Clinical performance of the VERIS HCV assay for hepatitis C virus RNA quantification

•Comparison of VERIS and Abbott assays for HCV RNA quantification is provided.•Qualitative discrepancies were observed only for low viral loads.•Overall minimal quantification difference is evidenced.•Underquantification of genotype 4 samples may depend on HCV RNA folding.•No evidence of an impact of genotype 4 underestimation on clinical management.

BackgroundDiagnosis of hepatitis C virus (HCV) infection and treatment monitoring rely on detection/quantification of HCV RNA and real-time polymerase chain reaction (PCR) techniques are expected to equivalently quantify the different HCV genotypes.ObjectiveThe clinical performance of the VERIS HCV assay for HCV RNA quantification was compared to that of the Abbott RealTime HCV assay.Study designQualitative concordance and quantitative comparison were evaluated on a first panel of 286 clinical samples containing HCV genotypes 1-6. Forty additional genotype 4 samples were tested to explore genotype 4 HCV RNA underquantification.ResultsQualitative discrepancies were observed for low viral loads (<2 log10 IU/mL) in patients under antiviral therapy and would not have had any impact on patients' management with the current guidelines for the monitoring of patients on direct-acting antivirals (DAAs). Quantification results were well correlated (R2 = 0.89) with an overall minimal quantification bias (mean VERIS − Abbott difference) of −0.09 log10 IU/mL. Quantification agreement for genotypes 1, 2 and 3 samples was excellent, but reached −0.57 log10 IU/mL for 46 genotype 4 samples. A lower quantification bias of −0.24 log10 IU/mL was observed when testing 40 additional genotype 4 samples with a second reagent lot. Underquantification was not associated with 5′ untranslated region (UTR) sequence polymorphisms but could be explained by 5′ UTR RNA molecular modeling.ConclusionHCV RNA quantification by the VERIS HCV assay and the Abbott RealTime HCV assay was well correlated for all HCV genotypes, except genotype 4 where 5′ UTR RNA folding may impact quantification. Nevertheless, this underestimation of HCV RNA levels had no impact on clinical use.