Development and performance of prototype serologic and molecular tests for hepatitis delta infection

Kelly E Coller,Mary A Rodgers,Ka-Cheung Luk,Birgit Bremer,Jeffrey Gersch,Emily K Butler,Mary C Kuhns,George J Dawson,Michael Cassidy,Lazare Kaptue,Heiner Wedemeyer,Gavin A Cloherty,Anne L Mcnamara

doi:10.1038/s41598-018-20455-5

Kelly E Coller, Mary A Rodgers + Show 11 more

Open Access

https://doi.org/10.1038/s41598-018-20455-5

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Abstract

Worldwide, an estimated 5% of hepatitis B virus (HBV) infected people are coinfected with hepatitis delta virus (HDV). HDV infection leads to increased mortality over HBV mono-infection, yet HDV diagnostics are not widely available. Prototype molecular (RNA) and serologic (IgG) assays were developed for high-throughput testing on the Abbott m2000 and ARCHITECT systems, respectively. RNA detection was achieved through amplification of a ribozyme region target, with a limit of detection of 5 IU/ml. The prototype serology assay (IgG) was developed using peptides derived from HDV large antigen (HDAg), and linear epitopes were further identified by peptide scan. Specificity of an HBV negative population was 100% for both assays. A panel of 145 HBsAg positive samples from Cameroon with unknown HDV status was tested using both assays: 16 (11.0%) had detectable HDV RNA, and 23 (15.7%) were sero-positive including the 16 HDV RNA positive samples. Additionally, an archival serial bleed panel from an HDV superinfected chimpanzee was tested with both prototypes; data was consistent with historic testing data using a commercial total anti-Delta test. Overall, the two prototype assays provide sensitive and specific methods for HDV detection using high throughput automated platforms, allowing opportunity for improved diagnosis of HDV infected patients.

Highlights

Worldwide, an estimated 5% of hepatitis B virus (HBV) infected people are coinfected with hepatitis delta virus (HDV)
Because of the higher risk of developing liver-related complications resulting from HDV superinfection, HDV diagnostic testing is recommended for all patients with chronic HBV infection[6,8]
1 strain, that can be used in nucleic acid amplification technique (NAT)-based assays[22], but assessment of assay performance using the World Health Organization (WHO) standard may not capture the challenge of detecting diverse HDV strains

Summary

Introduction

An estimated 5% of hepatitis B virus (HBV) infected people are coinfected with hepatitis delta virus (HDV). Prototype molecular (RNA) and serologic (IgG) assays were developed for high-throughput testing on the Abbott m2000 and ARCHITECT systems, respectively. The two prototype assays provide sensitive and specific methods for HDV detection using high throughput automated platforms, allowing opportunity for improved diagnosis of HDV infected patients. Because of the higher risk of developing liver-related complications resulting from HDV superinfection, HDV diagnostic testing is recommended for all patients with chronic HBV infection[6,8]. The current diagnostic landscape includes a need for highly sensitive and specific serologic and molecular assays for HDV detection: in resource limited areas availability is scarce and there is no standardized molecular assay for HDV detection globally available[8,22]. 1 strain, that can be used in nucleic acid amplification technique (NAT)-based assays[22], but assessment of assay performance using the WHO standard may not capture the challenge of detecting diverse HDV strains

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