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Journal of Clinical Microbiology, April 1998, p. 862-865, Vol. 36, No. 4
Servicio de Microbiologia Clinica y
Enfermedades Infecciosas, Hospital General Universitario Gregorio
Maranon, Madrid, Spain1;
Laboratorio di
Patologia Clinica, Ospedale S. Anna, Como,
Italy2;
Laboratoire de Biologie
Moleculaire, Hopital de Meaux, Meaux, France3;
PCR Unit, Roche Diagnostic Systems, Basel,
Switzerland5;
PCR Labor,
Gemeinschaftspraxis Dres Fenner, Hamburg,
Germany6;
Hopital St. Luc, Montreal,
Quebec, Canada4; and
Roche Molecular
Systems, Somerville, New Jersey7
Received 8 September 1997/Returned for modification 19 November
1997/Accepted 6 January 1998
The benefits shown by the recent introduction of PCR for the in
vitro diagnosis of hepatitis C virus (HCV) infection has prompted the
development of standardized, ready-to-use assays that can be
implemented in routine clinical laboratories. We have evaluated the clinical performance of COBAS AMPLICOR HCV
(COBAS), the first instrument system that allows the
automation of HCV RNA amplification and detection, to determine its
performance in the routine laboratory setting. More than 2,000 specimens collected at five centers were analyzed in parallel by the
COBAS and the manual AMPLICOR HCV (AMPLICOR) tests, and the
results were compared with the results for biochemical and serological
markers of HCV. In this study the two PCR systems showed the same
accuracy, with a concordance rate of 99.8%. As expected, the
correlation between serology and PCR was not absolute because the
presence of anti-HCV antibodies may be associated with a latent or past
infection. On the other hand, if the presence of confirmed anti-HCV
antibodies and elevated alanine aminotransferase levels are taken as
the "gold standard," indicating an active, ongoing infection,
the COBAS and AMPLICOR tests show high and comparable
sensitivities (100%) and specificities (98%), with positive and
negative predictive values of 100 and 97%, respectively. During the
study no false-positive reactions were detected. The use of an internal
control allowed the identification of inhibitory substances that
prevented amplification for 0.3 and 0.4% of samples tested by the
COBAS and AMPLICOR tests, respectively. Compared to the manual
system, the COBAS system allowed a significant reduction of
hands-on time and could improve the overall laboratory work flow. In
conclusion, these results support the use of the COBAS and
AMPLICOR tests for the molecular diagnosis of active HCV
infections.
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.
Multicenter Evaluation of the COBAS AMPLICOR HCV Assay, an
Integrated PCR System for Rapid Detection of Hepatitis C Virus RNA
in the Diagnostic Laboratory
*
Corresponding author. Mailing address: Roche Diagnostic
Systems, Bldg. 222/121, 4070 Basel, Switzerland. Phone: 41 61 6873363. Fax: 41 61 6872109. E-mail:
Giuseppe.Colucci.GC1{at}Roche.com.
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