Virology Laboratory at King's College Hospital

Laboratory overview

Our laboratories provide an extensive clinical virology service, including infection control, and specialist advice in virology to hospitals and general practitioners. We also receive specimens from a number of external microbiology laboratories for investigation.

We form part of the UK clinical virology network. We provide epidemiological data for the communicable disease surveillance centre at Colindale. Outbreaks of infectious disease are investigated in conjunction with the consultants in communicable disease control.

The laboratory serves in excess of a thousand fund-holding general practitioners. The response of King’s College Hospital to the evolving Primary Care Groups and Trusts has imposed further demands on the clinical virology service. The King’s local Primary Referral Guide reflects general practitioners’ expectations of direct access for prompt clinical advice, including virological advice. Specialist virology services and clinical advice are offered by virology to the London Boroughs of Lambeth, Southwark, Lewisham, Bromley, Bexley and Greenwich. The local authorities serviced by the laboratory are the London Boroughs of Bromley, Southwark, Bexley and Greenwich. South London Specialist Virology Centre Virology includes two Consultant Virologists, two Registrars, and a Principal Clinical Scientist and a team of other Healthcare Scientists, supported by a Health & Safety Manager, a Quality Manager and Administrative & Clerical team. The team manages a workload of over 150,000 samples of increasing complexity and requiring sophisticated laboratory processes and interpretation.

Key features:

Our routine diagnostic work includes general serology, hepatitis and retrovirus serology, and an extensive repertoire of molecular based tests which include both qualitative and quantitative assays as well as antiretroviral resistance testing using automated sequence analysis, employing a range of different platforms and technologies underpinned by our Service Development research.

General microbiology serological tests which are sent to the combined department are carried out in virology. In addition, all Chlamydia trachomatis and N gonorrhoea tests are carried out by APTIMA (TMA) technology on genital swab / urine samples.

We provide surveillance activity for:

• HIV antiretroviral resistance data to MRC database
• HCV sentinel surveillance study
• Norovirus diagnosis and outbreak analysis
• influenza virus diagnosis and typing
• pregnancy screening.

We provide a comprehensive viral and bacterial blood serology service together with molecular diagnosis on blood and non-blood samples, using real time in-house and commercial PCR assays. We have introduced a multiplex CMV, EBV and Adenovirus assay with work on a multiplex faecal assay and respiratory assay under development. 

The virus serology section detects antibodies to viruses and viral antigens in serum using automated assays. In addition, some bacterial antibodies are also assayed in this section.The majority of routine serology screening assays are performed by ELISA assay technology on a fully automated open platform system using Tecan robotics enabling the laboratory to process 90% of samples within 48 hours of receipt. Many of these screening assays are confirmed in house using other automated or semi-automated procedures, including the Abbott Architect, Biomerieux Vidas, and Immunogenetics Autoblot systems .

Routine screening is available for the following;

• viral antibodies and antigens: Hepatitis A, B and C, HIV Type 1 and 2, CMV, EBV, HSV, Measles, Mumps, Parvovirus B19, Rubella, HTLV, VZV, Influenza A and B, RSV and Adenovirus.
• Bacterial antibodies: coxiella burnetii, Mycoplasma pneumonia, Chlamydia genus antibody, Treponemal pallidum, Toxoplasma gondii, and anti streptolysin.
• Specialist Serology: Screening for other bacterial and viral antigens and antibodies which are not available in house are sent to various reference laboratories; e.g. Brucella serology, Lymes disease serology, dengue fever serology, yellow fever serology.

Regional and supraregional services include:

• Haemato-oncology (including UK’s largest bone marrow transplantation unit) •
• Institute for Liver Studies (providing 30% of UK liver therapy, including transplantation and liver failure) for both adult and paediatric hepatology
• Variety Club Children’s Hospital
• Regional Neurosciences and Neurosurgical services
• Renal unit (offering dialysis including HBV, HCV and HIV positive individuals)
• Harris Birthright Centre for Foetal Medicine
• Adult Intensive Care Unit, neonatal and paediatric intensive care
• Solid tumour oncology / cancer services (including skin, hepatobiliary, head and neck)
• Cardiac surgery (regional)
• Paediatric and adult Accident and Emergency departments
• Obstetrics and gynaecology; assisted conception
• Genito-urinary medicine (Caldecot Centre)
• Reproductive and Sexual Health Primary care