HEPATITIS C VIRAL RNA QUANTITATIVE FLUORESCENCE DIAGNOSTIC KIT (PCR-FLUORESCENCE PROBING)

Transcription

1 Amplification reaction Solution RNA Extraction HEPATITIS C VIRAL RNA QUANTITATIVE FLUORESCENCE DIAGNOSTIC KIT (PCR-FLUORESCENCE PROBING) Read the pack Insert before use provided along with the kit REF- Hcdqf-24 For Professional Use INTENDED USE This diagnostic kit is an in vitro nucleic acid amplification test for the quantification of Human Hepatitis C Virus (HCV) RNA in human serum or plasma. It is intended for use as an aid in diagnosing an HCV infection and observing drug efficacy. IVD TEST PRINCIPLE The diagnostic kit uses magnetic bead technology to extract HCV-RNA in clinical serum or plasma by applying real-time fluorescence quantitative PCR technology, this test utilizes a pair of specific primers which are designed to target at a conserved sequence of HCV-RNA, a specific fluorescence probe, accompanied with PCR mix to achieve quantitative detection of HCV RNA through fluorescent signal changes. The PCR detection system uses an internal positive control to monitor the presence of PC inhibitors in test specimens by detecting whether the internal control is normal or not, in order to avoid a false negative result. The PCR detection system uses ROX reference dye to eliminate variations existing among different tubes and facilitate the instrument's automatic analysis of the ratio between reported fluorescence and the reference fluorescence (ROX), achieving more accurate quantification. PACK SIZE: 24Tests/Kit COMPONENTS OF THE DIAGNOSTIC KIT Sl.No. Reagent name Specification & quantity 1 RNA Extraction Solution-1 15 ml/bottle 1 Bottle 2 RNA Extraction Solution ml/tube 1 Tube 3 RNA Extraction Solution-3 15ml/Bottle 1 Bottle 4 RNA Extraction Solution-4 5ml/Bottle 1 Bottle 5 HCV Internal Control 10μl / Tube 1 Tube 6 HCV PCR Mix 1.2ml / Tube 1 Tube 7 RT PCR Enhancer 25μl /Tube 1Tube 8 HCV Quantitative Reference-A 0.5 ml/tube 1 Tube 9 HCV Quantitative Reference-B 0.5ml / Tube 1 Tube 10 HCV Quantitative Reference-C 0.5ml / Tube 1 Tube 11 HCV Quantitative Reference-D 0.5ml / Tube 1 Tube 12 HCV Negative Control 0.5ml / Tube 1 Tube 13 HCV- Strong Positive control 0.5 ml/tube 1 Tube Page 1 of 6

2 NOTE: (1) All biological specimens in the detection kit should be handled as if infectious though they have been inactivated. (2) For the specific concentration of HCV quantitative reference A-D, please refer to the internal surface of the package box of the diagnostic kit. (3) Self-prepared equipment and consumables: 1.5 ml centrifuge tubes (make sure they do not contain DNase or RNase); 0.2 ml PCR reaction tubes; tabletop centrifuge; tabletop vortex mixer; magnetic bead separator; specific pipettes and tips (10µl, 200µl, 1000µl), tips with filter are recommended. Warning: Do NOT mix materials from different lots. STORAGE CONDITION AND TERM OF VALIDITY The diagnostic kit should be stored in a sealed pouch at C for extraction reagents and -20± 5 0 C for reaction reagent, and protected from light. Term of validity for each kit is 12 months. Care should be taken to avoid re-freezing and re-thawing. APPLICABLE INSTRUMENT The product applies to fluorescence PCR instruments such as ABI series (ABI7300, ABI7500), Stratagene series (Mx3000P, Mx3005P), Roche Light Cycler 480, etc. SPECIMEN REQUIREMENTS 1. Applicable specimen type: Serum or Plasma. 2. Collection of specimen: 2.1 Collection of serum: Use sterile syringe to draw 2 ml venous blood from testee and inject it into an aseptic tube, hold it at room temperature for less than 4 hours or centrifuge it at 1600 rpm for 5 min. to separate serum from the rest of blood, and then transfer the serum to a 1.5 ml sterile tube for later use. 2.2 Collection of plasma: Use sterile syringe to draw 2 ml venous blood from testee and inject it into an aseptic tube with EDTA or citric acid salt, mix them thoroughly by gentle inversion. Hold it at room temperature for less than 4 hours or centrifuge it at 1600 rpm for 5 min. to separate plasma from the rest of blood, and then transfer the plasma to a 1.5 ml sterile tube for later use. 3. Storage and transport of specimens: Specimens collected via the above mentioned method can be used for immediate detection, or stored at -20±5 0 C for 3 months or stored below C for a longer term. Care should be taken to avoid refreezing and re-thawing. Specimens should be transported in a sealed frozen pitcher with ice or in a sealed foam box with ice. TEST METHOD 1. Preparation of reagent (performed at "reagent preparation region", note: if PC instrument has no HEX or VIC channel, DO NOT add internal control at step 1.2) 1.1 Take out each component from the detection kit and place them at room temperature. When the components reach room temperature, mix them for later use. 1.2 Refer to quantities of test specimens, Negative controls, Positive controls and quantitative references, pipette appropriate quantities of RNA extraction Solution-1 and internal control (RNA extraction Solution-1 600µl/test+ HCV internal control 0.4µl/test), fully mix them into RNA extraction Solution-1 mix, centrifuge it instantaneously for later use. 1.3 Transfer the above-prepared reagents to the "specimen processing region" for later use. Page 2 of 6

