Obstetric Panel With Fourth-generation HIV

CPT: 85025; 86592; 86762; 86850; 86900; 86901; 87340; 87389
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Test Details

Test Includes

ABO grouping; CBC with platelet count and differential; HBsAg screen; Rh factor; rubella antibodies, IgG; syphilis serology; antigen/antibody screen (EIA) for HIV-1/O/2 with reflex to supplementary differentiation of HIV-1 or HIV-2 antibody. Specimens repeatedly reactive by the screening assay (but negative by the supplementary antibody typing assay) will reflex to qualitative nucleic acid amplification (NAA) for viral RNA.

Use

Evaluate woman's health status in early pregnancy; evaluate for anemia, leukemia, reaction to inflammation and infections, peripheral blood cellular characteristics, state of hydration and dehydration, polycythemia, hemolytic disease of the newborn, and ABO incompatibilities.

The fourth-generation HIV-1/O/2 assay is acknowledged to detect acute HIV infections 4 to 12 days earlier than third-generation assays. Coupled with supplemental tests and clinical information, this cascade can help decrease the spread of HIV infection. According to the CLSI guideline, anyone testing positive by a fourth-generation screening assay and supplemental tests (either antibody or RNA detection), should initiate care and follow-up tests (such as viral load) for clinical staging.1,2

Limitations

Reactive (repeatedly) specimens must be investigated by additional supplemental tests. A negative test for an individual does not preclude exposure to or infection with HIV-1 and/or HIV-2. Negative results can occur if the quantity of the marker present in the sample is too low for detection by the assay or if the marker is not present during the stage of disease in which a sample is collected.

Methodology

See individual tests.

Specimen Requirements

Specimen

Serum and whole blood

Volume

Three 10-mL gel-barrier tubes (preferred), one must remain unopened, and two 5-mL lavender-top tubes

Container

Three 10-mL gel-barrier tubes or three red-top tubes and two lavender-top (EDTA) tubes

Collection

Gently invert lavender-top tubes 8 to 10 times immediately to mix specimen with anticoagulant. Centrifuge serum tubes within 45 minutes of venipuncture. If red-top tube is used, transfer separated serum to a plastic transport tube.

Storage Instructions

Refrigerate serum tubes and one lavender-top (EDTA) tube. One lavender-top (EDTA) tube may be stored at room temperature for 24 hours.

Causes for Rejection

Hemolysis; clotted specimen; specimen diluted with IV fluid; tube not filled with minimum volume; improper labeling; specimen aliquot; received outside of specimen storage

Clinical Information

Special Instructions

This test requires a separate dedicated, unopened, gel-barrier tube or red-top tube sent directly to the test facility.

This test may exhibit interference when sample is collected from a person who is consuming a supplement with a high dose of biotin (also termed as vitamin B7 or B8, vitamin H, or coenzyme R). It is recommended to ask all patients who may be indicated for this test about biotin supplementation. Patients should be cautioned to stop biotin consumption at least 72 hours prior to the collection of a sample.

Footnotes

1. Clinical and Laboratory Standards Institute. Criteria for Laboratory Testing and Diagnosis of the Human Immunodeficiency Virus Infection, Approved Guideline. M53-A. Wayne, Pa: CLSI; 2011.
2. Centers for Disease Control and Prevention and Association of Public Health Laboratories. Laboratory Testing for the Diagnosis of HIV Infection: Updated Recommendations. Published June 27, 2014.

References

García T, Tormo N, Gimeno C, de Lomas JG, Navarro D. Performance of an automated human immunodeficiency virus (HIV) antigen/antibody combined assay for prenatal screening for HIV infection in pregnant women. J Med Microbiol. 2009 Nov; 58(Pt 11):1529-1530. 19589899
Pandori MW, Branson BM. 2010 HIV Diagnostics Conference. Expert Rev Anti Infect Ther. 2010 Jun; 8(6):631-633. 20521890

