J Bacteriol Virol.  2018 Mar;48(1):1-13. 10.4167/jbv.2018.48.1.1.

Diagnosis of Viral Infection Using Real-time Polymerase Chain Reaction

Affiliations
  • 1Department of Biotechnology, the Catholic University of Korea, Bucheon-si, Gyeonggi-do, Korea. jhnam@catholic.ac.kr
  • 2Department of Research and Development, Genetree Research, Seoul, Korea.

Abstract

The laboratory-based diagnosis of viral infection has been evolving over the years, to increase objectivity, accuracy, and sensitivity via the continuous development of various technologies. Cell culture, which is one of the methods used for the diagnosis of viral infection, is a "gold-standard" approach; however, it is time consuming and is associated with a high risk of contamination. To overcome these shortcomings, molecular biology methods, such as conventional polymerase chain reaction (cPCR), real-time PCR, and sequencing, have been used recently for virus diagnosis. Realtime PCR has higher accuracy and sensitivity compared with cPCR. Moreover, realtime PCR can quantify viral nucleic acids by confirming the amplification using the threshold cycle, which is the initial amplification point. Real-time PCR applications for the detection of various types of viruses in clinical settings should be based on the use of appropriate samples, nucleic acid extraction according to virus characteristics, and selection of diagnostic methods using sensitivity and specificity targets. In addition, the implementation of real-time PCR requires to evaluate the performance of the test protocol by measuring sensitivity, specificity, accuracy, and reproducibility. The verified real-time PCR method is an easy, fast, and accurate method for monitoring the diagnosis and treatment outcomes in a clinical setting. In this review, we summarize the characteristics of the typical diagnostic methods for viral infection, especially of the advanced real-time PCR method, to detect human pathogenic viruses.

Keyword

Virus; Diagnostics; Real-time PCR

MeSH Terms

Cell Culture Techniques
Diagnosis*
Humans
Methods
Molecular Biology
Nucleic Acids
Polymerase Chain Reaction
Real-Time Polymerase Chain Reaction*
Sensitivity and Specificity
Nucleic Acids

Figure

  • Figure 1 Types of probes in real-time PCR. (a) The hydrolysis probe emits light due to the hydrolysis of the probe bound to the template during primer extension (b) A molecular beacon probe with a stem structure emits light while hybridizing to the template. (c) The hybridization probe emits light adjacent to two different probes in the PCR annealing step. R=5′reporter dye, Q = Quencher, Fd = Donor dye, Fa = Acceptor dye, P = phosphate group


