{"id":1569,"date":"2017-10-30T09:49:18","date_gmt":"2017-10-30T09:49:18","guid":{"rendered":"https:\/\/www.mybiosource.com\/learn\/?page_id=1569"},"modified":"2023-03-02T09:51:29","modified_gmt":"2023-03-02T09:51:29","slug":"branched-dna-bdna-technology","status":"publish","type":"page","link":"https:\/\/www.mybiosource.com\/learn\/branched-dna-bdna-technology\/","title":{"rendered":"Branched DNA (bDNA) Technology"},"content":{"rendered":"<h3 style=\"text-align: left;\"><strong>Introduction<\/strong><\/h3>\n<p style=\"text-align: left;\">The branched DNA (bDNA) assay provides a unique and powerful tool for reliable <span id=\"urn:enhancement-e069488b-daaa-4923-bdb9-622c2c3e66bd\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/quantification\">quantification<\/span> of nucleic acid molecules. Fundamentally different from <span id=\"urn:enhancement-4dfaf4bf-77fe-4edf-8e42-27a772678182\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/target\">target<\/span> amplification methods such as <span id=\"urn:enhancement-155d28e0-068f-42c2-8ac3-858ddb360de7\" class=\"textannotation disambiguated wl-creative-work\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/pcr\">PCR<\/span>, the bDNA assay directly measures nucleic acid molecules at physiological levels by boosting the reporter signal, rather than replicating <span id=\"urn:enhancement-8309eda1-a5bc-4c95-b3ee-1cc64cb8e953\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/target\">target<\/span> sequences as the means of detection, and hence avoids the errors inherent in the extraction and amplification of <span id=\"urn:enhancement-cca52cea-4059-4425-b64f-e7cc1a23fec2\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/target\">target<\/span> sequences. The bDNA assay employs linear signal amplification using synthetic oligonucleotide probes and bDNA molecules, and can accurately and precisely measure between approximately 500 and 10,000,000 molecules. New advances in bDNA technology include the addition of preamplifier molecules and the incorporation of novel nucleotides, isoC and isoG, into oligonucleotide probe sequences to further enhance signal and reduce noise caused by nonspecific hybridization of bDNA assay components. These improvements have extended the quantitative <span id=\"urn:enhancement-c9f2f1c1-fc13-4117-b91e-42788136777a\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/detection-limit\">detection limit<\/span> of the bDNA assay to as low as 50 molecules.<\/p>\n<h3 style=\"text-align: left;\"><strong>History of bDNA technology<\/strong><\/h3>\n<p style=\"text-align: left;\">Well suited to routine use in a clinical or research setting, the bDNA assay has been applied successfully in a number of areas, including the prognosis and monitoring of patients with viral diseases. Providing a reliable means for direct <span id=\"urn:enhancement-79464042-5942-4966-aa45-dabc1b4c5191\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/quantification\">quantification<\/span> of viral load in clinical specimens, bDNA assays have been developed to measure <span id=\"urn:enhancement-d4ab2a45-a926-4f0b-959b-987410df43fb\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hepatitis-b\">hepatitis B<\/span> virus DNA, <span id=\"urn:enhancement-742f8266-260d-4f87-886a-dd122e565122\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hepatitis-c\">hepatitis C<\/span> virus RNA), human immunodeficiency virus type 1 RNA, and cytomegalovirus DNA. With the custom design of oligonucleotide probes, the potential applications of the bDNA assay reach far beyond viral nucleic acid <span id=\"urn:enhancement-64fe6b40-b3fc-428b-a061-a1ad29d56d21\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/quantification\">quantification<\/span>. By creating oligonucleotide probes for specific sequences of <span id=\"urn:enhancement-5f294afd-d45e-4615-9ead-b7cc58bb2e14\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/target\">target<\/span> nucleic acid molecules, the bDNA assay has been adapted to a wide variety of applications. For example, researchers have designed probes for the bDNA assay to measure cellular mRNA levels. This has proven to be a fruitful approach for a number of research applications, including monitoring changes in cytokine mRNA levels in healthy and immunocompromised patient populations, investigation of insulin <span id=\"urn:enhancement-5897ad87-a2b3-41b6-a8a8-300b1138207c\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/splicing\">splicing<\/span> patterns, and evaluation of stress <span id=\"urn:enhancement-6b0c3239-4625-4362-8c2d-7f20e211d1bc\" class=\"textannotation disambiguated wl-creative-work\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/gene\">gene<\/span> induction for molecular toxicology applications. Given its versatility, ease of use and high level of performance, the bDNA assay rapidly is becoming the method of choice for nucleic acid <span id=\"urn:enhancement-d4ad9743-5ca2-4b59-91a7-319e79917f77\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/quantification\">quantification<\/span><\/p>\n<h3 style=\"text-align: left;\"><strong>Outline<\/strong><\/h3>\n<p style=\"text-align: left;\">The bDNA assay uses a 96-well microplate format, and is based on a series of specific hybridization reactions and chemiluminescent detection of hybridized probes. Attached to the surface of each microwell are &#8220;capture&#8221; probes that contain a specific nucleotide sequence. These capture probes bind to a subset of &#8220;<span id=\"urn:enhancement-cb9121af-a857-4f12-9e5a-0d8bfb57b1dc\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/target\">target<\/span> probes&#8221; which are bound to specific nucleotide sequences in the <span id=\"urn:enhancement-88a21adc-4aad-423c-b6c6-780fea8c3a3e\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/target\">target<\/span> nucleic acid molecule. This series of hybridizations anchors the <span id=\"urn:enhancement-a79016de-8004-4e4f-80f9-3df469a94921\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/target\">target<\/span> nucleic acid molecule to the microwell surface. Detection of the <span id=\"urn:enhancement-f29e4cea-c2d0-4a69-acec-a5f9db3ccb00\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/target\">target<\/span> nucleic acid and amplification of the signal is accomplished through another series of hybridizations.