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Test Code HV1CD HIV-1 and HIV-2 Antibodies for Cadaveric or Hemolyzed Specimens, Serum

Reporting Name

HIV-1/-2 Cadaver/Hemolyzed, S

Useful For

Diagnosing HIV-1 and/or HIV-2 infection in cadaveric or hemolyzed serum specimens from symptomatic patients with or without risk factors for HIV infection

 

This test is not offered as a screening or confirmatory test for blood donor specimens.

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
HIVDI HIV Ab Confirm / Differentiation, S No No

Testing Algorithm

This test begins with HIV-1/-2 antibody enzyme immunoassay (EIA). If HIV-1/-2 antibody EIA is reactive, then HIV antibody confirmation/differentiation by immunochromatographic method is performed at an additional charge.

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Serum


Ordering Guidance


1. This test is not intended for testing asymptomatic individuals (ie, screening purposes). For testing hemolyzed specimens from such patients with or without risk factors for HIV infection, order HV1CM / HIV-1 and HIV-2 Antibody Screen for Hemolyzed Specimens, Serum.

2. New York State clients: This test should not be requested for maternal/newborn HIV screening on specimens originating in New York State, due to state regulatory requirements for expedited result reporting.



Additional Testing Requirements


If the initial enzyme immunoassay result is negative and this test was ordered as a follow-up evaluation of a specimen with a reactive rapid HIV antibody test result, clients must call 800-533-1710 or 507-266-5700 to request supplemental testing HIV antibody confirmation/differentiation by immunochromatography (HIVDI). The HIVDI / HIV-1 and HIV-2 Antibody Confirmation and Differentiation, Serum test is not US Food and Drug Administration approved for testing cadaveric specimens. If performed, test results will be reported with a disclaimer.



Necessary Information


Date of collection is required.



Specimen Required


Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 1.5 mL

Collection Instructions:

1. Centrifuge blood collection tube per collection tube manufacturer's instructions (eg, centrifuge within 2 hours of collection for BD Vacutainer tubes).

2. Aliquot serum into plastic vial.


Specimen Minimum Volume

0.2 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Frozen (preferred) 30 days
  Ambient  7 days
  Refrigerated  7 days

Reference Values

Negative

Day(s) Performed

Tuesday, Friday

Test Classification

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information

86703

86701

86702

LOINC Code Information

Test ID Test Order Name Order LOINC Value
HV1CD HIV-1/-2 Cadaver/Hemolyzed, S 31201-7

 

Result ID Test Result Name Result LOINC Value
83628 HIV-1/-2 Cadaver/Hemolyzed, S 31201-7

Clinical Information

Epidemiological data indicate that AIDS is caused by at least 2 types of HIV. The first virus, HIV-1, has been isolated from patients with AIDS or AIDS-related complex and from asymptomatic infected individuals at high risk for AIDS. HIV-1 is transmitted by sexual contact, exposure to infected blood or blood products, or from an infected mother to her fetus or infant. A second HIV virus, HIV-2, was isolated from patients in West Africa in 1986. HIV-2 appears to be endemic only in West Africa, but it has also been identified in individuals who have lived in West Africa or had sexual relations with individuals from that geographic region. HIV-2 is similar to HIV-1 in its morphology, overall genomic structure, and its ability to cause AIDS.

 

Antibodies against HIV-1 and HIV-2 are usually not detected until 6 to 12 weeks following exposure and are almost always detected by 12 months. Antibodies may fall into undetectable levels in the terminal stage of AIDS.

 

For more information see HIV Testing Algorithm (Fourth-Generation Screening Assay), Including Follow-up of Reactive Rapid Serologic Test Results.

Interpretation

A reactive HIV-1/-2 antibody screen result obtained by enzyme immunoassay (EIA) suggests the presence of HIV-1 and/or HIV-2 infection. However, it does not differentiate between HIV-1 and HIV-2 antibody reactivity. Diagnosis of HIV infection must be based on results of supplemental tests, such as HIV antibody confirmation/differentiation test (automatically reflexed on all samples with reactive screen test results at an additional charge).

 

All presumptive antibody-positive test results should be verified by submitting a second serum specimen for retesting.

 

A negative HIV-1/-2 antibody EIA screen result usually indicates the absence of HIV-1 or HIV-2 infection. However, for specimens reactive by the rapid HIV antibody tests, confirmatory testing is recommended, even if the EIA results are negative.

Method Description

The Genetic Systems HIV-1/HIV-2 PLUS O enzyme immunoassay is based on the principle of direct antibody sandwich technique. Microwell-strip plates (solid-phase) are coated with purified HIV antigens: gp160 and p24 recombinant proteins derived from HIV-1, gp36 peptide representing the immunodominant region of the HIV-2 transmembrane glycoprotein, and a synthetic polypeptide mimicking an artificial (not encoded by any existing virus) HIV-1 group O-specific epitope.

 

Serum samples and assay controls are added to the antigen-coated wells of the microwell-strip plate along with specimen diluent. The specimen diluent contains a dye which changes color from purple to blue when combined with a specimen or control. The wells are incubated and then washed. The next step is the addition of a colored conjugate solution (green) which contains the peroxidase-conjugated HIV-1 and HIV-2 antigens. The wells are then incubated. If HIV-1 or HIV-2 antibody is present, it will bind to the antigen coated on the well and to the peroxidase-conjugated antigens in the conjugate solution. The antigen-antibody-antigen complexes remain bound to the well during a subsequent wash step, which will remove any unbound materials. Working chromogen solution is added to the plate wells and allowed to incubate. A blue or blue-green color develops in proportion to the amount of HIV antibody present in the sample. Color development is stopped by the addition of acid, which changes the blue-green color to yellow. The optical absorbance of specimens and controls is determined spectrophotometrically at a wavelength of 450 nm.(Package insert: Genetics Systems HIV-1/HIV-2 PLUS O EIA. Bio-Rad Laboratories; 02/2019)

Reject Due To

Gross hemolysis OK
Gross lipemia Reject
Gross icterus Reject

Method Name

Enzyme Immunoassay (EIA)-Screening Procedure

Highlights

Indicated for testing symptomatic individuals (diagnostic purposes) with or without risk factors for HIV infection.

Forms

If not ordering electronically, complete, print, and send Infectious Disease Serology Test Request (T916) with the specimen.