Reference

1. Zaitlin M, Palukaitis P. Advances in Understanding Plant Viruses and Virus Diseases. Annu Rev Phytopathol. 2000; 38:117–143.
Article
2. Lawrence CM, Menon S, Eilers BJ, Bothner B, Khayat R, Douglas T, et al. Structural and functional studies of archaeal viruses. J Biol Chem. 2009; 284:12599–12603.
Article
3. Orlova EV. How viruses infect bacteria? EMBO J. 2009; 28:797–798.
Article
4. Bielefeldt Ohmann H, Babiuk LA. Viral infections in domestic animals as models for studies of viral immunology and pathogenesis. J Gen Virol. 1986; 67:1–25.
Article
5. Baltimore D. Expression of animal virus genomes. Bacteriol Rev. 1971; 35:235–241.
Article
6. Taylor MP, Kobiler O, Enquist LW. Alphaherpesvirus axon-to-cell spread involves limited virion transmission. Proc Natl Acad Sci U S A. 2012; 109:17046–17051.
Article
7. Roulston A, Marcellus RC, Branton PE. Viruses and apoptosis. Annu Rev Microbiol. 1999; 53:577–628.
Article
8. Jordan MC, Jordan GW, Stevens JG, Miller G. Latent herpesviruses of humans. Ann Intern Med. 1984; 100:866–880.
Article
9. Subramanya D, Grivas PD. HPV and cervical cancer: updates on an established relationship. Postgrad Med. 2008; 120:7–13.
Article
10. Smith AP. Respiratory virus infections and performance. Philos Trans R Soc Lond B Biol Sci. 1990; 327:519–528.
Article
11. Rook AH. Interactions of cytomegalovirus with the human immune system. Rev Infect Dis. 1988; 10:Suppl 3. S460–S467.
Article
12. Steven NM. Epstein-Barr virus latent infection in vivo. Rev Med Virol. 1997; 7:97–106.
13. Berris B. Chronic viral diseases. CMAJ. 1986; 135:1260–1268.
14. Smithey MJ, Li G, Venturi V, Davenport MP, Nikolich-Žugich J. Lifelong persistent viral infection alters the naive T cell pool, impairing CD8 T cell immunity in late life. J Immunol. 2012; 189:5356–5366.
Article
15. Horváth G, Tolvaj G, Dávid K. [Incidence of hepatitis B, C and D infection in chronic liver diseases]. Orv Hetil. 1992; 133:2475–2480.
16. Dunne EF, Park IU. HPV and HPV-associated diseases. Infect Dis Clin North Am. 2013; 27:765–778.
Article
17. Cantoni D, Hamlet A, Michaelis M, Wass MN, Rossman JS. Risks Posed by Reston, the Forgotten Ebolavirus. mSphere. 2016; 1.
Article
18. Leland DS, Ginocchio CC. Role of cell culture for virus detection in the age of technology. Clin Microbiol Rev. 2007; 20:49–78.
Article
19. Bell EJ, McCartney RA, Basquill D, Chaudhuri AK. Mu-antibody capture ELISA for the rapid diagnosis of enterovirus infections in patients with aseptic meningitis. J Med Virol. 1986; 19:213–217.
Article
20. Kemeny DM, Challacombe SJ. Advances in ELISA and other solid-phase immunoassays. Immunol Today. 1986; 7:67–68.
Article
21. Cai HY, Caswell JL, Prescott JF. Nonculture molecular techniques for diagnosis of bacterial disease in animals: a diagnostic laboratory perspective. Vet Pathol. 2014; 51:341–350.
Article
22. Espy MJ, Uhl JR, Sloan LM, Buckwalter SP, Jones MF, Vetter EA, et al. Real-time PCR in clinical microbiology: applications for routine laboratory testing. Clin Microbiol Rev. 2006; 19:165–256.
Article
23. Xiao XL, Wu H, Li YJ, Li HF, He YQ, Chen G, et al. Simultaneous detection of enterovirus 70 and coxsackievirus A24 variant by multiplex real-time RT-PCR using an internal control. J Virol Methods. 2009; 159:23–28.
Article
24. Cai MT, Wu YD, Wu XJ, Shang SQ. [Establishment and clinical application of a new real time PCR assay for simultaneous detection of human herpesvirus-6A and human herpesvirus-6B]. Zhonghua Er Ke Za Zhi. 2009; 47:527–531.
25. Detsika MG, Chandler B, Khoo SH, Winstanley C, Cane P, Back DJ, et al. Detection and quantification of minority HIV isolates harbouring the D30N mutation by real-time PCR amplification. J Antimicrob Chemother. 2007; 60:881–884.