<\/p>\n<p style=\"text-align: left;\">A second subset of <span id=\"urn:enhancement-92c67675-9109-426b-bead-b7ec8d5fa638\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/target\">target<\/span> probes links the <span id=\"urn:enhancement-68206574-f934-4f1c-a5ef-093376026956\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/target\">target<\/span> nucleic acid molecule to bDNA amplifier molecules. With the addition of preamplifier molecules to provide an additional layer of enhancement between the <span id=\"urn:enhancement-87116ffb-8c36-46da-8e63-6c38e821df03\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/target\">target<\/span> probes and the bDNA amplifier molecules, even greater signal amplification can be achieved. Each bDNA amplifier molecule has been designed to contain 15 arms, each of which contains three binding sites for alkaline phosphatase-conjugated &#8220;label probes&#8221;. A chemiluminescent signal is generated upon introduction of a dioxetane <span id=\"urn:enhancement-7bb740de-89a3-4ef8-a68b-1c3307e4ff6f\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/substrate\">substrate<\/span> which is activated by the alkaline phosphatase. This signal is easily quantified by counting the number of photons emitted in a luminometer. The bDNA assay is inherently quantitative since the number of photons emitted is directly related to the amount of <span id=\"urn:enhancement-84918357-5e00-495a-830e-045cba876a18\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/target\">target<\/span> nucleic acid in the specimen.<\/p>\n<h3 style=\"text-align: left;\"><strong>Materials<\/strong><\/h3>\n<p style=\"text-align: left;\">Equipment &#8211; Chiron plate heater equipped with 8&#215;12 microwell holder &#8211; Chiron plate-reading luminometer<\/p>\n<p style=\"text-align: left;\">Reagents for day 1<\/p>\n<ul style=\"text-align: left;\">\n<li>Oligonucleotide-modified microwells<\/li>\n<li>Lysis diluent<\/li>\n<li>Lysis reagent (proteinase K)<\/li>\n<li><span id=\"urn:enhancement-9e08325c-f64d-488a-b3cf-7dea90f2bcaf\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/target\">Target<\/span> probes for capture<\/li>\n<li><span id=\"urn:enhancement-8a51b165-c665-4b7c-98ce-ed3885b9a926\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/target\">Target<\/span> probes for label<\/li>\n<li>Specimens<\/li>\n<li>Standards and controls (optional)<\/li>\n<\/ul>\n<p style=\"text-align: left;\">Reagents for day 2<\/p>\n<ul style=\"text-align: left;\">\n<li>bDNA amplifier concentrate<\/li>\n<li>Label diluent<\/li>\n<li>Label probe concentrate<\/li>\n<li>Dioxetane <span id=\"urn:enhancement-715abb91-61f0-442b-a195-5d789bf21e54\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/substrate\">substrate<\/span> (LumiphosPlus)<\/li>\n<li>10% sodium dodecyl sulfate (SDS)<\/li>\n<li>Wash A (0.015 M NaCl, 0.0015 M sodium citrate, 0.1% SDS, 0.05% sodium azide, 0.05% Proclin 300<\/li>\n<li>Wash B (0.015 M NaCl, 0.0015 M sodium citrate, 0.05% sodium azide, 0.05% Proclin 300)<\/li>\n<\/ul>\n<h3 style=\"text-align: left;\"><strong>Procedure<\/strong><\/h3>\n<h4 style=\"text-align: left;\"><strong>Day 1<\/strong><\/h4>\n<ol style=\"text-align: left;\">\n<li>Prepare Specimen Working Reagent by combining:<\/li>\n<\/ol>\n<ul style=\"text-align: left;\">\n<li>6 mllysis diluent<\/li>\n<li>600 ml lysis reagent<\/li>\n<li>32 ml 500 fm\/ml <span id=\"urn:enhancement-74ed8ef3-05be-4174-ae62-f65315940608\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/target\">target<\/span> probes for capture (20 fm\/200 ml final)<\/li>\n<li>96 ml500 fm\/ml <span id=\"urn:enhancement-be76a183-c19f-4ded-9617-86c45facae6a\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/target\">target<\/span> probes for label (60 fm\/200 ml final)<\/li>\n<\/ul>\n<p style=\"text-align: left;\">Note: The actual concentrations of <span id=\"urn:enhancement-cd8a24b4-d3b5-457c-855d-3e6795b74f69\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/target\">target<\/span> probes will vary depending on the <span id=\"urn:enhancement-9ad491c8-4709-47c0-9933-b3e6bcc4ab7b\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/target\">target<\/span> nucleic acid molecule.<\/p>\n<ol style=\"text-align: left;\" start=\"2\">\n<li>For <span id=\"urn:enhancement-59f2642d-0e3d-4180-87a7-02558e2d0b7f\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/plasma\">plasma<\/span> or <span id=\"urn:enhancement-a32f0990-4238-408e-b1ae-949a5280d1b2\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/serum\">serum<\/span> specimens, pipette 150 ml Specimen Working Reagent and 50ml <span id=\"urn:enhancement-f7ab28fd-0328-42d4-8d78-2593d262636d\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/serum\">serum<\/span> or <span id=\"urn:enhancement-44c07ee3-6ca1-40f7-9163-6856aecd1de9\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/plasma\">plasma<\/span> into duplicate oligonucleotide-modified microwells. For cell or tissue specimens, prepare and extract RNA pellets in Specimen Working Reagent as described, and pipette 200 mlof each RNA extract into duplicate oligonucleotide-modified micro wells.<\/li>\n<li>If desired, positive and negative controls can be included for specificity purposes. Controls should be treated in the same manner as described for specimens in step 2 (above) and run in duplicate.<\/li>\n<li>If desired, standards can be included for absolute <span id=\"urn:enhancement-475cdab2-32e6-4f48-9deb-bcca135dafe6\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/quantification\">quantification<\/span>. Pipette 150 ml of Specimen Working Reagent and 50 ml of the appropriate standard curve member into duplicate oligonucleotide-modified microwells.<\/li>\n<li>Seal the microwells with Mylar film and incubate the microwells overnight at 53\u00b0C in the Chiron plate heater. (Note: Temperature will depend upon the defined optimal temperature for the specific assay.)<\/li>\n<\/ol>\n<h4 style=\"text-align: left;\"><strong>Day 2<\/strong><\/h4>\n<ol style=\"text-align: left;\">\n<li>Take the plate from the Chiron plate heater and let stand 10 min at room temperature. While the plate is cooling down, prepare the amplifier solution by diluting the amplifier concentrate at 200 fm\/ml in label diluent. The final concentration should be 10 fm\/50 ml.<\/li>\n<li>Wash the microwells twice with Wash A, then pipette 50 ml of diluted amplifier into each well. Incubate the microwells for 30 min at 53\u00b0C in the Chiron plate heater.<\/li>\n<li>Take the plate from the Chiron plate heater and let it stand 10 min at room temperature. While the plate is cooling down, prepare the Label Working Solution by diluting the label probe at 500 fm\/ml into label diluent. The final concentration should be 20 fm\/50 ml.<\/li>\n<li>Wash the microwells twice with Wash A, then pipette 50 ml of the Label Working Solution into each well. Incubate the microwells for 15 min at 53\u00b0C in the Chiron plate heater.