Integrated validation of internally controlled one-step multiplex real-time RT-PCR for dengue virus serotyping and monoplex assay for quantification.
Thuy LTP., Tran VT., Le Anh Huy H., Thai Hung T., Minh NN., Chanh HQ., Huyen TB., Vuong NL., Simmons CP., Thi Hue Kien D., Yacoub S.
Dengue is a major global health challenge, yet no commercially validated molecular kits currently provide both serotyping and viral load quantification in a single integrated format. To address this gap, we developed and internally validated a one-step multiplex real-time RT-PCR assay that simultaneously detects all four dengue virus (DENV) serotypes in a single reaction (5-PLEX), together with a complementary monoplex system for quantitative viral load measurement. The 5-PLEX assay demonstrated high specificity and reliable serotyping performance during acute and early critical phases of dengue infection (day of illness ≤4). Monoplex assays for each serotype showed strong linearity, precision, and low analytical limits of detection (3-10 copies/reaction), enabling accurate quantification. Based on these findings, we propose a diagnostic framework: 5-PLEX for samples collected within the first four days of illness, the previously validated 3-PLEX assay for samples collected from day 5 of illness onward, and monoplex assays for serotype-specific viral load measurement. Internal and external process controls were incorporated to support accuracy and reproducibility within the validated framework and to facilitate future multi-laboratory evaluation. This harmonized is designed to facilitate standardized implementation across laboratories and supports improved inter-laboratory consistency in clinical diagnostics, genomic surveillance, therapeutic trials, and pathogenesis research.