3 2. Processing of specimens (performed at "specimen processing region") (Negative control, Positive control, Quantitative references and specimens are processed in synchronization) 2.1 According to the number of samples to be tested, prepare the same number of 1.5 ml centrifuge tubes that are siliconized, plus six more for negative control, positive control, quantitative references A to D. Place the tubes in centrifuge tube rack and add 600µl RNA extraction Solution-1 to each tube. Cover the tubes. Mark samples, Negative controls, Positive controls and Quantitative references A-D. 2.2 Add 200µl samples, Negative controls, Positive controls, and Quantitative references A-D to the above marked tubes. Cover the tubes. 2.3 Add 100µl RNA extraction solution 2 to each tube. Replace the tip after each adding unless it's sure that the tip doesn't touch centrifuge tubes. Cover the tubes. Vortex them for 10 seconds to mix them thoroughly, hold them at room temperature for 30 min, then centrifuge them instantaneously until the residual liquid is centrifuged to the bottom of the tube and magnetic beads are not totally centrifuged to the bottom of the tube. 2.4 Place the tubes on the magnetic bead separator for 3 min, aspirate the solution out gently (Be aware not to touch the brown matters bound to the tube wall). 2.5 Add 600µl RNA extraction Solution-3 and 200µl RNA extraction Solution-4 into each tube. Vortex them for 5 seconds, centrifuge them instantaneously, and place them on the magnetic bead separator. 2.6 After 3 min., the solution separates into two layers, aspirate the solution out by putting the tip into the bottom of the tube. Wait for 1 min, and then aspirate all the residual out and discard it. 2.7 Refer to quantities of test specimens, negative controls, positive controls and quantitative references A-D, pipette appropriate quantities of PCR reaction solution and RT-PCR enhancer (PCR reaction solution 49µl/test + PCR enhancer 1µl/test), fully mix them into PCR-mix centrifuge them instantaneously for later use. 2.8 Add 50µl PCR-Mix into each tube. First pipette up 50µl PCR-Mix, then elute the brown matters bound to the tube wall by dispensing the PCR-Mix several times. Transfer them to 0.2ml PCR reaction tube and cover the tube lid. And then transfer them to PCR "amplification and analysis region". 3. PCR Amplification (performed at "amplification and analysis region") (refer to the user's manual for each instrument to do the settings) 3.1 Place PCR reaction tube into the specimen wells of the amplification device. Set Negative control Positive control, Quantitative references A-D and test specimens in sequence. Set specimen names and concentration of quantitative references A-D. 3.2 Select PCR test channel: (1) Select FAM channel (Reporter: FAM, Quencher: None) to test HCV-RNA. (2) Select HEX or VIC channel (Reporter: HEX/VIC, Quencher: None) to test HCV internal control. (3) Set passive reference: ROX. 3.3 Set cycle parameters: ABI AND STRATAGENE SERIES: S. no Step Temperature Time Cycle 1 Pre-Denature & UNG enzyme activation 95 0 C 1 min 1 2 Reverse Transcription 60 0 C 30 min 1 3 cdna Pre-Denature 95 0 C 1min 1 4 Denaturation 95 0 C 15 sec 45 Page 3 of 6

4 Annealing, Extension, Fluorescence collection 60 o C 30 sec* 5 Device cooling (optional) 25 0 C 10 sec 1 NOTE: *Due to the device ABI 7500's technical specifications, it cannot be set at 30 sec., but can be set at 31 sec. LIGHT-CYCLER 480 (CHOOSE THE DEFAULT FOR THE UN-LISTED PARAMETERS) Program Target( 0 C) Acquisition mode Hold(HH:MM:SS) Cycles Analysis Mode 1 95 None 00:01:00 1 None 1 60 None 00:30:00 1 None 2 95 None 00:01:00 1 None 3 95 None 00:00:15 60 Single 00:00:30 45 Quantification 4 25 None 00:00:10 1 None When settings are completed, save settings, operate the reaction procedure. 4. RESULT ANALYSIS (Refer to the user's manual for each instrument to do the settings; take ABI series for example) When the reactions are completed, results will be saved automatically. Analyze the HCV curve and the HCV internal control curve respectively. After analysis, adjust Start, End and Threshold values of Baseline of the graph (User can adjust according to actual situation. Start value can be set between 3-15, end value between Adjust the amplification curve of Negative control to be flat or below threshold). Click "Analyze" to implement the analysis so that the parameters comply with the requirements of "5. Quality Control", then go to the "Plate" window to record the detected quantitative value. 5. Quality Control 5.1 Four HCV Quantitative References: all are detected as positive and the coefficient of correlation of the standard curve R HCV-Negative Control: no display of Ct value, but the internal control is detected as positive. (Ct value 38) 5.3 HCV-Positive Control: detection concentration ranges from 1.58E2 to 1.58E3 IU/ml. 5.4 The above requirements must be satisfied at the same time in the same test, otherwise, the test is treated as invalid, and a retest is needed. REFERENCE RANGE Through the research on reference values, the lower detection limit of this diagnostic kit is determined to be 25 IU/ml the Ct reference value of internal control is determined to be 38. EXPLANATION OF DETECTION RESULT (1) For specimens which are detected with a value between 5.0E1 IU /ml and 1.0E8 IU /ml, the test results can be applied and reported. Page 4 of 6

