HIV-1 Diagnosis (RNA), Infants Less than 2 Years
Label Mnemonic: HIVP
Epic code: LAB8354
Downtime form: A-1a Doctor/Provider Orders - Pathology Core and Specialty Care Nursery
Commercial Mailout Laboratory
6240-8 RCP
356-8593
Specimen(s):
Plasma
Collection Medium:
Lavender top tube 3 mL (EDTA)
Minimum:
Preferred Minimum: 1 mL EDTA plasma
Absolute Minimum: 0.5 mL plasma

For pediatric collection, collect THREE full Microtainer® tubes.
Delivery Instructions:
Deliver to laboratory immediately after collection.
Turn Around Time:
3 days upon receipt at reference laboratory
Reference Range:
Undetected
Interpretive Data:
A "Detected" result is consistent with HIV infection. Per CDC and USPHS recommendations, a second specimen should be collected from any patient with first-time detectable HIV-1 DNA or RNA result and tested to verify the diagnosis of HIV-1 infection.

An "Undetected" result indicates that neither HIV-1 DNA nor RNA is detected in the specimen. Repeat testing in 1 to 2 months is recommended for those at risk of HIV-1 infection. The lower limits of detection (based on 95% detection rate) of this assay in plasma are 311 copies/mL for HIV-1 DNA and 75 copies/mL for HIV-1 RNA.

An "Inconclusive" result indicates that the absence or presence of HIV-1 DNA or RNA could not be determined with certainty after repeat testing of the clinical specimens in the laboratory, possibly due to PCR inhibition. Submission of a new specimen for testing is recommended.
Comments:
Effective 2/21/2013, the process for consent and documentation of consent for HIV testing will be done when placing an HIV order in Epic. There is no longer a need to obtain an "HIV Pre-Test Counseling Packet".

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:

G-2d16 Consent for Human Immunodeficiency Virus (HIV)-Related Testing to be used for Minors (<18 Years of Age)

HIV Pre-Test Education

This test can be used for detection and diagnosis of HIV-1 infections, including in children <18 months of age when serologic tests are not useful (due to presence of maternal HIV antibodies).

Useful for:
Virologic detection of HIV-1 infection in infants <18 months of age (an age group for which serologic tests are unreliable) born to HIV-1- infected mothers.

Early detection of acute HIV-1 infection in children and adults who may be receiving combination antiretroviral prophylaxis or pre-emptive treatment.

Determining eradication of HIV-1 in individuals receiving combination highly active antiretroviral therapies.
Methodology:
Real-Time Polymerase Chain Reaction (PCR)
CPT Code:
87536