<\/li>\n<li>Take the plate from the Chiron plate heater and let it stand 10 min at room temperature. During this time, prepare the <span id=\"urn:enhancement-5e2cd79b-4232-47f4-89a9-1e01529ee915\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/substrate\">Substrate<\/span> Solution made of 99.7% v\/v LumiphosPlus and 0.3% v\/v 10% SDS (for example: 3 ml LumiphosPlus, 9 ml 10% SDS).<\/li>\n<li>Wash the microwells twice with Wash A and then three times with Wash B. Add 50 ml of the <span id=\"urn:enhancement-ba0d7eab-2fed-41c2-a103-89554f788351\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/substrate\">Substrate<\/span> Solution into each well.<\/li>\n<li>Measure the chemiluminescence in the plate-reading luminometer. (This includes incubation of the microwells for 30 minutes at 37\u00b0C prior to measurement to reach steady-state kinetics).<\/li>\n<\/ol>\n<h3 style=\"text-align: left;\"><strong>Troubleshooting<\/strong><\/h3>\n<ul style=\"text-align: left;\">\n<li>Oligonucleotide-modified wells should be handled with care. Do not break apart well strips into segments. Seal the wells securely with a fresh plate sealer to prevent evaporation during incubations. When removing the plate sealer following incubations, use care not to pull the wells out of the microwell holder.<\/li>\n<li>All specimens, standards and controls should be assayed in duplicate for optimal <span id=\"urn:enhancement-8d90547f-89c8-4ad6-8501-bfbe88da487a\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/quantification\">quantification<\/span>. A void lipemic or turbid specimens as these may yield inconclusive results.<\/li>\n<li>For optimal results, all reagents should be brought to the temperature indicated in the assay procedure before use. Add reagent to the microwells by touching the pipet tip to the wall near the midpoint of the well, above the surface of the fluid in the well.<\/li>\n<\/ul>\n<h3 style=\"text-align: left;\"><strong>Application<\/strong><\/h3>\n<p style=\"text-align: left;\">Viral <span id=\"urn:enhancement-be32c702-ec9f-4621-8388-3310c85b492f\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/quantification\">quantification<\/span> or viral load testing has become part of the routine management of patients infected with <span id=\"urn:enhancement-b7560e01-b8dd-4994-b89a-769d54773114\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hiv\">HIV<\/span>-1 or <span id=\"urn:enhancement-ef13f6d0-6fe6-4477-b9ee-076fea47e2d8\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hepatitis-c\">hepatitis C<\/span> virus (<span id=\"urn:enhancement-3ea1101e-7d0a-48cc-90ef-e268a8a85fd0\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span>). There are currently several molecular technologies that are available for use in the clinical laboratory setting. Of these, only the branched DNA (bDNA) assays are FDA-approved for <span id=\"urn:enhancement-60155a68-bce1-49c8-9c50-57817f0ae404\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hiv\">HIV<\/span>-1 and <span id=\"urn:enhancement-f7b044ef-cb18-4d9a-baeb-57518fda9394\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> viral load testing. This signal amplification technology is built on a series of hybridization reactions that are highly amenable to full automation and thus lessen the amount of labor required to perform this type of analysis.<\/p>\n<p style=\"text-align: left;\">Molecular diagnostic assays using bDNA technology for detection of nucleic acid <span id=\"urn:enhancement-7ef7d83c-4b10-4d29-98c3-d1351c27dd38\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/target\">target<\/span> molecules are sensitive, specific, and reliable tools in the diagnosis of viral and <span id=\"urn:enhancement-5d33374d-30bc-43a2-b05f-308177fa7bb4\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/bacterial\">bacterial<\/span> infections and for monitoring disease progression during the course of therapy. bDNA tests have evolved from developmental stages in the research laboratory to US Food and Drug Administration\u2013approved quantitative assays with valuable clinical applications. The bDNA assays are less labor-intensive than many molecular-based procedures because they are highly amenable to total automation. Using bDNA, amplification of a <span id=\"urn:enhancement-0c12290a-283b-4ca0-8e02-4fe687f3e237\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/target\">target<\/span> sequence is not required, and, thus, cross-contamination between replicate samples due to excessive amplicons or carryover is less likely in bDNA assays. In addition, because bDNA is a signal amplification technology, the assay is able to quantify with less than a 0.5 log or 3-fold variability for its entire dynamic range.<\/p>\n<p style=\"text-align: left;\">bDNA technology has proved versatile because methods have been developed for the detection of infection by a wide range of microorganisms, including the parasite Trypanosoma<\/p>\n<p style=\"text-align: left;\">brucei, cytomegalovirus, antibiotic-sensitive and antibioticresistant Staphylococcus bacteria, human papillomavirus, and <span id=\"urn:enhancement-4e7dd1b0-8475-4358-ba53-8af2e0e1a08e\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hepatitis-b\">hepatitis B<\/span> virus. However, more recent efforts have focused on the development of bDNA assays for the <span id=\"urn:enhancement-2edfeb8e-f1c3-4015-83e6-d4dcc2358612\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/quantification\">quantification<\/span> of <span id=\"urn:enhancement-3bbe4f93-6295-42b7-b3e5-153408df2d82\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hiv\">HIV<\/span>-1 and <span id=\"urn:enhancement-10bb37ee-a07b-4f6f-9e53-4f08bf3b1024\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hepatitis-c\">hepatitis C<\/span> virus (<span id=\"urn:enhancement-d0480711-daa0-44c3-94f9-456120f6d778\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span>) RNA, leading to the routine application of bDNA methods in the clinical molecular diagnostics laboratory. In describing the advancement of bDNA methods, this review emphasizes bDNA assays for <span id=\"urn:enhancement-9aa7ca8c-033b-4f92-b630-f5e462dd6fd5\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hiv\">HIV<\/span>-1 and <span id=\"urn:enhancement-bf362a36-356b-44a8-bf13-785e09ad03f2\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span>.