PrEP, Female, Injectable Baseline + HIV RNA

CPT: 84702; 86704; 86706; 86780; 86803; 87340; 87389; 87491; 87535; 87538; 87591
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Synonyms

  • HIV
  • PrEP
  • Prophylaxis

Test Includes

HIV p24 antigen/antibody with reflex to antibody differentiation; HIV-1/2 qualitative RNA; T. pallidum antibody w/reflex to RPR (with titer); Chlamydia/Gonococcus, NAA; HBV Baseline Evaluation - Hepatitis B Surface Antigen (HBsAg) screen with reflex to HBV quant DNA; Hepatitis B Surface antibody (anti-HBS); Hepatitis B Core antibody, Total (anti-HBc); Hepatitis C Virus (HCV) antibody with reflex to quantitative real-time PCR; human chorionic gonadotropin (hCG), β-subunit, quantitative


Special Instructions

This profile requires a dedicated, unopened, gel-barrier tube and 2 frozen (preferred) or refrigerated serum pour-off tubes.

Note: Client must clearly label the site/source of each Chlamydia/Gonococcus Nucleic Acid Amplification specimen.

Tests included within this profile 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 testing about biotin supplementation. Patients should be cautioned to stop biotin consumption at least 72 hours prior to the collection of a sample.


Expected Turnaround Time

2 - 3 days (testing performed daily)


Related Documents


Specimen Requirements


Specimen

Serum and first-void urine (patient should not have urinated for one hour prior to specimen collection) or endocervical or vaginal swab


Volume

11 mL serum and 2 mL of a 20 mL to 30 mL urine collection or one swab (endocervical or vaginal)


Minimum Volume

7 mL serum (this volume does not allow for repeat testing) and 2 mL of a 15 mL urine collection or one swab (endocervical or vaginal)


Container

Gel-barrier tube and Gen-Probe® APTIMA® urine specimen transport or APTIMA® swab


Collection

Serum specimen: Usual blood collection technique.

Option 1: Gen-Probe® Aptima® Endocervical or Vaginal Swab

Endocervical swab: Remove excess mucus from the cervical os and surrounding mucosa using the cleaning swab (white-shaft swab in the package with red printing). Discard this swab. Insert the specimen collection swab (blue-shaft swab in the package with green printing) into the endocervical canal. Gently rotate the swab clockwise for 10 to 30 seconds in the endocervical canal to ensure adequate sampling. Withdraw the swab carefully; avoid contact with the vaginal mucosa. Remove the cap from the swab specimen transport tube and immediately place the specimen collection swab into the transport tube. Carefully break the swab shaft at the scoreline; use care to avoid splashing of the contents. Recap the swab specimen transport tube tightly.

Vaginal swab: Care provider specimen: Collect vaginal fluid sample using the Gen-Probe® Aptima® vaginal swab kit by contacting the swab to the lower third of the vaginal wall and rotating the swab for 10 to 30 seconds to absorb fluid. Immediately place the swab into the transport tube and carefully break the swab shaft against the side of the tube. Tightly screw on the cap. Patient self-collection: Partially open the package of the Gen-Probe® Aptima® vaginal swab kit. Do not touch the soft tip or lay the swab down. If the soft tip is touched, the swab is laid down, or the swab is dropped, use a new Aptima® swab specimen collection kit. Remove the swab. Carefully insert the swab into the vagina about two inches past the introitus and gently rotate the swab for 10 to 30 seconds, making sure the swab touches the walls of the vagina so that moisture is absorbed by the swab. Withdraw the swab without touching the skin. Immediately place the swab into the transport tube, and carefully break the swab shaft against the side of the tube. Tightly screw on the cap.

Option 2: Urine Specimen: The patient should not have urinated for at least one hour prior to specimen collection. Direct patient to provide a first-catch urine (approximately 20 to 30 mL of the initial urine stream) into a urine collection cup free of any preservatives. Collection of larger volumes of urine may result in specimen dilution that may reduce test sensitivity; lesser volumes may not adequately rinse organisms into the specimen. Female patients should not cleanse the labial area prior to providing the specimen. Add urine to the Aptima® Combo 2 urine collection device. The final volume must be between the two black lines on the device (about 2 mL).

PCR test: Centrifuge sample within 24 hours of collection. Transfer serum to a screw-cap polypropylene transport tube. Ship frozen (preferred) or refrigerated.


Storage Instructions

Serum: Gel-barrier tubes refrigerated up to 6 days

PCR test: Frozen up to 6 weeks

APTIMA® Swab or urine: Maintain at room temperature or refrigerate (2°C to 30°C)


Stability Requirements

Temperature

Period

Room temperature

Swab: 60 days; urine: 30 days (stability provided by manufacturer or literature reference)

Refrigerated

Serum: 6 days (stability provided by manufacturer or literature reference)

Frozen

Serum: 6 weeks (stability provided by manufacturer or literature reference)

Freeze/thaw cycles

Serum: Stable x4 (stability provided by manufacturer or literature reference)


Patient Preparation

Patient should not have urinated for one hour prior to specimen collection.


