Persson, Sofia, Alm, Erik, Karlsson, Måns, Enkirch, Theresa, Norder, Heléne, Eriksson, Ronnie, Simonsson, Magnus, and Ellström, Patrik
• A new assay for quantitative detection of hepatitis A virus was designed. • The new assay displayed better inclusivity than the assay recommended by ISO 15216−1. • The assay was validated for RT droplet digital PCR (RT-ddPCR) and RT real-time PCR (RT-qPCR). • RT-ddPCR had greater precision than RT-qPCR, especially between runs. • Due to the high precision, RT-ddPCR should be considered as an alternative to RT-qPCR. Hepatitis A virus (HAV) is mainly transmitted via contaminated food or water or through person-to-person contact. Here, we describe development and evaluation of a reverse transcription droplet digital PCR (RT-ddPCR) and reverse transcription real-time PCR (RT-qPCR) assay for detection of HAV in food and clinical specimens. The assay was evaluated by assessing limit of detection, precision, matrix effects, sensitivity and quantitative agreement. The 95 % limit of detection (LOD95 %) was 10 % higher for RT-ddPCR than for RT-qPCR. A Bayesian model was used to estimate precision on different target concentrations. From this, we found that RT-ddPCR had somewhat greater precision than RT-qPCR within runs and markedly greater precision between runs. By analysing serum from naturally infected persons and a naturally contaminated food sample, we found that the two methods agreed well in quantification and had comparable sensitivities. Tests with artificially contaminated food samples revealed that neither RT-ddPCR nor RT-qPCR was severely inhibited by presence of oysters, raspberries, blueberries or leafy-green vegetables. For this assay, we conclude that RT-qPCR should be considered if rapid, qualitative detection is the main interest and that RT-ddPCR should be considered if precise quantification is the main interest. The high precision of RT-ddPCR allows for detection of small changes in viral concentration over time, which has direct implications for both food control and clinical studies. [ABSTRACT FROM AUTHOR]