<\/p>\n<h3 style=\"text-align: left;\"><strong>First-Generation HIV-1 bDNA Assays<\/strong><\/h3>\n<p style=\"text-align: left;\">Accurate, reproducible first-generation bDNA assays were developed for the detection of <span id=\"urn:enhancement-c127633b-d586-4226-b938-67679b026618\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hiv\">HIV<\/span>-1 RNA and <span id=\"urn:enhancement-91a9e0f9-b995-4cf1-b67b-7a9394fe3af0\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> RNA in human <span id=\"urn:enhancement-7e40926b-8f67-40bc-baef-6e336630a63d\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/plasma\">plasma<\/span> (Quantiplex <span id=\"urn:enhancement-dbc8bb70-a20d-4543-bda4-5b9acb855e0d\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hiv\">HIV<\/span>-1 or <span id=\"urn:enhancement-ef618bec-bb2b-4a98-9210-eb951248cb7c\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> RNA 1.0 assay, Bayer, Tarrytown, NY).9-11 In one of the first reports of the Quantiplex bDNA assay, no reactivity using <span id=\"urn:enhancement-188f8917-4df9-4e21-b02c-7f19151666dd\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/plasma\">plasma<\/span> samples from seronegative donors was observed using the firstgeneration<\/p>\n<p style=\"text-align: left;\">bDNA assay, indicating excellent specificity.9 Positive results in the bDNA assay were observed in 83% of samples from 348 patients who were seropositive for <span id=\"urn:enhancement-a4670a90-7ae4-4405-93f3-2e2948a2a92a\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hiv\">HIV<\/span>-1.9 The dynamic range for <span id=\"urn:enhancement-22f2221a-b2c2-498b-9cd7-3c0146d56951\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/quantification\">quantification<\/span> using the Quantiplex <span id=\"urn:enhancement-f8a7eee0-0bae-4dd8-a470-12fbf8431efa\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hiv\">HIV<\/span>-1 RNA 1.0 assay extended from 104 (lower limit of detection) to more than 106 <span id=\"urn:enhancement-46b85ae6-8e9b-4e35-a2ab-256d74e35ebc\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hiv\">HIV<\/span> RNA copies\/mL.9,11 Changes in viral load of 2- to 3-fold were statistically significant using the bDNA test, indicating that the Quantiplex <span id=\"urn:enhancement-7ff17ddc-a4df-4de9-b6b5-ceb73ef6f514\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hiv\">HIV<\/span>-1 RNA 1.0 assay was highly accurate and reproducible.11 By comparison, changes in viral load of at least 3.7- to 5.8-fold were necessary before results were statistically significant using the earliest versions of the RT-<span id=\"urn:enhancement-1f0876b9-548f-45d7-af90-02112b9c9733\" class=\"textannotation disambiguated wl-creative-work\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/pcr\">PCR<\/span> assay.11 Thus, bDNA became the method of choice for most clinical trials evaluating viral load testing and the clinical efficacy of new <span id=\"urn:enhancement-01c2ea71-ce45-4bfc-9614-c78249e7e511\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hiv\">HIV<\/span>-1 <span id=\"urn:enhancement-a5b2e1da-2cb4-4c25-b0c6-7d6819864440\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/reverse-transcriptase\">reverse transcriptase<\/span> and protease inhibitors.<\/p>\n<p style=\"text-align: left;\">The sensitivity of the bDNA detection method was enhanced in the second-generation <span id=\"urn:enhancement-83d4c473-6087-440a-b3cf-d9e78e73f38f\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hiv\">HIV<\/span>-1 assay (Quantiplex <span id=\"urn:enhancement-588e6fdf-f598-4cef-8086-c96ea5f36556\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hiv\">HIV<\/span>-1 RNA 2.0 assay, Bayer) by changing the design of the <span id=\"urn:enhancement-740f607a-f8de-41b9-bd2a-166f172183f5\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/target\">target<\/span> and capture probes and by the addition of preamplifier oligonucleotides. The improved design of the <span id=\"urn:enhancement-ed9a0051-1d55-43aa-96d1-fb88e246bbfa\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/target\">target<\/span> and capture probes allowed an increase in the stringency of hybridization, thereby decreasing the assay background. Preamplifiers dramatically increase signal intensity because each preamplifier molecule has multiple regions for hybridization to many bDNA molecules. In addition, each bDNA molecule has multiple, repeat sequences for hybridization of AP-labeled probes. The signal output using the Quantiplex <span id=\"urn:enhancement-fd8150a2-0bf5-4695-a0b3-6059384fcf02\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hiv\">HIV<\/span>-1 RNA 2.0 assay showed linearity from approximately 500 copies\/mL to 1.6 \u00d7 106 copies\/mL (stated dynamic range was 500 to 8 \u00d7 105 copies\/mL). The sensitivity of the second-generation <span id=\"urn:enhancement-589b46e2-138d-4d46-b65f-7c5e7bcfe692\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hiv\">HIV<\/span>-1 bDNA assay was increased by 20-fold compared with the first-generation assay (lower limits of detection were 500 copies\/mL and 10 \u00d7 104 copies\/mL, respectively). In an extensive analysis of precision, initial test results and retest results in the Quantiplex <span id=\"urn:enhancement-07939bc2-2243-40ff-88df-ba53362dacc2\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hiv\">HIV<\/span>-1 RNA 2.0 assay were compared. The <span id=\"urn:enhancement-b62cbef4-d65a-4ce2-a9e4-39c1e41eec73\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hiv\">HIV<\/span>-1 RNA 2.0 assay was found to be highly reproducible.14 Of 174 samples with viral loads of more than 5,000 copies\/mL, 96% had differences of less than 0.3 log10 in copy number between initial results and retest results. Of 69 samples with viral loads between 500 and 5,000 copies\/mL, 86% had less than 0.3 log10 differences between initial and retest results. However, among 5,339 patients who were testedin routine clinical testing during a 1-year interval, viral loads of fewer than 500 copies\/mL were observed in 41.6% of samples.<\/p>\n<p style=\"text-align: left;\">Therefore, a bDNA assay with higher sensitivity (ie, lower limit of detection of &lt;500 copies\/mL) was needed for a substantial proportion of patients.<\/p>\n<p style=\"text-align: left;\">The performance characteristics of the Quantiplex <span id=\"urn:enhancement-d3f8450d-3c10-4407-8451-a02ef4e19706\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hiv\">HIV<\/span>-1 RNA 2.0 assay and an RT-<span id=\"urn:enhancement-a8e707a4-28f6-437b-87db-1281a96a77dd\" class=\"textannotation disambiguated wl-creative-work\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/pcr\">PCR<\/span> test (Amplicor <span id=\"urn:enhancement-dbd77116-09f4-4ebe-83c1-adb771e8f9fa\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hiv\">HIV<\/span>-1 Monitor 1.0 assay, Roche Diagnostics, Indianapolis, IN) were compared using dilutions of standard samples that had known <span id=\"urn:enhancement-b5f0a44d-1bb4-42c9-818a-bb82711e3ec2\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hiv\">HIV<\/span>-1 virus copy numbers. When dilutions of the same standards were tested in the 2 assays, <span id=\"urn:enhancement-7627ba3e-448f-4cc4-b2ac-bc7bb25dd6a1\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hiv\">HIV<\/span>-1 copy numbers generally were higher from the RT-<span id=\"urn:enhancement-a2360ae0-311e-4b53-9a56-f5ae0b6979db\" class=\"textannotation disambiguated wl-creative-work\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/pcr\">PCR<\/span> assay than from the bDNA assay. For example, the ranges of RNA copy numbers were 900 to 7.68 \u00d7 105 copies\/mL in the bDNA test and 3,360 to 1.88 \u00d7 106 copies\/mL in the RT-<span id=\"urn:enhancement-b6d15916-c39b-44af-b249-60fbb4e7e094\" class=\"textannotation disambiguated wl-creative-work\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/pcr\">PCR<\/span> assay. Both assays were linear for the stated dynamic ranges.