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Year : 2011  |  Volume : 17  |  Issue : 1  |  Page : 1-2

Quantitation of HBV DNA; another modification of the test: Will it withstand the test of time?

National Institute of Immunohaematology (ICMR), KEM Hospital Campus, Parel, Mumbai, India

Date of Web Publication18-Jun-2011

Correspondence Address:
Kanjaksha Ghosh
National Institute of Immunohaematology (ICMR), 13th Floor, New Multistoryed Building, K.E.M. Hospital Campus, Parel, Mumbai
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0971-6866.82184

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How to cite this article:
Ghosh K, Gorakshakar A. Quantitation of HBV DNA; another modification of the test: Will it withstand the test of time?. Indian J Hum Genet 2011;17:1-2

How to cite this URL:
Ghosh K, Gorakshakar A. Quantitation of HBV DNA; another modification of the test: Will it withstand the test of time?. Indian J Hum Genet [serial online] 2011 [cited 2016 May 13];17:1-2. Available from:

Measuring viral load has now become a cornerstone of therapy for many chronic viral infections like Hepatitis B, Hepatitis C, HIV, etc. There are several challenges in measuring these viral loads, which are as follows:

  1. Nonavailability of a universal standard/control.
  2. Differences due to nucleotide sequences selected from different areas of the virus and this is particularly relevant where specific dye chemistry is being applied.
  3. Biology of the infection where different levels of viral shedding into the circulation may cause differences in the circulating viral load.
  4. Presence of inhibitors of PCR amplifications in the sample. Moreover, similar techniques are also used for Nucleic Acid Amplification Testing to detect the presence of transfusion transmissible viruses with negative serology.

Hence, there is a need for universally acceptable tests to detect viral load predictably and there should be minimum variability of the detected viral load from one laboratory to another.

The paper by Naresh on in-house development of RQPCR technique for detection of Hepatitis B viral load should be evaluated from this perspective. [1] The process described by Naresh seems to be robust and correlation with plasmid control is also very good. The authors have chosen three areas, i.e. surface antigen, core and X region of HBV genome sequences, for amplifications. Presence of all three nucleotide sequences in the sample will make infection very likely.

Infection of hepatitis B virus transmitted through blood and blood products is an important preventable complication. [2] In India, NAT testing has not been made compulsory in all blood banks as yet, but the data that have been emerging from some of the blood banks [3],[4] clearly show Hepatitis B virus to be responsible for majority of seronegative but nucleic acid positive samples when Hepatitis B, Hepatitis C and HIV infections were tested from voluntary blood donors. Hepatitis C is also an important cause of transfusion transmitted liver infections in multi transformed hemophiliacs [5] and thalasseamic patients, [6] accounting for about 18-34% positivity in these patients.

One of the reasons why NAT testing could not be universalized is because of its cost. Authors of the present paper under discussion have commented on this issue and `250 per test seems to be acceptable.

However, this test needs to be used by other centers to evaluate its applicability in general.

   References Top

1.Naresh Y. Latest and promising approach for predication of viral load in Hepatitis B virus infected pts.  Back to cited text no. 1
2.Bhattacharya P, Chandra PK, Datta S, Banerjee A, Chakraborty S, Rajendran K, et al. Significant increase in HIV, HBV, HCV and syphilis infections among blood donors in West Bengal, Eastern India 2004-2005: Exploratory screening reveals high frequency of occult HBV infection. World J Gastroenterol 2007;13:3730-3  Back to cited text no. 2
3.Makroo RN, Choudhury N, Jagannathan L, Parihar-Malhotra M, Raina V, Chaudhary RK, et al. Multicenter evaluation of individual donor nucleic acid testing (NAT) for simultaneous detection of human immunodeficiency virus -1 and hepatitis B and C viruses in Indian blood donors. Indian J Med Res 2008;127:140-7.  Back to cited text no. 3
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4.Panigrahi R, Biswas A, Datta S, Banerjee A, Chandra PK, Mahapatra PK, et al. Anti-hepatitis B core antigen testing with detection and characterization of occult results by an in-house nucleic acid testing among blood donors in Behrampur, Ganjam, Orissa in southeastern India: Implications for transfusion. Virol J 2010;7:204.  Back to cited text no. 4
5.Ragni MV, Sherman KE, Jordan JA. Viral pathogens. Haemophilia 2010;16 Suppl 5:40-6.  Back to cited text no. 5
6.Di Marco V, Capra M, Angelucci E, Borgna-Pignatti C, Telfer P, Harmatz P, et al. Management of chronic viral hepatitis in patients with thalassemia: recommendations from an international panel. Blood 2010;116:2875-83.  Back to cited text no. 6


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