背景:由于输血安全是一个主要的公共卫生问题,一个快速的发展,敏感,具体,和经济有效的多重PCR检测同时检测乙型肝炎病毒(HBV),丙型肝炎病毒(HCV),戊型肝炎病毒(HEV),和梅毒螺旋体(T.苍白球)在血液中是至关重要的。
方法:针对靶基因的保守区设计了5对引物和探针,用于建立同时检测HBV的一步五重实时逆转录PCR(qRT-PCR)检测方法。HCV,HEV,T.苍白球,和RNaseP(管家基因),提供样品质量检查。用浙江省供血者和患者的2400份血样进一步测定了该方法的临床表现,并将结果与商业单重qPCR和血清学测定进行了比较。
结果:HBV的95%检测限(LOD),HCV,HEV,梅毒螺旋体为7.11拷贝/微升,7.65拷贝/微升,8.45份/微升,和9.06拷贝/微升,分别。此外,该方法具有良好的特异性和精密度。与单重qPCR分析相比,检测HBV的新方法,HCV,HEV,梅毒螺旋体表现出100%的临床敏感性,特异性,和一致性。在血清学和五重qRT-PCR测定之间发现了几个不同的结果。在2400份血液样本中,有2(0.08%)HBsAg阳性样本,3份(0.13%)抗HCV阳性样本,29(1.21%)IgM抗HEV阳性样品和6(0.25%)抗T。苍白球阳性样品在核酸检测中证明为阴性。血清学检测1份(0.04%)HBVDNA阳性样本和1份(0.04%)HEVRNA阳性样本均为阴性。
结论:开发的五重qRT-PCR是第一个同时,敏感,具体,和HBV的重复性检测,HCV,HEV,T.苍白球,和RNaseP在单管中。它可以在感染窗口期检测血液中的病原体,是有效筛查献血者和早期临床诊断的良好工具。
BACKGROUND: With the safety of blood transfusion being a major public health concern, the development of a rapid, sensitive, specific, and cost-effective multiplex PCR assay for simultaneous detection of hepatitis B virus(HBV), hepatitis C virus (HCV), hepatitis E virus (HEV), and Treponema pallidum(T. pallidum) in blood is crucial.
METHODS: Five primer pairs and probes were designed towards conserved regions of target genes and used to establish a one-step pentaplex real-time reverse transcription PCR(qRT-PCR) assay for simultaneous detection of HBV, HCV, HEV, T. pallidum, and RNase P(housekeeping gene), providing sample quality check. The clinical performance of the assay was further determined with 2400 blood samples from blood donors and patients in Zhejiang province, and compared the results with commercial singleplex qPCR and serological assays.
RESULTS: The 95% limit of detection(LOD) of HBV, HCV, HEV, and T. pallidum were 7.11 copies/µL, 7.65 copies/µL, 8.45 copies/µL, and 9.06 copies/µL, respectively. Moreover, the assay has good specificity and precision. Compared to the singleplex qPCR assay, the novel assay for detecting HBV, HCV, HEV, and T. pallidum presented 100% clinical sensitivity, specificity, and consistency. Several discrepant results between serological and pentaplex qRT-PCR assays were found. Of 2400 blood samples, there were 2(0.08%) HBsAg positive samples, 3(0.13%) anti-HCV positive samples, 29(1.21%) IgM anti-HEV positive samples and 6(0.25%) anti-T. pallidum positive samples proven negative in nucleic acid detection. 1(0.04%) HBV DNA positive sample and 1(0.04%) HEV RNA positive sample were detected negative by serological testing.
CONCLUSIONS: The developed pentaplex qRT-PCR is the first assay on simultaneous, sensitive, specific, and reproducible detection of HBV, HCV, HEV, T. pallidum, and RNase P in a single tube. It could detect pathogens in blood during the window period of infection and is a good tool for effectively screening blood donors and early clinical diagnosis.