Virology

The laboratory has strengthened for epidemic preparedness, rapid response, and risk communication to the public apart from the high-end research in diagnostic as well as translational virology. The laboratory has the bio-safety level measures to handle high-risk viruses (Bio-safety Level 3). The laboratory is an ICMR (Indian Council of Medical Research) designated COVID-19 diagnostic facility and offers real-time PCR testing for SARS CoV-2 infected patients from March 21, 2020.The department has been nominated as a satellite laboratory for INSACOG (Indian SARS-CoV-2 Genomics Consortium) and the sentinel whole genome sequencing surveillance site for SARS-CoV-2 by the Delhi state.

The Virology Lab has made an exhaustive protocol for Needle Stick Injuries, post exposure prophylaxis for healthcare professionals at ILBS and keep a track of the HBV immunization status of the entire ILBS staff. The laboratory also supervises the unique Needle stick injury control programme through our website: nsi.ilbs.in. The ILBS NSI – website aims to provide platform for a centralized registry for needle stick injuries. The vision of ILBS is not only to create an institutional database on needle stick/ sharps injuries but to expand it as a statewide and thereafter national NSI Registry. As a part of World Health Organization Collaborative Center (WHO-CC) in Viral Hepatitis, Virology laboratory is actively involved in imparting capacity building training to Microbiologists and other laboratory staff across the Nation.

A unique PDCC course in Hepatovirology has been introduced from August 2014 to train young budding microbiologists in this field which is followed by two new academic program of PDCC in Diagnostic Virology and Transplant Virology. Virology laboratory takes pride to be considered as the reference laboratory for testing of Hepatitis C by the Delhi Government under the Project “HEAD Start (Hepatitis C Elimination through Access to Diagnostics)” in collaboration with Foundation for Innovative New Diagnostics (FIND). Our laboratory has also been nominated as one of the authorized laboratories by the Central Drugs Standard Control Organization (CDSCO, DCGI) for evaluation and validation of various hepatitis, dengue and influenza diagnostic kits and equipment's.

Services rendered by the Department: From January'23 to November'23

• Serology
  • Hepatotropic viruses (HBV, HCV, HAV, HEV, HDV).
  • Transplant related viruses (CMV, EBV, HSV, VZV & BK virus).
  • Special serological (quantification) assays – HBs Ag quantification
  • Other Viruses: HIV, Dengue, SARS CoV-2.
• Molecular
  • Hepatotropic viruses (HAV, HBV, HCV, HDV, HEV) by Real- time PCR
  • Cartridge based nucleic acid amplification test for HCV
  • HBV and HCV genotyping
  • HBV drug resistance testing
  • HCV Resistance Associated Substitutions (RASs)testing
  • Occult HBV testing
  • Real time PCR for cccDNA in clinical samples
  • Transplant related viruses (CMV, EBV, HSV 1&2 ,VZV, HHV- 6/7, Parvovirus B-19, Adenoviruses, BK)by Real-time PCR
  • HIV-1 RNA real time PCR(Quantitative)
  • Real time PCR for Dengue
  • Multiplex Real time PCR for Influenza and other respiratory viruses
  • Cartridge based nucleic acid amplification test for Influenza A/B/RSV
  • Real Time PCR for SARS-CoV-2
  • Cartridge based nucleic acid amplification test for SARS-CoV-2
• Whole Genome Sequencing
  • Whole genome sequencing for SARS-CoV-2
• Needle stick injury protocol
  • Post exposure prophylaxis and counselling
• HBV vaccination and anti HBs titre determination
  • HBV vaccination at the time of recruitment
  • Anti HBs titre determination- at the time of recruitment and following vaccination

COVID - Related Activities : Department of Clinical Virology at ILBS is among one of the first few centres approved by ICMR in Delhi to initiate SARS-CoV-2 Real-Time PCR testing. We became functional for SARS-CoV-2 testing on 21St March, 2020 and since then providing 24 x 7 services. To date, we had tested over 2,48,717samples received samples from different districts of Delhi State maintaining high-quality standards and quick turnaround time. We are the only laboratory under GNCTD with fully operational BSL 3 services for the conduct of COVID testing. We are also appointed as one of the few centers in the country for the validation of various kits for SARS-CoV-2 by ICMR. Department of Clinical Virology had participated in the 4th, 5th and 6th serosurveyconducted in Delhi to estimate the population-level exposure (IgG antibodies) to the SARS-CoV-2 virus. The laboratory had tested over 70,000 serum samples and provided the report with rapid turnaround time. The department has been nominated as a satellite laboratory for INSACOG (Indian SARS-CoV-2 Genomics Consortium) and the sentinel whole genome sequencing surveillance site by the Delhi state. Our state-of- the-art Genome sequencing laboratory was inaugurated by the HonourableChief Minister Shri Arvind Kejriwal in August 2021 and can sequence over 300 samples a week and provide results in five to seven days. To date, we had sequenced over 6205 samples and the results are helping in classification of new strains or variants circulating in Delhi-NCR.

