HIV Quantitative PCR (Viral Load)

Label Mnemonic:	HIVQNTPCR
Epic code:	LAB2468
Order form:	Microbiology/Molecular Infectious Disease Requisition
Supply order:	Supply Order Form
Billing:	Billing Policies
CPT code:	87536

Specimen(s):

Plasma

Collection Medium:

Pink top tube 6 mL (K2-EDTA)

Minimum:

6 mL whole blood or 3 mL plasma.  Testing requires a dedicated 
collection tube.

If also testing for HCV RNA or Genotype, collect a second Pink top 
tube 
(6 mL whole blood or 3 mL plasma).

Testing Schedule:

Availability: twice per week

Reference Range:

Negative

Analytical range in log10 values:
  1.3 - 7.00 log   (20-10,000,000 CPM non-log transformed values)

Negative results and positive results less than 20 CPM will be 
reported as <1.3 log 10 (<20 CPM).

Comments:

Record draw time. Testing only approved for viral load testing to monitor therapy. Not for diagnostic testing. Current testing will detect HIV-1 group M subtypes and HIV-1 group O.

Effective 2/21/2013, there are changes in the process for consent for HIV testing.

These changes align with current state law requirements for HIV testing and UI Health Care Policy, Policy Governing Human Immunodeficiency Virus (HIV) Education, Testing, Reporting and Confidentiality.

The summary of consent requirements are as follows:

• For adults (18 years or older) able to consent:
  verbal consent must be obtained prior to testing.
  Written consent is not necessary for adult patients.

• For minors (less than 18 years old): Before
  undergoing HIV test, a minor must be informed that
  the legal guardian will be notified if the result is
  confirmed as positive. Minors must give written
  consent for HIV testing and treatment services. The
  consent form must note that that the legal guardian
  will be notified of confirmed positive results.

• For adults or minors unable to consent: The
  individual's guardian may give consent. If the legal
  guardian cannot be located or is unavailable, a
  health care provider may authorize an HIV test when
  the test is necessary for diagnostic purposes to
  provide appropriate urgent medical care. HIV orders
  in minors will all receive retrospective audit review
  to make sure proper written consent has been obtained
  and is scanned into the patient chart in Epic.

Below are hyperlinks to the education and minor informed consent forms:

Consent for HIV-Related Testing in Minors

HIV Pre-Test Education

A signed patient informed consent (where required for minors) to human immunodeficiency virus (HIV)-related testing should be kept on record with the patient medical record at the ordering physician office. Repeatable reactive plasma will be confirmed by western blot. No results will be given by telephone.

Methodology:

PCR amplification; Cobas HIV Test (Roche Diagnostics, Inc.)

Instructions:

Record draw time; all collection tubes need to be processed 
within 24 hours of collection.  If specimens cannot reach the 
Microbiology Laboratory at University of Iowa Hospitals and Clinics 
within the 24 hours, process as follows:

Centrifuge for 20 minutes at 800-1600 x g.  Aseptically enter the tube 
and aliquot into sterile tubes.

Sample Processing:

Within 24 hours of collection, centrifuge at 800-1600 x g for 10 minutes.
Label transport tube with two patient identifiers, date and time of collection.
Maintain sterility and forward promptly to lab.
Specimen should be collected and packaged as close to shipping time as possible.

Sample Storage:

Refrigerate.
See "Instructions:" above for special storage requirements.

Transport Instructions:

Place coolant packs into Styrofoam container.
Place requisition into outside pocket of bag.
DO NOT FREEZE, protect specimen by wrapping in bubble-wrap or toweling.
Recommend early AM overnight shipping or equivalent if not on courier service.

See Additional Information:
Conversion of Log Value to Integer Value Calculator