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Virology. 22-2-11. Diagnostic methods in virology. Detection of virus Detection of viral antigen Detection of viral genome Detection of serological response. Detection of viral antigens. Antisera (mono or polyclonal) are used to detect viral antigen

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virology

Virology

22-2-11

diagnostic methods in virology
Diagnostic methods in virology
  • Detection of virus
  • Detection of viral antigen
  • Detection of viral genome
  • Detection of serological response
detection of viral antigens
Detection of viral antigens
  • Antisera (mono or polyclonal) are used to detect viral antigen
  • These assays can be sensitive as they can detect antigens of disrupted viral particles
  • They are pathogen specific - separate immuno-assay must be used for each pathogen
  • In contrast electron microscopy and culture are catch all techniques which detect all pathogens
methods
Methods
  • Antigen capture ELISA - eg rotavirus, HBsAg, HIV
  • Latex particle agglutination (LPA) eg rotavirus
  • Immunoflouresence - eg RSV, influenza,
detection of viral genome
Detection of viral genome
  • Genome amplification eg. PCR (polymerase chain reaction)
detection of serological response
Detection of serological response
  • IgM detection
  • Detection of rising titre: ELISA, complement fixation test, haemagglutination inhibition
case 1
Case 1
  • The following is a report from a lady with a 10-year history of fatigue, anorexia and elevated LFTs.

Hepatitis B surface antigen: negative

Hepatitis C antibody: positive

Hepatitis C antibody immunoblot confirmation: positive Banding pattern: c100 c33 c22 NS5 3+ 3+ 4+ 4+

case 11
Case 1
  • What additional tests would you request?
  • What your treatment options
case 2
Case 2
  • You are given the following results on two different patients.
  • Are there any differences between the profiles?
  • What implications (if any) are there for these differences?
case 21
Case 2

Patient 1:

TestsResults

EIA for HBsAg Positive

***Infection Risk***

Hepatitis B e antigen Negative

Hepatitis B e antibody Positive

Hepatitis B core IgM antibody Negative

Report comment: Hepatitis B result profile consistent with

chronic hepatitis B infection.

case 22
Case 2

Patient 2:

TestsResults

EIA for HBsAg Positive

***Infection Risk***

Hepatitis B e antigen Positive

***High Infection Risk***

Hepatitis B e antibody Negative

Hepatitis B core IgM antibody Positive: 250 IU/ml.

Report comment: Hepatitis B result profile consistent with

chronic hepatitis B infection.

case 23
Case 2
  • Do you agree with the comments?
  • What additional test(s) would you request for after a discussion with the microbiologist?
case 3
Case 3
  • You have vaccinated 2 patients against hepatitis B virus for the purpose of foreign travel.
  • What test would you request to assess the vaccination status?
  • Comment on the following results.
case 31
Case 3
  • Patient 1:

Hepatits B surface antibody: >1000 mIU/ml

  • Patient 2:

Hepatitis B surface antibody: <10 mIU/ml

case 4
Case 4
  • A patient presents with malaise, elevated LFTs and a history of intravenous drug abuse. You are given the following result:

Hepatitis B surface antigen: Positive

Hepatitis B surface antibody: Negative

Report comment: If this is the first positive serological test on this patient, please repeat to confirm.

case 41
Case 4
  • Comment on the above report.
  • What additional tests would you request?
case 42
Case 4

Hepatitis B surface antigen: Positive

***Infection Risk***

Hepatitis B e antigen: Positive

***High Infection Risk***

Hepatitis B e antibody: Negative

Hepatitis B core IgM antibody: Negative

Hepatitis B core total antibody: Positive

Report comment: ………..

  • What is your report comment?
case 5
Case 5
  • A 23 year old female patient presents to the A/E department with malaise, lymphadenopathy, malaise and a rash. She has a history of unsafe sexual activity.
  • What investigations would you request?
case 51
Case 5
  • Shown below is one of the patient’s laboratory results:

TestsResults

EIA for anti-HIV 1 (Organon) Positive

EIA for anti-HIV 1+2 (Murex) Positive

Report comment: ***confirmed anti-HIV 1 positive***

  • What additional tests would you require?
  • What would you advise the patient?
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