Validation of a hepatitis B virus (HBV) Next Generation Sequencing (NGS) pipeline at Barts Health NHS Trust

At Barts Health NHS Trust, historically HBV genotyping and resistance testing is performed using nested PCR followed by Sanger sequencing. With the development of NGS assays for HIV and HCV, in order to harmonise workflows an NGS HBV pipeline was developed. Primers were designed for the whole genome amplification of HBV. Plasma samples were extracted for nucleic acid using a Qiagen Qiasymphony. Whole genomes of HBV were amplified in a single round PCR and quantified using a Qubit fluorometer. Libraries were prepared using the Nextera XT library preparation kit and sequencing was performed on an Illumina Miseq. Sequencing reads were assembled into consensus sequences using a Linex-based pipeline. Resistances and genotypes were determined using the HBV Grade website. Minority variants were variants <20 % of the overall population. Pan-genotypic PCR primers were designed in the nick region of the partially double stranded HBV genome. In-silico analysis allowed primers to be designed to bind multiple genotypes. Sensitivity analysis of primers was investigated for the most common circulating genotypes. A panel of HBV positive and external quality assurance samples showed good comparability to Sanger sequencing results. Inter- and intra-assay variability showed the assay was robust and fit for purpose. No resistance associated minority variants were observed. The development an NGS pipeline for analysis of HBV allowed the harmonisation of diagnostic pathways within the virology sequencing laboratory. Introduction of this test would allow data to be gathered to assess the importance of minority variants in HBV infection.