Navigating Uncertainties in RT-qPCR and Infectivity Assessment of Norovirus

Human norovirus (HuNoV) is the primary cause of gastroenteritis globally. Due to the lack of a reliable cultivation system, RT-qPCR is a gold standard technique for the detection and quantification of HuNoV. However, the inability of PCR to differentiate between infectious from non-infectious particles remains a significant limitation. This study aims to address this limitation by exploring the relationship between culture-based (plaque assay and TCID₅₀) and non-culture-based (RT-qPCR) methods for HuNoV quantification, using Tulane virus as a cultivable surrogate. The ultracentrifuge-purified Tulane virus at 6.7 log₁₀ PFU/ml or 5.8 log₁₀ TCID₅₀/ml in Tris-EDTA buffer (pH 7.2), was serially diluted and subjected to RNA extraction, with or without RNase pretreatment, followed by quantification with RT-qPCR. Further physical characterization of the virus stock was performed with dynamic light scattering and transmission electron microscopy. A strong correlation (Pearson's Correlation Coefficient of 0.99) was observed between log₁₀ genome copies (GC) and log₁₀ plaque forming units (PFU) per PCR reaction for both RNase-pretreated and unpretreated samples. Beta distributions indicated a similar median GC:PFU ratio of ca. 3.7 log₁₀ for both RNase-pretreated and unpretreated samples. The high GC:PFU ratio may indicate the sensitive nature of RT-qPCR or the presence of intact, non-infectious virus particles. The outcomes of this study will contribute to the more accurate estimation of infectious norovirus particles in food and environmental matrices.