<\/p>\n<p style=\"text-align: left;\">Comparison of the slopes of <span id=\"urn:enhancement-ecdad989-80ad-4073-b3cf-07ce37f8efcd\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hiv\">HIV<\/span>-1 copy number vs signal output regression lines suggested that the bDNA test had less proportional systematic error. Between-run variability, using a standard sample with 1,650 <span id=\"urn:enhancement-5e59079e-0aee-43ff-a311-68b0222a06d5\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hiv\">HIV<\/span>-1 copies\/mL, was lower in the bDNA test than in the RT-<span id=\"urn:enhancement-942de014-9276-4f11-b860-aafa5acb59f9\" class=\"textannotation disambiguated wl-creative-work\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/pcr\">PCR<\/span> assay; coefficients of variations for the bDNA and RT-<span id=\"urn:enhancement-8709536f-953b-4181-8150-beacb8b0e68d\" class=\"textannotation disambiguated wl-creative-work\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/pcr\">PCR<\/span> assays were 24.3% and 34.3%, respectively, indicating that the bDNA assay was slightly more precise at this <span id=\"urn:enhancement-c1a8d565-e60c-40e8-9ec6-7b93ca462c1c\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hiv\">HIV<\/span>-1 RNA copy number. Compared with using the 1,650-copies\/mL standard, the between-run coefficients of variation were higher for a sample containing 165 <span id=\"urn:enhancement-2078ee24-29d6-4b8a-9266-a3b644bc3019\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hiv\">HIV<\/span>-1 RNA copies\/mL (44.0% and 42.7% for the bDNA and RT-<span id=\"urn:enhancement-c524eb8a-e43c-428d-8711-58431f5b6fa4\" class=\"textannotation disambiguated wl-creative-work\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/pcr\">PCR<\/span> assays, respectively). Assay results were similar when equal <span id=\"urn:enhancement-4fab2093-27c5-4a34-89d1-e663e085066d\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hiv\">HIV<\/span>-1 copy numbers were compared across <span id=\"urn:enhancement-e07320dd-24b1-4b3f-9c26-b59bce3e92b6\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hiv\">HIV<\/span> subtypes A through F by using the bDNA test. However, by this version of RT-<span id=\"urn:enhancement-9dc58ff3-577e-41c2-b45b-89e388623893\" class=\"textannotation disambiguated wl-creative-work\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/pcr\">PCR<\/span>, subtypes A, E, and F were detected less efficiently than the B, C, and D subtypes. The differences between the second-generation bDNA test and the Amplicor Monitor RT-<span id=\"urn:enhancement-287ab1e6-5869-4195-a0c9-6b8b82ed97f6\" class=\"textannotation disambiguated wl-creative-work\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/pcr\">PCR<\/span> test for <span id=\"urn:enhancement-9e4a36b5-44ef-43a6-a09d-2c6bbe334613\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hiv\">HIV<\/span>-1 <span id=\"urn:enhancement-12506dbd-bb7b-4b71-8736-575fd87ca6ad\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/quantification\">quantification<\/span> indicated that consistency in testing method was required for each individual patient throughout diagnosis and treatment.<\/p>\n<p style=\"text-align: left;\"><strong><span id=\"urn:enhancement-f0b3dfe9-1061-45df-8819-985471b6784b\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> bDNA Assays<\/strong><\/p>\n<p style=\"text-align: left;\">While continuing to develop an improved third-generation <span id=\"urn:enhancement-9a4855fb-1aab-49ce-8e9b-4e66263d537d\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hiv\">HIV<\/span>-1 bDNA assay, Bayer recognized the need to develop an <span id=\"urn:enhancement-ed2102f8-c842-4e67-b2d4-bb0c32c8f610\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> viral load assay with an emerging clinical usefulness similar to that for <span id=\"urn:enhancement-30526900-aa64-450e-a7a5-c72c5ef6f9d5\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hiv\">HIV<\/span>-1 testing. For the detection of <span id=\"urn:enhancement-a21ab1c0-eccf-4201-98a2-58897b40d103\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span>, the first-generation bDNA assay (Quantiplex <span id=\"urn:enhancement-8e2e17ad-539a-4a9c-b43d-7e362d8a8e3f\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> RNA 1.0 assay, Bayer) had a dynamic <span id=\"urn:enhancement-6d43267a-514b-4deb-b215-e1a5344260a5\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/quantification\">quantification<\/span> range in human <span id=\"urn:enhancement-970ec325-22b0-4fe8-9a05-e8f269bc83be\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/plasma\">plasma<\/span> from 3.5 \u00d7 105 to 1.2 \u00d7 108 <span id=\"urn:enhancement-7b2f361b-6377-4e2b-9898-e29dca63767b\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> RNA copies\/mL. Genotypes 1 through 6 were detected by using this assay, although the sensitivity was lower for genotypes 2 and 3 (67% detection rate: positive signal for 60 of 89 <span id=\"urn:enhancement-cd48c0ee-b48c-4f12-b353-6e34e54b0225\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/serum\">serum<\/span> samples known to contain <span id=\"urn:enhancement-f158707d-a825-448a-8acb-e60430c24eaf\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> genotypes 2 or 3) compared with genotype 1 (97% detection rate: positive signal for 67 of 69 <span id=\"urn:enhancement-5684209b-1152-4e80-8305-cf0136a00017\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/serum\">serum<\/span> samples known to contain the <span id=\"urn:enhancement-42392e05-b155-4ef4-af61-9a25d8a53847\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> genotype 1). A comparison of the Quantiplex <span id=\"urn:enhancement-8476438b-4cd2-4b1d-89ac-637d5d7d2e2b\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> RNA 1.0 assay and a research