Article
26. Stránská R, van Loon AM, Polman M, Schuurman R. Application of real-time PCR for determination of antiviral drug susceptibility of herpes simplex virus. Antimicrob Agents Chemother. 2002; 46:2943–2947.
Article
27. Lindh M, Hannoun C. Genotyping of hepatitis C virus by Taqman real-time PCR. J Clin Virol. 2005; 34:108–114.
Article
28. Hodinka RL. Point: is the era of viral culture over in the clinical microbiology laboratory? J Clin Microbiol. 2013; 51:2–4.
Article
29. Hematian A, Sadeghifard N, Mohebi R, Taherikalani M, Nasrolahi A, Amraei M, et al. Traditional and Modern Cell Culture in Virus Diagnosis. Osong Public Health Res Perspect. 2016; 7:77–82.
Article
30. Mengelle C, Mansuy JM, Da Silva I, Guerin JL, Izopet J. Evaluation of a polymerase chain reaction-electrospray ionization time-of-flight mass spectrometry for the detection and subtyping of influenza viruses in respiratory specimens. J Clin Virol. 2013; 57:222–226.
Article
31. Mendelson E, Aboudy Y, Smetana Z, Tepperberg M, Grossman Z. Laboratory assessment and diagnosis of congenital viral infections: Rubella, cytomegalovirus (CMV), varicella-zoster virus (VZV), herpes simplex virus (HSV), parvovirus B19 and human immunodeficiency virus (HIV). Reprod Toxicol. 2006; 21:350–382.
Article
32. Yolken RH, Leister FJ. Enzyme immunoassays for measurement of cytomegalovirus immunoglobulin M antibody. J Clin Microbiol. 1981; 14:427–432.
Article
33. Kao HW, Ashcavai M, Redeker AG. The persistence of hepatitis A IgM antibody after acute clinical hepatitis A. Hepatology. 1984; 4:933–936.
Article
34. Schmitz H, von Deimling U, Flehmig B. Detection of IgM antibodies to cytomegalovirus (CMV) using an enzyme-labelled antigen (ELA). J Gen Virol. 1980; 50:59–68.
Article
35. Jankowski M, Gut W, Imbs D, Switalski L. Study of interaction between IgG and IgM antibodies against rubella virus by the immunofluorescence method. Acta Microbiol Pol. 1979; 28:63–69.
36. Arstila P, Vuorimaa T, Kalimo K, Halonen P, Viljanen M, Granfors K, et al. A solid-phase radioimmunoassay for IgG and IgM antibodies against measles virus. J Gen Virol. 1977; 34:167–176.
Article
37. Calisher CH, Fremount HN, Vesely WL, el-Kafrawi AO, Mahmud MI. Relevance of detection of immunoglobulin M antibody response in birds used for arbovirus surveillance. J Clin Microbiol. 1986; 24:770–774.
Article
38. Schmidt SD, Mazzella MJ, Nixon RA, Mathews PM. Abeta measurement by enzyme-linked immunosorbent assay. Methods Mol Biol. 2012; 849:507–527.
39. Hornsleth A, Friis B, Andersen P, Brenøe E. Detection of respiratory syncytial virus in nasopharyngeal secretions by ELISA: comparison with fluorescent antibody technique. J Med Virol. 1982; 10:273–281.
Article
40. Gerna G, Passarani N, Cattaneo E, Torsellini M, Percivalle E, Battaglia M, et al. Diagnosis of acute non-bacterial gastroenteritis by rotavirus detection and serology. Microbiologica. 1984; 7:29–39.
41. Sundqvist VA, Wahren B. Development of sensitive and enzyme-linked immunoassays for herpesvirus antigens and some applications. Dev Biol Stand. 1982; 52:245–253.
42. Iancu LS, Macovei O, Tourle C, Beadsworth A, Duca M. [The prevalence of anti-hepatitis C virus antibodies in children from social assistance units in the county of Iasi]. Rev Med Chir Soc Med Nat Iasi. 1996; 100:109–113.
43. Baron EJ, Miller JM, Weinstein MP, Richter SS, Gilligan PH, Thomson RB Jr, et al. , et al. A guide to utilization of the microbiology laboratory for diagnosis of infectious diseases: 2013 recommendations by the Infectious Diseases Society of America (IDSA) and the American Society for Microbiology (ASM)(a). Clin Infect Dis. 2013; 57:e22–e121.
