Evaluation of the Aptima HBV Quant Assay Compared to Abbott RealTime M2000 HBV Quant Assay and Procleix Ultrio Plus dHBV Assay in Plasma Samples

Abstract

Analytical performance of hepatitis B virus (HBV) DNA quantitative assay is critical for screening infection and initiating and monitoring antiviral treatment. In this study, the limit of detection (LoD) and linearity of Aptima HBV Quant assay were evaluated, and analytical performance was compared with that of the Abbott RealTime M2000 HBV Quant assay and the Procleix Ultrio Plus dHBV assay in plasma samples. The LoDs for genotypes B, C, and D plasma samples were 2.139 (1.531, 4.520), 3.120 (2.140, 7.373), and 3.330 (2.589, 4.907) IU/mL, respectively. The R² value fitted by linear regression of serially diluted samples less than 2,000 IU/mL was above 0.9. There was no difference in positive rate between Aptima and Abbott or between Aptima and Procleix. Quantitative results of Aptima and Abbott showed good correlation with an r of >0.9 using Spearman analysis, while the quantitative results of Aptima were slightly lower than those of Abbott. Usual mutations in the HBV S region had no impact on Aptima assay. This study showed that Aptima is a dual-targeted transcription-mediated amplification (TMA) assay suitable for HBV DNA detection in clinical practice, with quantitative performance comparable to that of the Abbott RealTime M2000 HBV Quant assay and qualitative performance comparable to that of the Procleix Ultrio Plus dHBV assay. IMPORTANCE The Aptima HBV Quant assay (Hologic Inc., San Diego, CA, USA) is a dual-target real-time transcription-mediated amplification (RT-TMA) assay. This study aims to evaluate whether this assay is suitable for HBV DNA detection. As a result, the assay showed high sensitivity with LoDs below 3.5 IU/mL. The amplification efficiency of Aptima for samples below 2,000 IU/mL is adequate for clinical practice, with an R² of >0.9 fitted by linear regression. Usual mutations in the HBV S region did not affect the performance of Aptima. Moreover, its performance was comparable to the widely used Abbott RealTime M2000 HBV Quant assay for detecting HBV DNA in plasma specimens. Although not indicated for use as a diagnostic or blood screening assay, the Aptima HBV Quant assay demonstrated comparable qualitative performance to the Procleix Ultrio Plus dHBV system.

Keywords: Abbott RealTime M2000 HBV Quant assay; Aptima HBV Quant assay; HBV DNA; Procleix Ultrio Plus dHBV assay; dual-target; limit of detection; mutation; real-time TMA.

FIG 1

Linearity of Aptima quantitation of genotype B (A), C (B), and D (C) plasma samples.

FIG 2

Flow chart of comparing Aptima HBV Quant assay with Abbott RealTime M2000 assay and Procleix Ultrio Plus dHBV assay using plasma samples.

FIG 3

Comparison of quantitative results between Aptima and Abbott assays. Spearman analysis was used to estimate the correlation of all of the samples (A), those below 2,000 IU/mL (B), and those above 2,000 IU/mL (C). Differences were analyzed by Bland-Altman plot (D to F).

FIG 4

Comparison of quantitative results of mutation panel between Aptima and Abbott assays. Spearman analysis was used for estimation of the correlation of all of the samples (A), genotype B samples (B), and genotype C samples (C). Differences were analyzed by Bland-Altman plot (D to F).

FIG 5

Relative light unit of Procleix Ultrio Plus dHBV assay between three groups divided by the results of Aptima HBV Quant assay.