laboratory\u2013developed RT-<span id=\"urn:enhancement-a41095a6-b239-4370-8ccc-d0ea69389159\" class=\"textannotation disambiguated wl-creative-work\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/pcr\">PCR<\/span> test for <span id=\"urn:enhancement-0756da77-98a0-428b-9492-e187529bd1db\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> showed greater sensitivity in the RT-<span id=\"urn:enhancement-6551e572-b3cd-4710-9e50-ce104922e34f\" class=\"textannotation disambiguated wl-creative-work\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/pcr\">PCR<\/span> test, which had a lower limit detection of 2.5 \u00d7 104 <span id=\"urn:enhancement-ff749ff0-43f3-459b-8d51-149c905ebcf4\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> RNA copies\/mL. However, the <span id=\"urn:enhancement-7abf890e-d301-4b8a-88c0-d930e862830c\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> bDNA test had greater reproducibility and was less time-consuming than the laboratory-developed <span id=\"urn:enhancement-89764204-96e8-42b6-9ad7-1093712cc7c3\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> RT-<span id=\"urn:enhancement-61203563-32fb-4172-a4b7-b8e9e8a43a9a\" class=\"textannotation disambiguated wl-creative-work\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/pcr\">PCR<\/span> test.<\/p>\n<p style=\"text-align: left;\">To improve the detection rate for <span id=\"urn:enhancement-9aa32cf2-54cd-475f-9fec-5db3df7c6086\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> genotypes 2 and 3, a second-generation assay was developed (Quantiplex <span id=\"urn:enhancement-ec227105-6e40-48d2-a5e9-120423723a57\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> RNA 2.0 assay, Bayer).15 The major design change in the second- generation <span id=\"urn:enhancement-2c63bdfa-6760-4851-9ae5-be92e34f4ef8\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> RNA assay was to use probes to sequences in the <span id=\"urn:enhancement-fcdb2863-0bc0-4ffc-9a91-ba7a5dd53e67\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> genome that were more highly conserved across genotypes. These conserved regions were 5&#8242; untranslated sequences and sequences in the core <span id=\"urn:enhancement-3eb40fd0-fb7f-4fe8-bb35-1fb129491c88\" class=\"textannotation disambiguated wl-creative-work\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/gene\">gene<\/span> of the <span id=\"urn:enhancement-82a025da-a069-4bd9-a54f-6c74fd8abc1a\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> genome. The result of changes to the <span id=\"urn:enhancement-599f0fac-7f9c-41ae-85d3-1845f235e88a\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/target\">target<\/span> and capture probes was to dramatically reduce the variation in detection rate among <span id=\"urn:enhancement-5e2d36ea-27cf-4d17-ae24-199b66b69f4c\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> genotypes in the second-generation assay. Each of the 6 <span id=\"urn:enhancement-b8d2ea32-daf7-4be1-b2b3-beed909c8acb\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> genotypes had a high detection rate, and there was marked improvement in the detection of <span id=\"urn:enhancement-d899a735-297b-4a7d-bd7e-564d819fefad\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> genotypes 2 and 3 (detection of 93% vs 67% of samples known to contain <span id=\"urn:enhancement-3bbe057f-ae4d-4033-939a-b19f728c349d\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> genotypes 2 or 3 in the <span id=\"urn:enhancement-4566ebb7-e2fc-4ac8-9af9-9bdc81c3ae06\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> 2.0 and <span id=\"urn:enhancement-49b8bfc0-b2a4-4393-8f35-f8bfdbccb0f0\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> 1.0 assays, respectively). Also, the sensitivity of the second-generation bDNA assay was slightly enhanced compared with the <span id=\"urn:enhancement-cdc0a53e-a349-44f3-be52-dda11c744f1b\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> 1.0 assay (lower limits of <span id=\"urn:enhancement-827571ad-5d05-47cb-b410-4d53e081bce1\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/quantification\">quantification<\/span> were 2.0 \u00d7 105 [HCV 2.0] versus 3.5 \u00d7 105 [HCV 1.0]).<\/p>\n<h3 style=\"text-align: left;\"><strong>Third-Generation bDNA Assays for HIV-1 and HCV<\/strong><\/h3>\n<p style=\"text-align: left;\">In the first- and second-generation bDNA assays, nonspecific hybridization of oligonucleotide probes to nontarget sequences limited assay sensitivity. The critical technological improvement in the third-generation bDNA assay (Quantiplex [also referred to as VERSANT] <span id=\"urn:enhancement-cae5d872-86fe-4618-9083-8873705fb3e7\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hiv\">HIV<\/span>-1 RNA 3.0 assay, Bayer) was to use nonnatural bases, 5&#8242;-methyl-2&#8242;- deoxyisoguanosine (isoG) and 5&#8242;-methyl-2&#8242;-isodeoxycytidine (isoC), in the synthesis of all probes in the bDNA system, with the exception of capture extenders that mediate capture of the <span id=\"urn:enhancement-42a6ed4f-9a9b-4714-a6b8-a9635b6ba96b\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/target\">target<\/span> viral nucleic acid to the plate surface. Because oligonucleotides containing isoG and isoC are not present in nature, nonspecific hybridization is reduced significantly. Thus, probes modified with the nonnatural bases do not form stable hybrids with the capture probe in the absence of <span id=\"urn:enhancement-2f6417e1-e260-42d1-a272-2339669bbf2e\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/target\">target<\/span> RNA. In the initial description of the thirdgeneration assay, the limit of detection of <span id=\"urn:enhancement-43022bb9-e8b3-4c8a-b219-d3beae7a192f\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hiv\">HIV<\/span>-1 in <span id=\"urn:enhancement-99207fb9-7d19-4f7d-a7cf-0beac6598a8e\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/plasma\">plasma<\/span> samples from 11 patients was 50 copies per mL.This represents a 10-fold improvement in the limit of detection compared with the second-generation assay. During treatment with highly active antiretroviral therapy, <span id=\"urn:enhancement-a36c1785-cd5a-44e3-9882-d6bd679c3be0\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hiv\">HIV<\/span>-1 viral load decreased to below the limit of detection for all 11 patients.