Development of molecular platform for the confirmatory and discriminatory diagnosis of HTLV-1/2 infection based on real-time PCR methodology

Author(s)

Maurício Cristiano Rocha Júnior

• Document type: Doctoral Thesis
• Press: Ribeirão Preto.
• Institution: Universidade de São Paulo (USP). Faculdade de Ciências Farmacêuticas de Ribeirão Preto (PCARP/BC)
• Defense date: 2014-10-10

Examining board members

Simone Kashima Haddad; Newton Satoru Odashima

• Advisor: Simone Kashima Haddad

Abstract

The significant prevalence of HTLV-1/2 infection in Brazil has turned the serological testing for this virus mandatory in national blood banks since 1993. The performance of efficient and safe diagnosis of this infection has importance on the correct counseling of the patients and the prevention of the transfusion/hemoderivatives transmitted HTLV-1/2 infection. However, the inefficiency of the available confirmatory tests combined with their high cost present limiting factors for adequate conclusions over the clinical status of the patient. A safe diagnosis of the HTLV-1/2 infection is of crucial importance for the correct counseling of the patients and prevention of the transmission of the infection by blood transfusions, breastfeeding and solid organ transplantations. Therefore, the objective of this study was to develop, optimize and validate a molecular multiplex platform (NAT) utilizing the real-time PCR methodology for confirmatory and discriminatory diagnosis of the HTLV-1/2 infection. DNA samples obtained from HTLV-1/2 positive patients, blood donor candidates, and HIV, HBV and HCV infected patients were used in this study. The real-time PCR was optimized using the TaqMan® system (hydrolysis probes) and the pol gene was a target for real-time amplification. After optimization, the molecular platform was validated by analysis of the analytic and diagnostic sensitivity, analytic and diagnostic specificity, precision, and robustness. The detection limit (LoD) of the test was 3.85 copies/reaction for HTLV-1 and 10.88 copies/reaction for HTLV-2. Evaluation of the specificity did not demonstrate cross reaction with human viruses like HAV, HBV, HCV, HIV-1, HIV-2 and B19V obtained from a diagnostic panel and also with samples obtained from HIV, HBV or HCV positive individuals. The diagnostic sensitivity was 94.6% for HTLV-1 and 78.6% for HTLV-2. The estimated variation coefficient of the precision analysis was not more than 0.475%. Therefore, this methodology presents simple, inexpensive, sensitive and highly specific test, and can be used adequately for the detection and discrimination of this retroviral infection. The optimization of this molecular platform have important impact on the improvement of the technologic capability and it can be used for the definition of a national diagnostic algorithm which will permit a safe conclusion of the HTLV-1/2 diagnosis. (AU)