5 (2) For specimens which are detected with a value >1.0E8 IU/ml, note ">1.0E8 IU/ml "in the report. If precise quantification is required, dilute the specimen below 1.0E8 IU/ml and retest it. (3) For specimens which are detected with a value25 IU/ml and < 50 IU/ml and whose internal control is detected positive (Ct value 38), it means the virus is in low load, the test result can be reported with a note "the test result is only for reference". (4) For specimens which are detected with a value < 25 IU/ml, and whose internal control is detected positive (Ct value 38), it should be reported that the HCV-DNA is below the detection limit of the kit. If the internal control is off normal (Ct value > 38 or there is no display), then the specimen's detection result is invalid. An investigation should be performed to find out reasons and then retest the specimens. (If the test results from iterative tests still show invalid, please contact Bhat Bio-Tech India Pvt. Ltd. Bangalore) LIMITS OF DETECTION METHOD Detection result of specimen is related to specimen collection, processing, delivery and storage quality. Any deviation from the stated procedure will lead to an inaccurate detection result Crosscontamination during specimen processing may result in a false positive result. PRODUCT PERFORMANCE INDEX When the kit is used to detect the HCV-RNA quantitative reference provided by the National Institute for Food and Drug Control, the conformity rate for both negative and positive reaches 100%. The quantitative references for lower detection limit and references for serial dilution L0-L3 are all tested positive. The lower detection limit is determined to be 25 IU/ml. Liner range is between 5.0E1 IU/ml - 1.0E8 IU/ml. PRECAUTIONS (1) The product can only be used for in vitro diagnosis. Please read carefully the product manual before operation. (2) Please familiarize with and learn the operation procedures and precautions for each instrument before performing tests. Conduct quality control for each test. (3) Laboratory management shall strictly follow management practices of PCR gene amplification laboratory; test staff must receive professional training; testing process must be performed in separated regions; all used consumables should be of sterile single use; use specific instruments and devices for each stage; appliances for different stages and regions shall not be cross-used. (4) Before use, all reagents must be fully thawed at room temperature and mixed well; before the specimen is extracted, please make sure the temperature of the RNA extraction Solution-1, Solution-2, Solution-3 and Solution-4 has reached room temperature or above (suggestion: hold them for at least 1 hour at room temperature or incubate them for more than 30 min in 30 water bath). The RNA extraction Solution-1 may produce a brown precipitate, so mixed it thoroughly before use. The HCV enhancer easily sticks to the tube wall, so centrifuge it for a couple of seconds before use. (5) For the specimen detected as negative, make sure the amplification signal of HCV internal control is normal, in order to ensure that the test is operated properly and reagents are use correctly and no PCR inhibitors are generated in order to avoid a false Negative result. For the specimen detected as Positive, the amplification signal of the internal control needn't be considered. (6) Because HCV is RNA virus, care should be taken to avoid RNA being degraded by RNase. All the instruments such as pipettes must be specific for RNA. Make sure consumables such as centrifuge tubes, PCR reaction tubes and tips are not contaminated by RNase. Page 5 of 6

6 R-0, (7) If there are no HEX or VIC channel in the PCR system, monitoring of internal control can be omitted. DO NOT add internal control at step 1.2 to avoid the interference of multicolor fluorescence. BIBLIOGRAPHIES [1] Armstrong GL, Wasley A, Simard EP, et al. The prevalence of hepatitis C virus infection in the United States,1999 through 2002.Ann Intern Med. 2006; 144: [2] Everson, GT. Treatment of hepatitis C in patients who have decompensated cirrhosis. Clin Liver Dis. 2005; 9: [3] Ferenci P, Fried M, Shiffman M, et al. Predicting sustained virologic responses in chronic hepatitis C patients treated with peginterferon alfa-2alribavirin. J Hepatol. 2005; 43: [4] Longo MC, Berninger MS, Hartley JL.Use of uracil DNA glycosylase to control carryover contamination in polymerase chain reactions. Gene. 1990; [5] Clinical and Laboratory Standards Institute. Evaluation of the Linearity of Quantitative Measurement Procedures: A Statistical Approach; Approved Guideline. NCCLS, EP6-A, Volume 23, Number 16. Manufactured in India by: BHAT BIO-TECH INDIA (P) LTD. 11-A, 4TH CROSS, VEEREASANDRA INDUSTRIAL AREA ELECTRONICS CITY, BANGALORE , KARNATAKA, INDIA TEL.: (30 LINES) FAX: Page 6 of 6