Nucleic acid amplification-based diagnosis of respiratory virus infections

Abstract

The appearance of eight new respiratory viruses in the human population in the past 9 years, including two new pandemics (SARS coronavirus in 2003 and swine-origin influenza A/H1N1 in 2009), has tested the ability of virology laboratories to develop diagnostic tests to identify these viruses. Nucleic acid amplification tests (NATs) that first appeared two decades ago have been developed for both conventional and emerging viruses and now form the backbone of the clincical laboratory. NATs provide fast, accurate and sensitive detection of respiratory viruses and have significantly increased our understanding of the epidemiology of these viruses. Multiplex PCR assays have been introduced recently and several commercial tests are now available. The final chapter in the evolution of respiratory virus diagnostics will be the addition of allelic discrimination and detection of single nucleotide polymorphisms associated with antiviral resistance to multiplex assays. These resistance assays together with new viral load tests will enable clinical laboratories to provide physicians with important information for optimal treatment of patients.

Keywords::

• diagnosis
• nucleic acid amplification
• performance
• respiratory viruses

Acknowledgements

The secretarial assistance of Angela Bailey is greatly appreciated. The author apologizes to those authors whose work has not been cited due to space limitations.

Fianancial & competing interests disclosure

James B Mahony has received speaking honoraria and consulting fees from Luminex Molecular Diagnostics and Eragen Biosciences. He has been a scientific advisor for Luminex Molecular Diagnostics, Chemicon Corporation (now Millipore) and EraGen Biosciences. He received a research grant from TmBiosciences Corporation (now Luminex Molecular Diagnostics) to assist with the development of the xTAG™ RVP test and is co-holder of a patent on this product. The author has no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.