New services & facilities added to the department in 2023

• HHV-6/7 Qualitative Real Time PCR
• Adenovirus Quantitative Real Time PCR
• Parvovirus B-19 Quantitative Real Time PCR

Figure 4: COVID-19 RT PCR Testing Facility

Educational Activities:

Details of the Educational activities (CME/Conf/workshop/webinars) hosted by the department in 2023:

I) Name of activity- Two days “Training Program on Viral Hepatitis”
Date:21st February 2023 to 22nd February 2023
Date: 03rd November 2022

About 55 participants, from 12 different states and 27 different institutes/hospitals attended this two-days training program. The participants came from diverse scientific backgrounds including faculties, MBBS/MD students, and PhD students. Many medical staff from VRDL labs attended the program. The training session included Technical lectures followed bydemonstrations. The scientific sessions were engaging and provided useful insights on various clinical aspects including epidemiology and laboratory diagnosis of Viral Hepatitis, management of Hepatitis in pregnancy/ pediatric population /post transplant recipients. Algorithm of pre-transplant recipient and donor screening was discussed. The pivotal role of Indian Virology Laboratories in pandemic preparedness was emphasized. In addition, basics and clinical application of newer techniques like Whole genome sequencing, Proteonomics/ metabolomics were also discussed in details. The scientific sessions were followed by lab demonstration of various serological/ molecular methods, Drug resistance and mutational analysis of Hepatitis B and C, Whole Genome Sequencing and Proteonomics/Metabolomics

ii) Name of activity- Training program “Viral Hepatitis”
Date : 26th October 2023

About 36 participants, from 3 different states and 26 different institutes/hospitals attended this training program. The participants included medical laboratory technician and technical staff working in different laboratories across India. The technical lectures provide insight on the epidemiology of Viral Hepatitis, various new non-invasive markers in the diagnosis of Viral Hepatitis, quality control measures and importance in Clinical Virology, newer emerging techniques viz whole genome sequencing, needle stick injury and post exposure prophylaxis. The lectures were followed by lab demonstration which emphasized on recent advances in molecular and serological diagnosis of Viral Hepatitis and Whole genome sequencing. This would help the participants to understand the usefulness of molecular, serological and sequencing assays in any viral outbreak and escalate the preparedness for any epidemic/pandemic in near future.

Courses offered by the Department

• Research Project Details Under Dr Ekta Gupta, Professor, Department Of Clinical Virology

Departmental Achievements

• Dr Snigdha Purohit/ Dr Reshu Agarwal was awarded ID Aggarwal - Broor prize for the Best paper in Virology on “Epstein-Barr virus DNAemia among liver transplant recipients- is regular monitoring required in India??” in 46th Annual Conference of IAMM held at Lucknow from 23th to 26th November 2023
• Dr Malika Grover presented a poster titled “Post-transplant CMV infections – a tertiary care institute experience over a decade” atthe 46th Annual Conference of IAMM held at Lucknow from 23th to 26th November 2023
• Dr Malika Grover was awarded Ashok Kumar Chakravarty Memorial Award for poster presentation “Genotype IIIA Takes Center Stage: Clinical and Virological Perspectives of Hepatitis A Virus Infection”- in MICRO-D-CON 2023 held in New Delhi from 02nd-04th November 2023
• Dr Ruchita Chhabra presented poster titled “Clinical spectrum of Parainfluenza virus infection in patients with Liver Disease” in MICRO-D-CON 2023 held in New Delhi on 22nd July 2023.
• Dr. Ambati Mrudula presented poster titled “ BK virus infection and its correlation with clinical, biochemical and histopathology features in renal transplant recipients: an observational single centre study” in 2nd National Update on Nephrology and Kidney transplant held at Institute of Liver and Biliary Sciences on 27th May 2023.
• Dr. Ambati Mrudula presented poster titled “Distribution & prevalence of Hepatitis B virus genotypes in Hepatitis B infected patients and their role in disease severity- a retrospective study from a tertiary care institute in India” in Global Hepatitis Summit 2023 held at Paris from 25th-28th April 2023.
• Dr Jasmine Samal received Stephan Urban Foundation travel grant to attend Global Hepatitis Summit 2023 held at Paris from 25th-28th April 2023.
• Dr Ruchita Chhabra presented poster titled “Genomic and mutational profiling of SARS-CoV- 2 virus causing infection in liver transplant recipients: a single centre study' at 33rd European Congress of Clinical Microbiology and Infectious Diseases 2023 held at Copenhagen, Denmark from 15th-18th April 2023
• Dr Jasmine Samal presented a poster titled on “Incidence of Respiratory Syncytial Virus Infection among adults with liver disease: a single center study" in Research Day, held at Institute of Liver and Biliary Sciences on 07th January 2023.
• Organized screening camp for Hepatitis B and C on the occasion of 26th Hepatitis Day celebrated at ILBS on 4th December 2023

Visiting faculty to the department in 2023