44. van Tongeren SP, Degener JE, Harmsen HJ. Comparison of three rapid and easy bacterial DNA extraction methods for use with quantitative real-time PCR. Eur J Clin Microbiol Infect Dis. 2011; 30:1053–1061.
Article
45. Sun Y, Zhao L, Zhao M, Zhu R, Deng J, Wang F, et al. Four DNA extraction methods used in loop-mediated isothermal amplification for rapid adenovirus detection. J Virol Methods. 2014; 204:49–52.
Article
46. Poste G. Molecular diagnostics: a powerful new component of the healthcare value chain. Expert Rev Mol Diagn. 2001; 1:1–5.
Article
47. Valle L, Amicizia D, Bacilieri S, Banfi F, Riente R, Durando P, et al. Performance testing of two new one-step real time PCR assays for detection of human influenza and avian influenza viruses isolated in humans and respiratory syncytial virus. J Prev Med Hyg. 2006; 47:127–133.
48. Monne I, Ormelli S, Salviato A, De Battisti C, Bettini F, Salomoni A, et al. Development and validation of a one-step realtime PCR assay for simultaneous detection of subtype H5, H7, and H9 avian influenza viruses. J Clin Microbiol. 2008; 46:1769–1773.
Article
49. Holland PM, Abramson RD, Watson R, Gelfand DH. Detection of specific polymerase chain reaction product by utilizing the 5′----3′ exonuclease activity of Thermus aquaticus DNA polymerase. Proc Natl Acad Sci U S A. 1991; 88:7276–7280.
Article
50. Tyagi S, Kramer FR. Molecular beacons: probes that fluoresce upon hybridization. Nat Biotechnol. 1996; 14:303–308.
Article
51. Tomaso H, Scholz HC, Neubauer H, Al Dahouk S, Seibold E, Landt O, et al. Real-time PCR using hybridization probes for the rapid and specific identification of Francisella tularensis subspecies tularensis. Mol Cell Probes. 2007; 21:12–16.
Article
52. Paulasova P, Pellestor F. The peptide nucleic acids (PNAs): a new generation of probes for genetic and cytogenetic analyses. Ann Genet. 2004; 47:349–358.
Article
53. Kaur H, Arora A, Wengel J, Maiti S. Thermodynamic, counterion, and hydration effects for the incorporation of locked nucleic acid nucleotides into DNA duplexes. Biochemistry. 2006; 45:7347–7355.
Article
54. Owczarzy R, You Y, Groth CL, Tataurov AV. Stability and mismatch discrimination of locked nucleic acid-DNA duplexes. Biochemistry. 2011; 50:9352–9367.
Article
55. Bustin SA. Absolute quantification of mRNA using real-time reverse transcription polymerase chain reaction assays. J Mol Endocrinol. 2000; 25:169–193.
Article
56. Stadhouders R, Pas SD, Anber J, Voermans J, Mes TH, Schutten M. The effect of primer-template mismatches on the detection and quantification of nucleic acids using the 5′ nuclease assay. J Mol Diagn. 2010; 12:109–117.
Article
57. Jothikumar N, Cromeans TL, Sobsey MD, Robertson BH. Development and evaluation of a broadly reactive TaqMan assay for rapid detection of hepatitis A virus. Appl Environ Microbiol. 2005; 71:3359–3363.
Article
58. Ririe KM, Rasmussen RP, Wittwer CT. Product differentiation by analysis of DNA melting curves during the polymerase chain reaction. Anal Biochem. 1997; 245:154–160.
Article
59. Reiter M, Pfaffl MW. Effects of Plate Position, Plate Type and Sealing Systems on Real-Time PCR Results. Biotechnol Biotechnol Equip. 2008; 22:824–828.
Article
60. Kralik P, Ricchi M. A Basic Guide to Real Time PCR in Microbial Diagnostics: Definitions, Parameters, and Everything. Front Microbiol. 2017; 8:108.
Article
61. Hong YJ, Lim MS, Hwang SM, Kim TS, Park KU, Song J, et al. Detection of herpes simplex and varicella-zoster virus in clinical specimens by multiplex real-time PCR and melting curve analysis. Biomed Res Int. 2014; 2014:261947.
Article
