New test uses a single drop of blood to reveal entire history of viral infections

[Kati]

I agree that you cannot just expect GPs to find patients and leave it at that. That is not the idea. The idea is that you have a geographic area where all GP practices agree to become involved in a demographic study that involves detailed education of staff and formalised referral protocols. You then have an expert team of validators for every case offered. This sort of thing was used for the big cardiovascular risk studies and has been done for rheumatoid arthritis in Norfolk. You have to remember that secondary and tertiary referral centres are only as good as the primary care referrals in the first place - the more specialist you get the more bias you can get. 'Usual' or well known clinics will have a grossly biased referral pattern based on all sorts of things like whether patients can pay or travel, whether the clinicians are popular with certain types of patient - it is endless. We will never get reliable data from studying populations in tertiary centres. For a start there are no relevant control populations. The people who do epidemiological studies properly just don't touch that sort of cohort with a barge pole. Nobody knows whether samples are from patients or controls right up to the point of publishing and often not even after - everything is analysed in a blind coded form so that you can do more studies without having broken codes. We need to raise the level of research to this sort of quality of methodology.

We needed that kind of study 20 years ago.
And this kind of study with proposed methodology would probably take 3 years to implement, 5 years to publication. With the existence of such cheap and seemingly quick tests, you'd think it would be easier.

i could swear that such study in the HIV population is already under way.

Sorry don't mind me I'm really nervous, I am seeing a new specialist in a couple of hours.

 

[Jonathan Edwards]

We needed that kind of study 20 years ago.
And this kind of study with proposed methodology would probably take 3 years to implement, 5 years to publication. With the existence of such cheap and seemingly quick tests, you'd think it would be easier.

i could swear that such study in the HIV population is already under way.

Sorry don't mind me I'm really nervous, I am seeing a new specialist in a couple of hours.

The point is that the background methodology is in place - the whole point of the UK ME Biobank is that it collects material from systematic primary care trawling. It may not yet be perfect but it is pretty good. So the study takes as long as it takes to take samples out of the liquid nitrogen and pack them off to the lab that does the test.

 

[barbc56]

Now, if only we had the same test for bacteria...

Your ahead of your time.​

This new assay may one day become a routine diagnostic tool that is used along with complete blood counts and chemistries to know if a patient’s signs and symptoms might be attributable to a past virus infection. VirScan technology is not limited to virus infections – it can be used to provide a history of bouts with bacteria, fungi, and parasites

.

 

[barbc56]

Oops, I didn’t see @Gemini post as I thought there were only two pages for this thread!

Barb​

 

[barbc56]

Would this bloodtest be able to tell if there is an active infection. Is that even relevant?

 

[Bob]

Would this bloodtest be able to tell if there is an active infection. Is that even relevant?

Yes, it's a relevant and interesting question, barb. I believe that this specific test is testing for antibodies only, so it doesn't distinguish active infections from past infections, except in certain cases where a virus is incurable. The test characterises your history of infections rather than determining current infection. But, of course, if you had certain symptoms and the test identified an antibody to a virus that causes such symptoms then it would give you a clue. And if it detected e.g. HIV, then that would almost certainly indicate a current infection. Same for e.g. Hep C if you hadn't been treated for Hep C. (Except I'm not certain if Hep C is curable or not these days?) That as I understand it anyway.

 

[Simon]

The point is that the background methodology is in place - the whole point of the UK ME Biobank is that it collects material from systematic primary care trawling. It may not yet be perfect but it is pretty good. So the study takes as long as it takes to take samples out of the liquid nitrogen and pack them off to the lab that does the test.

This sounds great. I've heard bits and pieces about the biobank but never really got a feel for the whole - is there a good description of it anywhere, including the issues of unbiased sampling you mention? It seems to me to be a brilliant initiative that that community haven't quite understood - or may it's just me.

