Identification of Clinically Relevant Hb Variants During HbA1c Testing Using the ARKRAY HA-8180V in Fast Mode: Reliable HbE Detection Based on Retention Time

Background: Hb variants are often incidentally detected during HbA1c testing and can cause interference. We evaluated the ability of the ARKRAY HA-8180V HPLC system operating in fast mode (FM) to identify Hb variants, particularly HbE, in samples submitted for HbA1c testing based on characteristic retention times (RTs). Methods: Chromatograms of samples tested for HbA1c were analyzed; those showing predefined abnormal chromatographic patterns suggestive of Hb variants were further evaluated using capillary electrophoresis (CE) and β- and α-globin gene sequencing. RTs were recorded. Results: ABart'sH samples produced falsely low HbA1c values. Artificially decreased HbA1c was detected in 21/27 (77.8%) HbEE samples. ARKRAY HA-8180V FM analysis yielded reproducible RTs for HbE, achieving 100% sensitivity, specificity, and accuracy in the validation cohort. Conclusions: HbE and thalassemia variants can interfere with HbA1c quantification. ARKRAY HA-8180V FM chromatogram review allows reliable detection of HbE and prevents misinterpretation of HbA1c results.