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Effect of inactivation procedure of Ebola virus on routine biochemistry parameters

Background: Latest Ebola breakthrough encouraged a study of the effect of recommended procedure for inactivation of hemorrhagic fever viruses on routine biochemistry parameters. Materials and methods: Recommended inactivation protocol consist of use of detergent 20% Triton X-100 and 20% tri-(n-butyl)-phosphate in final concentration of 1% and one hour incubation period of sera on 45°C. Effect of inactivation procedure on biochemistry parameters was tested using routine patient samples (n=31). Determination of sodium, potassium, chloride, urea, creatinine, aspartat aminotransferase (AST), alanin aminotransferase (ALT) and C-reactive protein (CRP) prior and after simulated inactivation was done on a Beckman Coulter AU680 analyzer (Beckman Coulter, Tokyo, Japan) using original reagents and applications recommended by manufacturer. All statistical analysis, including descriptive statistics, Kolmogorov-Smirnov test for normal distribution, paired t-test, Passing-Bablok regression analysis and Bland-Altman plot was done using MedCalc, 12.5.0 (Ostend, Belgium). Results: Paired t-test showed statistically significant difference in all parameters before and after inactivation procedure (creatinine, P=0.001 ; AST, P=0.010 ; ALT, P=0.001 ; CRP, P=0.004 and for other parameters, P<0, 001). Passing-Bablok regression analysis showed constant and proportional difference between native and inactivated samples for following analysis: AST, y= -14.7(95% CI -32.8 to -6.0) + 1.8(95% CI 1.3 to 2.7)x ; CRP, y= -0.3(95% CI -0.8 to -0.1) + 0.7(95% CI 0.7 to 0.8)x ; chloride, y= -45.7(95% CI -80.3 to -21.8) + 1.3(95% CI 1.1 to 1.7)x. Bland-Altman analysis showed a clinically significant difference for following parameters (mean difference as%, ±1.96SD): ALT (35.2%, 5.4 to 64.9), AST (-10.0%, -10.61 to 86.1), CRP (51.3%, -40.1 to 142.8), potassium (11.7%, 5.6 to 17.7), chloride (13.0%, 6.3 to 19.6), sodium (8.4%, 3.3 to 13.6), creatinine (10.6%, -18.0 to 39.2) and urea (8.5%, -1.0 to 18.0). Conclusion: Comparison of biochemistry parameters in native and inactivated samples showed statistically significant differences. However, in order to protect laboratory personnel, inactivation procedure could be used, but results should be carefully interpreted.

Ebola virus; inactivation procedure; biochemistry parameters

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