The microarray technology: facts and controversies

Abstract

Molecular diagnostic techniques for viral testing have undergone rapid development in recent years. They are becoming more widely used than the classical virological assays in the majority of clinical virology laboratories, and now represent a new method for the diagnosis of human viral infections. Recently, new techniques based on multiplex RT-PCR amplification followed by microarray analysis have been developed and evaluated. On the basis of amplification of viral genome-specific fragments by multiplex RT-PCR and their subsequent detection via hybridization with microorganism-specific binding probes on solid surfaces, they allow simultaneous detection and identification of multiple viruses in a single clinical sample. The management of viral central nervous system and respiratory tract infections currently represents the two main applications of the microarrays in routine virological practice. Microarrays have shown reliable results in comparison with those of referenced (RT)-PCR assays, and appear to be of major interest for the detection of a broad range of respiratory and neurotropic viruses, assessment of the pathogenicity of newly discovered or neglected viruses, and identification of multiple viral infections in clinical samples. Despite several limitations observed during the different studies performed, this new technology might improve the clinical management of patients by enlarging the range of the viruses detected, in particular in cases of severe infections leading to patient hospitalization in the intensive-care unit. They might also help in the prevention of nosocomial transmission in hospital departments by contributing to the development of new epidemiological surveillance systems for viral infections.

Figure 1

Place of microarray technology in virology laboratories: (A) After rapid antigen tests (RATs) and monoplex (RT)‐PCR assays; (B) directly after RATs; (C) as first‐line tests for the detection of viral pathogens. ICU, intensive‐care unit.