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Figure 1

Figure 1 HBV LAMP primer tests (A) Three newly designed HBV LAMP primer sets (S1, S2, and X) and a previous report [19] were tested with standard HBV DNA (108 copies/reaction) and deionized distilled water as positive and negative controls. (B) S2 primer set was tested with serially diluted standard HBV DNA (102–108 copies/reaction). M and NTC were abbreviated from marker and no template control, respectively. (C) Sensitivity results from polymerase chain reaction using universal primers.
Figure 1 HBV LAMP primer tests (A) Three newly designed HBV LAMP primer sets (S1, S2, and X) and a previous report [19] were tested with standard HBV DNA (108 copies/reaction) and deionized distilled water as positive and negative controls. (B) S2 primer set was tested with serially diluted standard HBV DNA (102–108 copies/reaction). M and NTC were abbreviated from marker and no template control, respectively. (C) Sensitivity results from polymerase chain reaction using universal primers.

Figure 2

Turbidity-based HBV LAMP sensitivity test S2 primer set was tested with serially diluted standard HBV DNA (102–108 copies/reaction) in (A) turbidimeter and (B) direct visualization at the end point of the reaction.
Turbidity-based HBV LAMP sensitivity test S2 primer set was tested with serially diluted standard HBV DNA (102–108 copies/reaction) in (A) turbidimeter and (B) direct visualization at the end point of the reaction.

Figure 3

Specificity test S2 primer set was tested with 2 × 105 copies of standard DNAs of hepatitis B virus (HBV), human immunodeficiency virus (HIV), Epstein–Barr virus (EBV), cytomegalovirus (CMV), hepatitis C virus (HCV), and herpes simplex virus (HSV) and analyzed by 2% agarose gel electrophoresis.
Specificity test S2 primer set was tested with 2 × 105 copies of standard DNAs of hepatitis B virus (HBV), human immunodeficiency virus (HIV), Epstein–Barr virus (EBV), cytomegalovirus (CMV), hepatitis C virus (HCV), and herpes simplex virus (HSV) and analyzed by 2% agarose gel electrophoresis.

Performance of turbidity-, and gel electrophoresis-based HBV LAMP assay at other cutoff titers of HBV qPCR results

CutoffSensitivitySpecificityPPVNPVAccuracy
Turbidity
106131/13994.2%74/10570.5%131/16280.9%74/8290.2%84.0%
5 × 105140/15292.1%70/9276.1%140/16286.4%70/8285.4%86.1%
105146/16290.1%66/8280.5%146/16290.1%66/8280.5%86.9%
5 × 104150/17088.2%62/7283.8%150/16292.6%62/8275.6%86.9%
104156/18584.3%53/5989.8%156/16296.3%53/8264.6%85.7%
103157/20277.7%37/4288.1%157/16296.9%37/8245.1%79.5%
Gel electrophoresis
106135/13997.1%63/10560.0%135/17776.3%63/6794.0%81.1%
5 × 105147/15296.7%62/9267.4%147/17783.1%62/6792.5%85.7%
105154/16295.1%59/8272.0%154/17787.0%59/6788.1%87.3%
5 × 104157/17092.4%54/6773.0%157/17788.7%54/6780.6%86.5%
104163/18588.1%45/5976.3%163/17792.1%45/6767.2%85.2%
103168/20283.2%33/4278.6%168/17794.9%33/6749.3%82.4%

Sensitivity of turbidity- and gel electrophoresis-based HBV LAMP detection system

HBV DNA (copies/ reaction)Percent detection (No. of times detected/total replicated)
Turbidity basedGel electrophoresis based
2000100 (6/6)100 (3/3)
1000100 (6/6)100 (3/3)
20083 (5/6)100 (3/3)
15083 (5/6)100 (3/3)
100100 (9/9)100 (3/3)
5050 (3/6)67 (2/3)
2067 (4/6)67 (2/3)
1033 (1/3)
533 (1/3)
2.567 (2/3)
133 (1/3)
0.50 (0/3)
0.133 (1/3)

Performance of turbidity-, and gel electrophoresis-based HBV LAMP assay at the 2 × 105 IU/mL cutoff titer of HBV qPCR results

MethodsSensitivity (%)Specificity (%)Positive predictive value (%)Negative predictive value (%)Accuracy (%)
Turbidity-based90.12 (146/162)83.33 (90/108)89.02 (146/164)84.90 (90/106)87.40 (236/270)
Gel electrophoresis95.06 (154/162)75.00 (81/108)85.08 (154/181)91.01 (81/89)87.03 (235/270)

Cost comparison between quantitative PCR and LAMP

MethodsPrice (per equipment)Price (per reaction)Price (per test, include positive and negative controls)
EquipmentDNA extractionAmplification reagentsDetectionTotal
Quantitative PCRqPCR 30,000–50,000 USD5 USD30 USD105 USD
LAMPTurbidimeter 2000 USD, or heat block (200–1200 USD), or waterbath (50–100 USD)20 USD60 USD

Oligonucleotide sequences of three newly designed and one previously reported primer sets

Primer setPrimer nameLocationPrimer sequence (5‘ à 3‘)Genetic region
S1S1_F3470–491CCGTTTGTCCTCTAATTCCAGGS and P gene
S1_B3665–688GCACTAGTAAACTGAGCCAGGAGA
S1_FIP541–564GGAGGGATACATAGAGGTTCCTTG-TTTT-CCTCAACAACCAGCACGGGA
494–513
S1_BIP571–592TGTACCAAACCTTCGGACGGAA-TTTT-CCCACTCCCATAGGAATTTTCC
631–652
S1_LF520–540AGCAGTAGTCATGCAGGTCCG
S1_LB595–616TGCACCTGTATTCCCATCCCAT
S2S2_F3659–678CTGCATGACTACTGCTCAAGGAS and P gene
S2_B3712–731AGCCAAACAGTGGGGGAAAG
S2_FIP595–615TGGGATGGGAATACAGGTGCA-TTTT-CCTCTATGTATCCCTCCTGTTGCT
548–571
S2_BIP631–651GGAAAATTCCTATGGGAGTGGG-TTTT-CCCTACGAACCACTGAACAAATGG
688–711
S2_LF572–591TCCGTCCGAAGGTTTGGTAC
S2_LB659–678CCCGTTTCTCCTGGCTCAGT
XX_F31493–1512CCTTCTCCGTCTGCCGTTCCX gene
X_B31728–1747CCCCAACTCCTCCCAGTCTT
X_FIP1577–1596GTGAAGCGAAGTGCACACGG-TTTT-CACCTCTCTTTACGCGGACTCC
1529–1540
X_BIP1627–1646CGCCCACCAAATATTGCCAA-TTTT-TATGCCTCAAGGTCGGTCGTTG
1686–1707
X_LF1559–1576TCCGGCAGATGAGAAGGC
X_LB1662–1685GGACTCTTGGACTCTCAGCAATGT
Nyan et al. [19]Ref_F3530–249TCCTCACAATACCGCAGAGTS and P gene
Ref_B3402–421GCAGCAGGATGAAGAGGAAT
Ref_FIP305–326GTTGGGGACTGCGAATTTTGGC-TTTT-TAGACTCGTGGTGGACTTCT
251–270
Ref_BIP333–354TCACTCACCAACCTCCTGTCCT-TTTT-AAAACGCCGCAGACACAT
379–396
Ref_LF271–294GGTGATCCCCCTAGAAAATTGAG
Ref_LB357–378AATTTGTCCTGGTTATCGCTGG
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