Causes for Rejection

Hemolysis; lipemia; received outside of specimen and/or storage and/or labeling requirements; aliquot received for HIV testing; specimen in expired transport or incorrect transport device; specimens with inappropriate source for test requested; APTIMA® urine transport >30 days from collection; APTIMA® urine transport with incorrect specimen volume; APTIMA® swab transport >60 days from collection; APTIMA® swab specimen without a swab; cleaning swab (white-shaft swab) in APTIMA® swab transport; APTIMA® transport device with multiple swabs


Test Details


Use

This profile aligns with current guidelines for assessment of female patients prior to the initiation of injectable HIV PrEP.

The profile includes HIV Antibody/p24 Antigen and HIV-1/2 RNA for the detection of HIV infection; Chlamydia trachomatis and Neisseria gonorrhoeae nucleic acid amplification; serologic testing for syphilis; serological assessment of HBV infection status; reflexive testing for the detection of HCV infection; and assessment of pregnancy status.


Limitations

HIV p24 antigen/antibody specimens with reactive results 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 test components.


References

Centers for Disease Control and Prevention (CDC). Pre-Exposure Prophylaxis (PrEP). CDC website: https://www.cdc.gov/hiv/clinicians/prevention/prep.html. Accessed January 2023.

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
254988 PrEP, BL Inj + HIV RNA (F) 083903 HIV Antibody/p24 Antigen 56888-1
254988 PrEP, BL Inj + HIV RNA (F) 139826 HIV-1 RNA 25835-0
254988 PrEP, BL Inj + HIV RNA (F) 139827 HIV-2 RNA 69353-1
254988 PrEP, BL Inj + HIV RNA (F) 083969 Test Information 55752-0
254988 PrEP, BL Inj + HIV RNA (F) 082356 T pallidum Antibodies 47236-5
254988 PrEP, BL Inj + HIV RNA (F) 188078 Chlamydia trachomatis, NAA 43304-5
254988 PrEP, BL Inj + HIV RNA (F) 188086 Neisseria gonorrhoeae, NAA 43305-2
254988 PrEP, BL Inj + HIV RNA (F) 019054 PDF N/A
254988 PrEP, BL Inj + HIV RNA (F) 006510 HBsAg Screen 5196-1
254988 PrEP, BL Inj + HIV RNA (F) 006408 Hep B Surface Ab, Qual 22322-2
254988 PrEP, BL Inj + HIV RNA (F) 006718 Hep B Core Ab, Tot 13952-7
254988 PrEP, BL Inj + HIV RNA (F) 144721 Rfx to HBcIgM 77202-0
254988 PrEP, BL Inj + HIV RNA (F) 006720 Interpretation 56850-1
254988 PrEP, BL Inj + HIV RNA (F) 144035 HCV Ab 40726-2
254988 PrEP, BL Inj + HIV RNA (F) 004417 hCG,Beta Subunit,Qnt,Serum mIU/mL 45194-8
Reflex Table for HIV Antibody/p24 Antigen
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 083938 HIV 1/2 Ab Differentiation 083907 HIV 1 Ab 68961-2
Reflex Table for HIV Antibody/p24 Antigen
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 083938 HIV 1/2 Ab Differentiation 083908 HIV 2 Ab 81641-3
Reflex Table for T pallidum Antibodies
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 082361 PrEP: RPR 006097 RPR 20507-0
Reflex 2 006476 RPR, Quant 006476 RPR, Quant titer 31147-2
Reflex Table for T pallidum Antibodies
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 082361 PrEP: RPR 006097 RPR 20507-0
Reflex 2 163038 T pallidum Antibody, EIA 163038 T pallidum Antibody, EIA 34147-9
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 Rfx to HBcIgM
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 144722 PrEP: Hep B Core Ab, IgM 016881 Hep B Core Ab, IgM 24113-3
Reflex Table for HCV Ab
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 144030 Interpretation: 144030 Interpretation: 13955-0
Reflex Table for HCV Ab
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 550644 HCV RT-PCR, Quant (Non-Graph) 550338 Hepatitis C Quantitation IU/mL 11011-4
Reflex 2 550352 HCV RNA (International Units) 550353 HCV RNA (International Units) IU/mL 11011-4
Reflex Table for HCV Ab
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 550644 HCV RT-PCR, Quant (Non-Graph) 550338 Hepatitis C Quantitation IU/mL 11011-4
Reflex 2 550352 HCV RNA (International Units) 550354 HCV log10 log10 IU/mL 38180-6
Reflex Table for HCV Ab
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 550644 HCV RT-PCR, Quant (Non-Graph) 550339 HCV log10 log10 IU/mL 38180-6
Reflex Table for HCV Ab
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 550644 HCV RT-PCR, Quant (Non-Graph) 550314 Test Information: 19147-8
Reflex Table for HCV Ab
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 550644 HCV RT-PCR, Quant (Non-Graph) 550396 Interpretation: 62365-2

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