<\/p>\n<p style=\"text-align: left;\">The VERSANT <span id=\"urn:enhancement-50ed9710-1bbb-4558-875f-48a689215514\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hiv\">HIV<\/span>-1 RNA 3.0 assay has a dynamic range of 75 to 5 \u00d7 105 <span id=\"urn:enhancement-84a83614-d5d8-4a79-92fa-ff4d5da126df\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hiv\">HIV<\/span> RNA copies\/mL. Version 3.0 also has been approved to a lower limit of detection equal to 50 copies\/mL in several other countries. When matched samples were compared in the secondgeneration <span id=\"urn:enhancement-565f3aaa-bc71-4d3f-8c50-2dbdabf8ce49\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hiv\">HIV<\/span>-1 bDNA assay (Quantiplex version 2.0) and the Amplicor Monitor 1.0 RT-<span id=\"urn:enhancement-1a5d5149-4f8f-4773-b582-14254985ae3c\" class=\"textannotation disambiguated wl-creative-work\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/pcr\">PCR<\/span> assay, consistently lower <span id=\"urn:enhancement-ff67f6eb-a9e3-4b96-b47e-2bab4d35d69f\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hiv\">HIV<\/span>-1 copy numbers were obtained using the bDNA test. However, a close quantitative correlation in <span id=\"urn:enhancement-a7355b89-f4ed-4f6b-9f46-35f1beccac98\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hiv\">HIV<\/span>-1 RNA copy numbers was observed between the third-generation (version 3.0) assay and the Amplicor Monitor 1.5 RT-<span id=\"urn:enhancement-9c29a25f-a55b-463c-b081-8e54f2c46f3d\" class=\"textannotation disambiguated wl-creative-work\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/pcr\">PCR<\/span> test.18 Viral load results in the version 3.0 bDNA assay and in the Amplicor RT-<span id=\"urn:enhancement-1aaa8708-9097-4bf0-9d1d-d796cc5eadba\" class=\"textannotation disambiguated wl-creative-work\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/pcr\">PCR<\/span> assay were approximately 2-fold higher than in the version 2.0 assay. Quantitatively similar results in the version 3.0 bDNA test and the RT-<span id=\"urn:enhancement-859667ee-0e5c-4120-90cc-550bb0cfd0a1\" class=\"textannotation disambiguated wl-creative-work\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/pcr\">PCR<\/span> test are important in patient care because of the likely possibility that different methods will be used in testing samples from the same patient for the course of anti-<span id=\"urn:enhancement-8c1eef1b-5ad3-4b4a-a29b-3f985e0b9d13\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hiv\">HIV<\/span> therapies. Recent data suggest that rebaselining for patients tested with an RT-<span id=\"urn:enhancement-2ab01bea-a185-4d8e-95b9-2d232472c55a\" class=\"textannotation disambiguated wl-creative-work\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/pcr\">PCR<\/span> assay may not be necessary.<\/p>\n<p style=\"text-align: left;\">Similar to the <span id=\"urn:enhancement-6e0dac1a-faa5-4d73-8bc9-c67a0f3c1811\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hiv\">HIV<\/span>-1 version 3.0 bDNA assay, the thirdgeneration bDNA assay for <span id=\"urn:enhancement-4f7ad10f-98e3-4cc2-8520-b323c5d701ec\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> also used isoC- and isoG-substituted oligonucleotides to reduce nonspecific hybridization. The use of isoC- and isoG-substituted oligonucleotides increased assay sensitivity approximately 62-fold. The <span id=\"urn:enhancement-2a79d6ee-87d2-4913-bf82-c746de109d25\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> RNA 3.0 assay lower limit of detection was 3.2 \u00d7 103 copies\/mL compared with 2 \u00d7 105 copies\/mL in the <span id=\"urn:enhancement-097f02ba-6bff-487b-b2b5-0b1beb556be8\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> RNA 2.0 assay. The dynamic linear <span id=\"urn:enhancement-8fdd1bf8-4d9c-45f3-a18f-a054021a6080\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/quantification\">quantification<\/span> range of the <span id=\"urn:enhancement-a632ba84-39aa-4705-86ae-31943ce1d38b\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> RNA 3.0 assay extended from 3.2 \u00d7 103 copies\/mL (615 IU\/mL) to 4 \u00d7 107 <span id=\"urn:enhancement-7faf576f-d63b-4376-9120-0be5ca65ed21\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> RNA copies\/mL (7.7 \u00d7 106 IU\/mL). The <span id=\"urn:enhancement-7b77a142-43a1-48be-86a8-d4f0bcbd142e\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> RNA 3.0 assay had a high specificity (98.2%) and, similar to the second-generation assay, was equally effective in the <span id=\"urn:enhancement-9d7ad42e-6e34-4b8d-8641-58c0138ba719\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/quantification\">quantification<\/span> of <span id=\"urn:enhancement-e1465221-ef15-4839-b08f-0bb91fb14f98\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> RNA across all genotypes. Between-run and within-run standard deviations for replicate samples were 0.2 log10 and 0.14 log10, respectively, indicating that the third-generation assay was highly reproducible.<\/p>\n<p style=\"text-align: left;\">In addition to the eradication of <span id=\"urn:enhancement-a39a7782-b4b8-4000-a932-653b566a6587\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> in <span id=\"urn:enhancement-a614e4d8-f833-4f68-973d-0b7727ebae51\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/serum\">serum<\/span>, an important goal of anti-<span id=\"urn:enhancement-251b9ced-7f8c-47c9-b835-1af20659969e\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> therapies is to reduce <span id=\"urn:enhancement-d47f64cf-7f0b-4e85-bb98-e4713afe4708\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> levels in the liver. The usefulness of the <span id=\"urn:enhancement-2f5daf21-f003-401a-a2ef-7e74a292eaf4\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> RNA 3.0 assay for the detection and <span id=\"urn:enhancement-a86803ae-c94e-4637-8a8f-58d72ee25381\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/quantification\">quantification<\/span> of <span id=\"urn:enhancement-76d027ee-040b-4d09-ab18-bdd58bd70ff6\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> RNA in liver biopsy specimens was studied in 25 patients coinfected with <span id=\"urn:enhancement-b488be7d-433e-4705-bed9-3477f6cfee80\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> and HIV.20 The reproducibility of the third-generation <span id=\"urn:enhancement-18923282-9dca-4ef8-af0d-1842e57035d2\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> bDNA assay was similar between liver biopsy specimens and <span id=\"urn:enhancement-4f5e7be0-0192-48d5-a390-3630451f6d1a\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/serum\">serum<\/span> samples. Also, detection of <span id=\"urn:enhancement-ba2f54c2-8945-4a0a-b191-57b4b74a92d7\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> RNA in liver specimens from patients infected with genotypes 1, 3, and 4 by the <span id=\"urn:enhancement-55a9dd0c-c493-4ccc-8275-7f1c8858ded5\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> RNA 