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
231950 Obstetric Panel, Including HIV 006510 HBsAg Screen 5196-1
231950 Obstetric Panel, Including HIV 006072 RPR 20507-0
231950 Obstetric Panel, Including HIV 006204 Rubella Antibodies, IgG index 5334-8
231950 Obstetric Panel, Including HIV 006056 ABO Grouping 883-9
231950 Obstetric Panel, Including HIV 006064 Rh Factor 10331-7
231950 Obstetric Panel, Including HIV 006015 Antibody Screen 890-4
231950 Obstetric Panel, Including HIV 083936 HIV Screen 4th Generation wRfx 56888-1
231950 Obstetric Panel, Including HIV 321856 . N/A
231950 Obstetric Panel, Including HIV 321871 CBC, Platelet Ct, and Diff N/A
231950 Obstetric Panel, Including HIV 005025 WBC x10E3/uL 6690-2
231950 Obstetric Panel, Including HIV 005033 RBC x10E6/uL 789-8
231950 Obstetric Panel, Including HIV 005041 Hemoglobin g/dL 718-7
231950 Obstetric Panel, Including HIV 005058 Hematocrit % 4544-3
231950 Obstetric Panel, Including HIV 015065 MCV fL 787-2
231950 Obstetric Panel, Including HIV 015073 MCH pg 785-6
231950 Obstetric Panel, Including HIV 015081 MCHC g/dL 786-4
231950 Obstetric Panel, Including HIV 105007 RDW % 788-0
231950 Obstetric Panel, Including HIV 015172 Platelets x10E3/uL 777-3
231950 Obstetric Panel, Including HIV 015107 Neutrophils % 770-8
231950 Obstetric Panel, Including HIV 015123 Lymphs % 736-9
231950 Obstetric Panel, Including HIV 015131 Monocytes % 5905-5
231950 Obstetric Panel, Including HIV 015149 Eos % 713-8
231950 Obstetric Panel, Including HIV 015156 Basos % 706-2
231950 Obstetric Panel, Including HIV 115398 Immature Cells N/A
231950 Obstetric Panel, Including HIV 015909 Neutrophils (Absolute) x10E3/uL 751-8
231950 Obstetric Panel, Including HIV 015917 Lymphs (Absolute) x10E3/uL 731-0
231950 Obstetric Panel, Including HIV 015925 Monocytes(Absolute) x10E3/uL 742-7
231950 Obstetric Panel, Including HIV 015933 Eos (Absolute) x10E3/uL 711-2
231950 Obstetric Panel, Including HIV 015941 Baso (Absolute) x10E3/uL 704-7
231950 Obstetric Panel, Including HIV 015108 Immature Granulocytes % 38518-7
231950 Obstetric Panel, Including HIV 015911 Immature Grans (Abs) x10E3/uL 51584-1
231950 Obstetric Panel, Including HIV 015945 NRBC % 58413-6
231950 Obstetric Panel, Including HIV 015180 Hematology Comments: 18314-5
Reflex Table for HBsAg Screen
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 016105 HBsAg Confirmation 016105 HBsAg Confirmation 7905-3
Reflex Table for RPR
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 006464 RPR, Quant. 006464 RPR, Quant. 31147-2
Reflex Table for RPR
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 012021 RPR Qn+TP Abs 006464 RPR, Quant. 31147-2
Reflex 2 000000 012006 000000 N/A
Reflex Table for RPR
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 012021 RPR Qn+TP Abs 082371 Treponema pallidum Antibodies 24110-9
Reflex Table for ABO Grouping
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 114067 ABO Grouping 006051 ABO Grouping 883-9
Reflex Table for Rh Factor
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 114066 Rh Factor 006052 Rh Factor 10331-7
Reflex Table for Antibody Screen
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 114041 Ab Scr+Antibody ID 114033 Antibody Screen 890-4
Reflex Table for Antibody Screen
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 114041 Ab Scr+Antibody ID 019786 Antibody Id. #1 888-8
Reflex 2 000000 114034 000000 890-4
Reflex Table for Antibody Screen
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 114041 Ab Scr+Antibody ID 019786 Antibody Id. #1 888-8
Reflex 2 000000 114035 000000 888-8
Reflex Table for Antibody Screen
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 114041 Ab Scr+Antibody ID 019786 Antibody Id. #1 888-8
Reflex 2 000000 114036 000000 50970-3
Reflex Table for Antibody Screen
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 114041 Ab Scr+Antibody ID 019786 Antibody Id. #1 888-8
Reflex 2 000000 114037 000000 888-8
Reflex Table for Antibody Screen
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 114041 Ab Scr+Antibody ID 019786 Antibody Id. #1 888-8
Reflex 2 000000 114038 000000 50970-3
Reflex Table for Antibody Screen
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 114041 Ab Scr+Antibody ID 019802 Coombs Titer #1 50970-3
Reflex Table for Antibody Screen
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 114041 Ab Scr+Antibody ID 019810 Antibody Id. #2 888-8
Reflex Table for Antibody Screen
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 114041 Ab Scr+Antibody ID 019836 Coombs Titer #2 50970-3
Reflex Table for HIV Screen 4th Generation wRfx
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 083940 HIV 1/2 Ab Differentiation 083947 HIV 1/2 Ab Differentiation N/A
Reflex Table for HIV Screen 4th Generation wRfx
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 083940 HIV 1/2 Ab Differentiation 083941 HIV 1 Ab 68961-2
Reflex Table for HIV Screen 4th Generation wRfx
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 083940 HIV 1/2 Ab Differentiation 083942 HIV 2 Ab 81641-3
Reflex Table for HIV Screen 4th Generation wRfx
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 083940 HIV 1/2 Ab Differentiation 083954 Interpretation: 80203-3
Reflex 2 000000 083951 000000 25835-0
Reflex Table for HIV Screen 4th Generation wRfx
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 083940 HIV 1/2 Ab Differentiation 083954 Interpretation: 80203-3
Reflex 2 000000 083960 000000 62365-2
Reflex Table for HIV Screen 4th Generation wRfx
