Performance of Version 2.0 of the Cobas AmpliPrep/Cobas TaqMan Real-Time PCR Assay for Hepatitis B Virus DNA Quantification

The detection and quantification of hepatitis B virus (HBV) DNA are essential for the diagnosis and treatment of chronic HBV infection. The use of real-time PCR assays for HBV DNA quantification is strongly recommended. The goal of this study was to evaluate the intrinsic characteristics and clinical performance of version 2.0 (v2.0) of the Cobas AmpliPrep/Cobas TaqMan (CAP/CTM) assay, a fully automated platform for HBV DNA quantification in serum or in plasma with a claimed lower limit of detection of 20 IU/ml and a claimed upper limit of quantification of 1.7 × 10⁸ IU/ml. The specificity of the assay was 99% (95% confidence interval, 94.7 to 100%). Intra-assay and interassay coefficients of variation ranged from 0.21% to 2.67% and from 0.65% to 2.25%, respectively. The calibration of the assay was found to be satisfactory. Study of blood specimens from patients infected with HBV genotypes A to F showed good correspondence between HBV DNA levels measured by the CAP/CTM v2.0 assay, version 1.0 of the same assay, and the third-generation “branched DNA” assay. The CAP/CTM v2.0 assay quantified HBV DNA levels in serum or plasma from the same patients equally. In conclusion, the new version of the CAP/CTM assay is sensitive, specific, and reproducible. It accurately quantifies HBV DNA levels in patients chronically infected with HBV genotypes A to F. Improvements made to ensure equal quantification of HBV DNA in serum and plasma have been successful. Overall, the CAP/CTM assay, version 2.0, is well suited to monitoring clinical HBV DNA levels according to current clinical practice guidelines.Chronic hepatitis B virus (HBV) infection is associated with a large spectrum of liver diseases, ranging from a low-viremia inactive carrier state to chronic active hepatitis, which may subsequently evolve toward cirrhosis and hepatocellular carcinoma (HCC). Morbidity and mortality are linked to the persistence of viral replication, and hepatic complications develop in 15% to 40% of patients chronically infected with HBV. Overall, HBV-related end-stage liver disease and HCC are responsible for more than 750,000 deaths worldwide per year (5).The detection and quantification of HBV DNA are essential for diagnosing ongoing HBV infection and establishing the prognosis of related liver disease, influence the decision to treat, and are indispensable for monitoring the virological response to antiviral therapy and the emergence of resistance in order to tailor therapy (4). A number of HBV DNA detection and quantification assays are available. For many years, such methods were based on either hybrid capture, signal amplification by means of branched DNA (bDNA) technology, or classical PCR, all of which suffered from poor analytical sensitivity and a narrow range of HBV DNA quantification (3). More recently, assays based on real-time PCR quantification have been developed. Their use for the routine detection and quantification of HBV DNA is recommended, because of their excellent analytical sensitivity (lower limit of detection, 10 to 20 IU/ml), their specificity, their accuracy, and their broad dynamic range of linear quantification, which fully covers clinical needs (9). Among these assays, we recently evaluated the first-generation (V1.0) Cobas AmpliPrep/Cobas TaqMan (CAP/CTM; Roche Molecular Systems, Pleasanton, CA) assay. This assay was found to be sensitive, specific, and reproducible and to accurately quantify HBV DNA levels in patients chronically infected by HBV genotypes A to F (2). However, this assay could be used only for the quantification of HBV DNA in plasma.A second version of the CAP/CTM assay (v2.0) has been released recently. Several changes have been made; in particular, the assay can be used on both serum and plasma, and it requires 650 μl of sample instead of 850 μl. Its claimed dynamic range of quantification is 20 IU/ml to 1.7 × 10⁸ IU/ml (1.3 to 8.2 log₁₀ IU/ml). The goal of this study was to evaluate the intrinsic characteristics and clinical performance of the CAP/CTM v2.0 assay.