 

[Gemini]

Science paper: Comprehensive serological profiling of human populations using a synthetic human virome

Table 2: Frequently Detected Viruses (% of Samples Positive for Virus)

Virus species %

Human herpesvirus 4 87.1%
Rhinovirus B 71.8%
Human adenovirus C 71.8%
Rhinovirus A 67.3%
Human respiratory syncytial virus 65.7%
Human herpesvirus 1 54.4%
Influenza A virus 53.4%
Human herpesvirus 6B 52.8%
Human herpesvirus 5 48.5%
Influenza B virus 40.5%
Poliovirus 33.7%
Human herpesvirus 3 24.3%
Human adenovirus F 20.4%
Human adenovirus B 16.8%
Human herpesvirus 2 15.5%
Enterovirus A 15.2%
Enterovirus B 13.3%

herpes 4 = EBV, herpes 5 = CMV, herpes 3 = zoster(chicken pox/shingles)

Edit: Sorry I tried to space and align the % column but the edit wouldn't take when I saved it.

 

[Never Give Up]

Here's another posting. No big revelations, just a look at one of the human beings behind the testing.




Suzanne Vernon
11 hrs · YouTube ·
This is a great one and a half minute explanation of the test that detects the immune response to hundreds viruses in a drop of blood. Steve and his team used blood samples from ME/CFS patients in the results that were reported in this Science paper http://www.sciencemag.org/content/348/6239/aaa0698.abstract. We will look for different viral patterns that could give us clues about ME/CFS.

Dr Stephen Elledge on blood test breakthrough VirScan

Like · Comment · Share

 

[Denise]

Am I correct that this test is only useful if one retains antibodies to a virus?
What are the implications for those who do not retain antibodies?

 

[Snow Leopard]

Virus species %

Human herpesvirus 4 87.1%
Rhinovirus B 71.8%
Human adenovirus C 71.8%
Rhinovirus A 67.3%
Human respiratory syncytial virus 65.7%
Human herpesvirus 1 54.4%
Influenza A virus 53.4%
Human herpesvirus 6B 52.8%
Human herpesvirus 5 48.5%
Influenza B virus 40.5%
Poliovirus 33.7%
Human herpesvirus 3 24.3%
Human adenovirus F 20.4%
Human adenovirus B 16.8%
Human herpesvirus 2 15.5%
Enterovirus A 15.2%
Enterovirus B 13.3%

The detection of poliovirus is strange, unless it simply indicates reactivity due to immunisation.

Lastly, I wonder why no one has tried to develop an EBV vaccine yet?

 

[heapsreal]

The detection of poliovirus is strange, unless it simply indicates reactivity due to immunisation.

Lastly, I wonder why no one has tried to develop an EBV vaccine yet?

My understanding is there is a vaccine for ebv but nnot commercially available .

I have posted links a few months back where a researcher/dr treated successfully an MS pt by exposing his t cells to an ebv vaccine and reinfusing into pt.

 

[Bob]

Am I correct that this test is only useful if one retains antibodies to a virus?
What are the implications for those who do not retain antibodies?

Yes, the test will only detect antibodies if they're present. My thoughts: If a significant subset of ME patients lack certain antibodies to common viruses, then perhaps that will be apparent from the data, and could potentially be a useful finding.

 

[Jonathan Edwards]

The detection of poliovirus is strange, unless it simply indicates reactivity due to immunisation.

Lastly, I wonder why no one has tried to develop an EBV vaccine yet?

The polio antibodies would be due to vaccination - I think it is a live vaccine so in effect we have all had poliovirus infection - just a harmless one.

The question about EBV vaccine is interesting. But it may not be logical to try. Most people have good antibody levels to EBV but still carry the virus around, so vaccinating people to raise antibodies would not necessarily be any better than catching the live virus as an infant. So in a way most of us get 'vaccinated' by live EBV as infants and there is not much reason to think that is a problem. The main problem is that a few people fail to catch EBV as infants and then when they get a girlfriend or boyfriend who did catch it they go down with a nasty glandular fever. Maybe someone could develop a variant of EBV to give infants live which did not cause illness if passed on. I doubt that a dead vaccine would produce long term immunity sufficient to stop being infected with the wild virus. Moreover, I think people might be cagey about giving live engineered EBV. It might do something rather catastrophic. That's not to say that somebody may not be trying to do just that.