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 083940 HIV 1/2 Ab Differentiation 083954 Interpretation: 80203-3
Reflex 2 000000 083944 000000 N/A
Reflex Table for HIV Screen 4th Generation wRfx
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 083940 HIV 1/2 Ab Differentiation 083954 Interpretation: 80203-3
Reflex 2 000000 083951 000000 25835-0
Reflex Table for HIV Screen 4th Generation wRfx
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 083940 HIV 1/2 Ab Differentiation 083954 Interpretation: 80203-3
Reflex 2 000000 083961 000000 62365-2
Reflex Table for HIV Screen 4th Generation wRfx
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 083940 HIV 1/2 Ab Differentiation 083954 Interpretation: 80203-3
Reflex 2 000000 083944 000000 N/A
Reflex Table for HIV Screen 4th Generation wRfx
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 083940 HIV 1/2 Ab Differentiation 083954 Interpretation: 80203-3
Reflex 2 000000 083951 000000 25835-0
Reflex Table for HIV Screen 4th Generation wRfx
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 083940 HIV 1/2 Ab Differentiation 083954 Interpretation: 80203-3
Reflex 2 000000 083959 000000 62365-2
Reflex Table for HIV Screen 4th Generation wRfx
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 083940 HIV 1/2 Ab Differentiation 083954 Interpretation: 80203-3
Reflex 2 000000 083944 000000 N/A
Reflex Table for HIV Screen 4th Generation wRfx
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 083940 HIV 1/2 Ab Differentiation 083954 Interpretation: 80203-3
Reflex 2 000000 083951 000000 25835-0
Reflex Table for HIV Screen 4th Generation wRfx
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 083940 HIV 1/2 Ab Differentiation 083954 Interpretation: 80203-3
Reflex 2 000000 083959 000000 62365-2
Reflex Table for HIV Screen 4th Generation wRfx
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 083940 HIV 1/2 Ab Differentiation 083954 Interpretation: 80203-3
Reflex 2 000000 083944 000000 N/A
Reflex Table for HIV Screen 4th Generation wRfx
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 083940 HIV 1/2 Ab Differentiation 083954 Interpretation: 80203-3
Reflex 2 000000 083951 000000 25835-0
Reflex Table for HIV Screen 4th Generation wRfx
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 083940 HIV 1/2 Ab Differentiation 083954 Interpretation: 80203-3
Reflex 2 000000 083959 000000 62365-2
Reflex Table for HIV Screen 4th Generation wRfx
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 083940 HIV 1/2 Ab Differentiation 083954 Interpretation: 80203-3
Reflex 2 000000 083944 000000 N/A
Reflex Table for HIV Screen 4th Generation wRfx
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 083940 HIV 1/2 Ab Differentiation 083954 Interpretation: 80203-3
Reflex 2 000000 083951 000000 25835-0
Reflex Table for HIV Screen 4th Generation wRfx
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 083940 HIV 1/2 Ab Differentiation 083954 Interpretation: 80203-3
Reflex 2 000000 083959 000000 62365-2
Reflex Table for HIV Screen 4th Generation wRfx
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 083940 HIV 1/2 Ab Differentiation 083954 Interpretation: 80203-3
Reflex 2 000000 083944 000000 N/A
Reflex Table for Immature Granulocytes
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 015111 Please note: 015111 Please note: N/A
Reflex Table for Immature Grans (Abs)
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 015111 Please note: 015111 Please note: N/A
Reflex Table for Hematology Comments:
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 115246 Differential 115247 Neutrophils % 23761-0
Reflex Table for Hematology Comments:
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 115246 Differential 115250 Lymphs % 737-7
Reflex Table for Hematology Comments:
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 115246 Differential 115251 Monocytes % 744-3
Reflex Table for Hematology Comments:
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 115246 Differential 115252 Eos % 714-6
Reflex Table for Hematology Comments:
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 115246 Differential 115253 Basos % 707-0
Reflex Table for Hematology Comments:
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 115246 Differential 115398 Immature Cells N/A
Reflex Table for Hematology Comments:
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 115246 Differential 115254 Neutrophils Absolute X10E3/uL 753-4
Reflex Table for Hematology Comments:
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 115246 Differential 115255 Lymphs (Absolute) X10E3/uL 732-8
Reflex Table for Hematology Comments:
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 115246 Differential 115256 Monocytes(Absolute) X10E3/uL 743-5
Reflex Table for Hematology Comments:
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 115246 Differential 115257 Eos (Absolute Value) X10E3/uL 712-0
Reflex Table for Hematology Comments:
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 115246 Differential 115258 Baso(Absolute) X10E3/uL 705-4
Reflex Table for Hematology Comments:
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 115246 Differential 115260 Differential Comment 18723-7
Reflex Table for Hematology Comments:
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 115246 Differential 005034 RBC Comment 6742-1
Reflex Table for Hematology Comments:
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 115246 Differential 015171 Platelet Comment 9317-9

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