3.0 assay was highly specific and sensitive. In this study of 25 patients, high pretreatment levels of intrahepatic<\/p>\n<p style=\"text-align: left;\"><span id=\"urn:enhancement-010d92a0-6c18-4f4c-83f8-a919ba2dc44b\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> correlated with a low frequency of response to anti- <span id=\"urn:enhancement-2a118cc0-cc65-4ef3-aef5-05c57efd180b\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> therapy. Pretreatment intrahepatic <span id=\"urn:enhancement-4a16a807-a897-4de6-bb31-1a46c5538d3a\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> levels were highest in patients infected with <span id=\"urn:enhancement-ce3267cf-35b8-47b8-bc4d-1633a47b7fce\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> genotype 1. Results of this study demonstrated that important markers of <span id=\"urn:enhancement-833682c7-271d-4028-a34b-1a1dc3e77bb6\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> disease progression, <span id=\"urn:enhancement-7e9725f5-dc8f-4233-bedb-7cfa0092d1de\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> levels in liver and in <span id=\"urn:enhancement-74ac186e-eec9-4317-a0d9-44e87cba4314\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/serum\">serum<\/span>, can be quantitated reliably by bDNA analysis during treatment. The methods for third-generation bDNA assays include sample preparation, hybridization, and signal detection forHIV-1 RNA and <span id=\"urn:enhancement-22d3af5f-c3a5-4b89-8c53-744ad3da590d\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> RNA. All 3 s eps are performed in the microwells on the System 340 platform for the <span id=\"urn:enhancement-5db3025a-3585-4f62-8934-1afd724ff250\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> RNA 3.0 assay that does not require a separate extraction step. In the version 3.0 <span id=\"urn:enhancement-c322c79a-e046-4af0-92ec-9c3e5dc38374\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hiv\">HIV<\/span>-1 RNA assay, sample preparation is different from the <span id=\"urn:enhancement-30f034ea-451e-4080-a718-564032906258\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> RNA method and is performed outside the System 340 platform. A recent study evaluated an adaptation of the version 3.0 <span id=\"urn:enhancement-57c1d0a4-1405-4613-8006-46b65aad4086\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hiv\">HIV<\/span>-1 RNA method in which the <span id=\"urn:enhancement-64c9dd9a-3116-4dce-9cfe-a927750b3551\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hiv\">HIV<\/span>&#8211; 1 sample processing step was modified to accommodate simultaneous testing for <span id=\"urn:enhancement-362eafe1-2461-494e-8d1e-21ed3f23f062\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> and <span id=\"urn:enhancement-2e151927-3cd7-4e9d-8971-d397cbdde940\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hiv\">HIV<\/span>-1 on the System 340 platform. The <span id=\"urn:enhancement-27106eb4-d3eb-4688-9079-c5957daf96b3\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hiv\">HIV<\/span>-1 method was modified by omitting the 2-hour incubation at 63\u00b0C for viral lysis. Instead, <span id=\"urn:enhancement-66886249-75d5-4fb7-84ba-8cf2fad03b1f\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hiv\">HIV<\/span>-1 and <span id=\"urn:enhancement-228c5f62-ca28-4c75-bf50-314f1365b236\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> lysis was performed on the System 340 platform. The <span id=\"urn:enhancement-6c093b26-c518-45ea-a0a7-f79a4d68c739\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> bDNA test methods were unchanged in the combined assay. The specificity and <span id=\"urn:enhancement-ea633ad7-22a8-4b33-8bc8-a95e708e95ec\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/quantification\">quantification<\/span> by the combined bDNA method were within specifications for the individual <span id=\"urn:enhancement-0406883d-0b38-473c-89f7-1add38bfcaeb\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hiv\">HIV<\/span>-1 and <span id=\"urn:enhancement-29d921c2-60b2-487d-8cd9-fd1bce9bc8a1\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> assays. Simultaneous testing for <span id=\"urn:enhancement-a1107992-de24-4784-b829-2f33ca682bff\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hiv\">HIV<\/span>-1 and for <span id=\"urn:enhancement-e52894e8-02a8-4a54-87d1-58db43dfd57d\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> improved workflow in the clinical laboratory and resulted in lower costs. Because <span id=\"urn:enhancement-006ecf69-b2ef-4f7a-948c-b5753a539b02\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hiv\">HIV<\/span>-1 RNA and <span id=\"urn:enhancement-1bc39d1e-f0f1-4198-842c-f9a592a9876e\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/hcv\">HCV<\/span> RNA detection and <span id=\"urn:enhancement-a00a07fa-e152-412e-a4ed-77c67df2000d\" class=\"textannotation disambiguated wl-thing\" itemid=\"https:\/\/data.wordlift.io\/wl1503301\/entity\/quantification\">quantification<\/span> are crucial for diagnosis and for the evaluation of responses to therapy, the ability to carry out simultaneous testing for both viruses represents a significant advance in molecular diagnostics.<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Introduction The branched DNA (bDNA) assay provides a unique and powerful tool for reliable quantification of nucleic acid molecules. Fundamentally different from target amplification methods such as PCR, the bDNA assay directly measures nucleic acid molecules at physiological levels by boosting the reporter signal, rather than replicating target sequences as the means of detection, and [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":401,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"class_list":["post-1569","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.mybiosource.com\/learn\/wp-json\/wp\/v2\/pages\/1569","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.mybiosource.com\/learn\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.mybiosource.com\/learn\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.mybiosource.com\/learn\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.mybiosource.com\/learn\/wp-json\/wp\/v2\/comments?post=1569"}],"version-history":[{"count":0,"href":"https:\/\/www.mybiosource.com\/learn\/wp-json\/wp\/v2\/pages\/1569\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/www.mybiosource.com\/learn\/wp-json\/wp\/v2\/pages\/401"}],"wp:attachment":[{"href":"https:\/\/www.mybiosource.com\/learn\/wp-json\/wp\/v2\/media?parent=1569"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}