Poster Presentation Australian Society for Microbiology Annual Scientific Meeting 2016

Resolving inconclusive HCV genotypes generated by the Siemens Versant HCV Genotype 2.0 method with the Abbott RealTime HCV Genotype II assay. (#226)

Todd M Pryce 1 , Ian D Kay 1 , Zamri Ahmad 1 , Diane Quinlan-Price 1 , Courtney Jeffery 1 , James P Flexman 1
  1. Microbiology, PathWest Fiona Stanley Hospital, Perth, WA, Australia

The Siemens Versant HCV Genotype 2.0 assay is a line probe assay (LIPA) for the identification of HCV genotypes 1 to 6a-b, 6c-l and subtypes a and b of genotype 1. This assay produces banding patterns on a nitrocellulose strip which are compared to reference banding patterns of known HCV genotypes. In contrast, the Abbott RealTime HCV Genotype II (GTII) assay uses real-time PCR and fluorescent probes for the identification of HCV genotypes 1 to 6a-b and subtypes a and b of genotype 1. In the 2014 year we encountered 40 patient samples that demonstrated inconclusive banding patterns from HCV-positive samples of known viral load. A sub-set of these samples (n=29) were tested using the GTII assay. We evaluated the use of the GTII assay to resolve these inconclusive genotypes. The GTII assay was able to resolve the HCV genotype for all samples tested (no samples were identified that required reflex testing to identify HCV genotype 6c-l). The GTII assay identified HCV genotype 1a (n=4), 1a + 2 (n=1), 1a + reactivity with 3 (n=5), 1a + reactivity with 4 (n=1), 1b + reactivity with 4 (n=2), 3 (n=9), 4 (n=3), 6ab (n=1) and 3 not detected results. Sixty-nine percent of all unresolved results were able to be resolved to a single genotype or below the limit of detection. Thirty-one percent were considered mixed infection, recombination or cross-reactivity. Cross-reactivity with genotype 3 for genotype 1a is known to occur with this assay and can be resolved with reflex testing if clinically required. We conclude that the GTII assay is useful for resolving inconclusive HCV genotypes generated by LIPA. In addition the Abbott RealTime probe-based assay is also useful for resolving mixed infection and is less subjective as there is no need for manual interpretation of results.  The assay is performed on the automated Abbott m2000 system, is less labour intensive and is well-suited for routine diagnostic use.