 100 and 95%, respectively.
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- Busch M. P., Wilber J. C., Johnson P., Tobler L., Evans C. S. Impact of specimen handling and storage on detection of hepatitis C virus RNA. Transfusion. 1992 Jun;32(5):420–425. doi: 10.1046/j.1537-2995.1992.32592327714.x. [DOI] [PubMed] [Google Scholar]
- Chan C. Y., Lee S. D., Wu J. C., Hwang S. J., Wang Y. J., Huang Y. S., Lo K. J. Superinfection with hepatitis C virus in patients with symptomatic chronic hepatitis B. Scand J Infect Dis. 1991;23(4):421–424. doi: 10.3109/00365549109075089. [DOI] [PubMed] [Google Scholar]
- Chayama K., Saitoh S., Arase Y., Ikeda K., Matsumoto T., Sakai Y., Kobayashi M., Unakami M., Morinaga T., Kumada H. Effect of interferon administration on serum hepatitis C virus RNA in patients with chronic hepatitis C. Hepatology. 1991 Jun;13(6):1040–1043. [PubMed] [Google Scholar]
- Cristiano K., Di Bisceglie A. M., Hoofnagle J. H., Feinstone S. M. Hepatitis C viral RNA in serum of patients with chronic non-A, non-B hepatitis: detection by the polymerase chain reaction using multiple primer sets. Hepatology. 1991 Jul;14(1):51–55. doi: 10.1002/hep.1840140109. [DOI] [PubMed] [Google Scholar]
- Farci P., Alter H. J., Wong D., Miller R. H., Shih J. W., Jett B., Purcell R. H. A long-term study of hepatitis C virus replication in non-A, non-B hepatitis. N Engl J Med. 1991 Jul 11;325(2):98–104. doi: 10.1056/NEJM199107113250205. [DOI] [PubMed] [Google Scholar]
- Garson J. A., Brillanti S., Ring C., Perini P., Miglioli M., Barbara L. Hepatitis C viraemia rebound after "successful" interferon therapy in patients with chronic non-A, non-B hepatitis. J Med Virol. 1992 Jul;37(3):210–214. doi: 10.1002/jmv.1890370311. [DOI] [PubMed] [Google Scholar]
- Garson J. A., Tuke P. W., Makris M., Briggs M., Machin S. J., Preston F. E., Tedder R. S. Demonstration of viraemia patterns in haemophiliacs treated with hepatitis-C-virus-contaminated factor VIII concentrates. Lancet. 1990 Oct 27;336(8722):1022–1025. doi: 10.1016/0140-6736(90)92487-3. [DOI] [PubMed] [Google Scholar]
- Godec M. S., Asher D. M., Swoveland P. T., Eldadah Z. A., Feinstone S. M., Goldfarb L. G., Gibbs C. J., Jr, Gajdusek D. C. Detection of measles virus genomic sequences in SSPE brain tissue by the polymerase chain reaction. J Med Virol. 1990 Apr;30(4):237–244. doi: 10.1002/jmv.1890300402. [DOI] [PubMed] [Google Scholar]
- Kwok S., Higuchi R. Avoiding false positives with PCR. Nature. 1989 May 18;339(6221):237–238. doi: 10.1038/339237a0. [DOI] [PubMed] [Google Scholar]
- Loeffelholz M. J., Lewinski C. A., Silver S. R., Purohit A. P., Herman S. A., Buonagurio D. A., Dragon E. A. Detection of Chlamydia trachomatis in endocervical specimens by polymerase chain reaction. J Clin Microbiol. 1992 Nov;30(11):2847–2851. doi: 10.1128/jcm.30.11.2847-2851.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Longo M. C., Berninger M. S., Hartley J. L. Use of uracil DNA glycosylase to control carry-over contamination in polymerase chain reactions. Gene. 1990 Sep 1;93(1):125–128. doi: 10.1016/0378-1119(90)90145-h. [DOI] [PubMed] [Google Scholar]
- Mulder J., McKinney N., Christopherson C., Sninsky J., Greenfield L., Kwok S. Rapid and simple PCR assay for quantitation of human immunodeficiency virus type 1 RNA in plasma: application to acute retroviral infection. J Clin Microbiol. 1994 Feb;32(2):292–300. doi: 10.1128/jcm.32.2.292-300.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Mullis K. B., Faloona F. A. Specific synthesis of DNA in vitro via a polymerase-catalyzed chain reaction. Methods Enzymol. 1987;155:335–350. doi: 10.1016/0076-6879(87)55023-6. [DOI] [PubMed] [Google Scholar]
- Myers T. W., Gelfand D. H. Reverse transcription and DNA amplification by a Thermus thermophilus DNA polymerase. Biochemistry. 1991 Aug 6;30(31):7661–7666. doi: 10.1021/bi00245a001. [DOI] [PubMed] [Google Scholar]
- Shibata M., Kudo T., Kajiyama M., Takahashi T., Matsushima M., Kimura H., Kuzushima K., Morishima T. Hepatitis C viral sequences in sera during the acute phase of infection. Am J Med. 1990 Dec;89(6):830–832. doi: 10.1016/0002-9343(90)90237-8. [DOI] [PubMed] [Google Scholar]
- Shimizu Y. K., Weiner A. J., Rosenblatt J., Wong D. C., Shapiro M., Popkin T., Houghton M., Alter H. J., Purcell R. H. Early events in hepatitis C virus infection of chimpanzees. Proc Natl Acad Sci U S A. 1990 Aug;87(16):6441–6444. doi: 10.1073/pnas.87.16.6441. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Shindo M., Di Bisceglie A. M., Cheung L., Shih J. W., Cristiano K., Feinstone S. M., Hoofnagle J. H. Decrease in serum hepatitis C viral RNA during alpha-interferon therapy for chronic hepatitis C. Ann Intern Med. 1991 Nov 1;115(9):700–704. doi: 10.7326/0003-4819-115-9-700. [DOI] [PubMed] [Google Scholar]
- Udaykumar, Epstein J. S., Hewlett I. K. A novel method employing UNG to avoid carry-over contamination in RNA-PCR. Nucleic Acids Res. 1993 Aug 11;21(16):3917–3918. doi: 10.1093/nar/21.16.3917. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Young K. K., Resnick R. M., Myers T. W. Detection of hepatitis C virus RNA by a combined reverse transcription-polymerase chain reaction assay. J Clin Microbiol. 1993 Apr;31(4):882–886. doi: 10.1128/jcm.31.4.882-886.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Zaaijer H. L., Cuypers H. T., Reesink H. W., Winkel I. N., Gerken G., Lelie P. N. Reliability of polymerase chain reaction for detection of hepatitis C virus. Lancet. 1993 Mar 20;341(8847):722–724. doi: 10.1016/0140-6736(93)90488-3. [DOI] [PubMed] [Google Scholar]