 

[SOC]

Table 2: Frequently Detected Viruses (% of Samples Positive for Virus)

Virus species %

Human herpesvirus 4 87.1%
Rhinovirus B 71.8%
Human adenovirus C 71.8%
Rhinovirus A 67.3%
Human respiratory syncytial virus 65.7%
Human herpesvirus 1 54.4%
Influenza A virus 53.4%
Human herpesvirus 6B 52.8%
Human herpesvirus 5 48.5%
Influenza B virus 40.5%
Poliovirus 33.7%
Human herpesvirus 3 24.3%
Human adenovirus F 20.4%
Human adenovirus B 16.8%
Human herpesvirus 2 15.5%
Enterovirus A 15.2%
Enterovirus B 13.3%

herpes 4 = EBV, herpes 5 = CMV, herpes 3 = zoster(chicken pox/shingles)

Edit: Sorry I tried to space and align the % column but the edit wouldn't take when I saved it.

I find it interesting that HHV3 (chicken pox) antibodies were only detected in 24% of the study group given the prevalence of chicken pox itself and the vaccine.

Similarly, the "everybody has antibodies to CMV and HHV6, so high antibody titres are meaningless" claim seems quite weak in the face of this data showing only 50% of the study group having detectable antibodies. If only 50% of the population has any detectable antibodies, it seems unlikely that high titres in adulthood (decades after likely age of infection) would be at all common.

I wonder why only HHV6B is listed and not HHV6A. HHV6A is probably more relevant in serious illness as it is the more pathogenic and neurotropic of the two. Was it in the table, but further down the list and just not reported here?

 

[Snow Leopard]

The polio antibodies would be due to vaccination - I think it is a live vaccine so in effect we have all had poliovirus infection - just a harmless one.

It wasn't so harmless to me (I couldn't walk for weeks and now I have ME), but I digress, I know what you meant...

They phased out the live vaccine in Australia just a few years after.

 

[Bob]

I find it interesting that HHV3 (chicken pox) antibodies were only detected in 24% of the study group given the prevalence of chicken pox itself and the vaccine.

The authors acknowledge that the result for chicken pox is lower than should be expected. They suggest it might be related to B cell response to the virus, but basically they don't know why they aren't detecting it in more samples.

 

[SOC]

The authors acknowledge that the result for chicken pox is lower than should be expected. They suggest it might be related to B cell response to the virus, but basically they don't know why they aren't detecting it in more samples.

So how do we know they aren't underdetecting everything?

Might underdetection suggest that finding antibodies in blood might not be as definitive a test of exposure and/or infection as is believed? If we know nearly 100% of people are exposed to HHV3 (chicken pox) and that the virus remains in the body life-long, but blood testing for antibodies is only showing exposure in 24% of the population, then it might be reasonable to hypothesize that these infections are not reliably detectable via blood antibody titres.

Or their test has a long way to go before it's ready for the big leagues.

 

[Bob]

So how do we know they aren't underdetecting everything?

Or their test has a long way to go before it's ready for the big leagues.

They say the test is not ready for commercialism yet, but that they are using it for research purposes.

Might underdetection suggest that finding antibodies in blood might not be as definitive a test of exposure and/or infection as is believed? If we know nearly 100% of people are exposed to HHV3 (chicken pox) and that the virus remains in the body life-long, but blood testing for antibodies is only showing exposure in 24% of the population, then it might be reasonable to hypothesize that these infections are not reliably detectable via blood antibody titres.

I've no idea how their tests compare to other tests for chicken pox antibodies. And I'm not sure if antibody tests are usually/always seen as a reliable indicator of infection for all pathogens. I'm not familiar with the science of diagnosing infection. The reliable use of antibodies for diagnosis may depend on the individual pathogen. But, yes, it seems that antibodies are not a fool-proof way of detecting infection, perhaps depending on the pathogen. There is some discussion of the various reasons for this in the full paper. Others might have far more insight into this area of medicine than I do.

 

[Gemini]

Lastly, I wonder why no one has tried to develop an EBV vaccine yet?

Glaxo had an EBV vaccine in Phase II ten years ago,

There have been human clinical trials but are no currently licensed EBV vaccines,

March 2015 Glaxo literature indicates researchers are still working on it....

You're right, it's needed.