62. Pang Z, Li A, Li J, Qu J, He C, Zhang S, et al. Comprehensive multiplex one-step real-time TaqMan qRT-PCR assays for detection and quantification of hemorrhagic fever viruses. PLoS One. 2014; 9:e95635.
Article
63. Bustin SA, Benes V, Garson JA, Hellemans J, Huggett J, Kubista M, et al. The MIQE guidelines: minimum information for publication of quantitative real-time PCR experiments. Clin Chem. 2009; 55:611–622.
Article
64. Schmittgen TD, Livak KJ. Analyzing real-time PCR data by the comparative C(T) method. Nat Protoc. 2008; 3:1101–1108.
Article
65. Hellemans J, Mortier G, De Paepe A, Speleman F, Vandesompele J. qBase relative quantification framework and software for management and automated analysis of real-time quantitative PCR data. Genome Biol. 2007; 8:R19.
66. Procop GW. Molecular diagnostics for the detection and characterization of microbial pathogens. Clin Infect Dis. 2007; 45:Suppl 2. S99–S111.
Article
67. Cockerill FR 3rd. Genetic methods for assessing antimicrobial resistance. Antimicrob Agents Chemother. 1999; 43:199–212.
Article
68. Versalovic J, Lupski JR. Molecular detection and genotyping of pathogens: more accurate and rapid answers. Trends Microbiol. 2002; 10:S15–S21.
Article
69. Hecht FM, Grant RM, Petropoulos CJ, Dillon B, Chesney MA, Tian H, et al. Sexual transmission of an HIV-1 variant resistant to multiple reverse-transcriptase and protease inhibitors. N Engl J Med. 1998; 339:307–311.
Article
70. Hue-Roye K, Vege S. Principles of PCR-based assays. Immunohematology. 2008; 24:170–175.
Article
71. Saiki RK, Scharf S, Faloona F, Mullis KB, Horn GT, Erlich HA, et al. Enzymatic amplification of beta-globin genomic sequences and restriction site analysis for diagnosis of sickle cell anemia. Science. 1985; 230:1350–1354.
Article
72. Shin SY, Ki CS, Kim HJ, Kim JW, Kim SH, Lee ST. Mutant Enrichment with 3′-Modified Oligonucleotides (MEMO)-Quantitative PCR for Detection of NPM1 Mutations in Acute Myeloid Leukemia. J Clin Lab Anal. 2015; 29:361–365.
Article
73. Carr AC, Moore SD. Robust quantification of polymerase chain reactions using global fitting. PLoS One. 2012; 7:e37640.
Article
74. Gulliksen A, Solli L, Karlsen F, Rogne H, Hovig E, Nordstrøm T, et al. Real-time nucleic acid sequence-based amplification in nanoliter volumes. Anal Chem. 2004; 76:9–14.
Article
75. Hoffmann B, Beer M, Reid SM, Mertens P, Oura CA, van Rijn PA, et al. A review of RT-PCR technologies used in veterinary virology and disease control: sensitive and specific diagnosis of five livestock diseases notifiable to the World Organisation for Animal Health. Vet Microbiol. 2009; 139:1–23.
Article
76. Yang S, Rothman RE. PCR-based diagnostics for infectious diseases: uses, limitations, and future applications in acute-care settings. Lancet Infect Dis. 2004; 4:337–348.
Article
77. Kubista M, Andrade JM, Bengtsson M, Forootan A, Jonák J, Lind K, et al. The real-time polymerase chain reaction. Mol Aspects Med. 2006; 27:95–125.
Article
78. Mirmajlessi SM, Loit E, Mänd M. General Principles of Real-Time PCR: A Technology for Quantitative Detection of Phytopathogens. J Med Bioeng. 2016; 5:49–52.
Article
79. Damond F, Benard A, Ruelle J, Alabi A, Kupfer B, Gomes P, et al. Quality control assessment of human immunodeficiency virus type 2 (HIV-2) viral load quantification assays: results from an international collaboration on HIV-2 infection in 2006. J Clin Microbiol. 2008; 46:2088–2091.
Article
80. Broeders S, Huber I, Grohmann L, Berben G, Taverniers I, Mazzara M, et al. Guidelines for validation of qualitative real-time PCR methods. Trends Food Sci Technol. 2014; 37:115–126.
Article
Full Text Links
  • JBV
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr