Human Immunodeficiency Virus Serology

Transcription

1 Participant No: _ Human Immunodeficiency Virus Serology Survey No: RT :20 Please print the document labelled Clinical Notes & Test Instructions at the top of this module list for details of specimens to test. Enter your results at the RCPAQAP Serology website > Direct Data Entry Clerical Error Clerical errors are occasionally included in questionnaires. demographic data that has the clerical error. Please circle the specimen and tick the appropriate : A, B (circle) First Name Last Name Kit Information Please supply kit lot number and expiry date (Please write expiry date as Mmm/yy example, Nov 17) If you have changed kits since the last RCPAQAP Serology survey, OR have not previously supplied your kit details to the RCPAQAP Serology, please provide us with your new kit details Test Results Units for example, S/CO Cut-off value is the absolute value that designates the cut-off point below which is negative or equivocal, and above or equal to is low positive or positive. Do not use >,,, < for cut-off value. Enter N/A (not applicable) if any of the above do not relate to your test for example, a latex agglutination test HIV Ag/ Ab Combination Testing HIV Ag/Ab Combination (Screening Assay) No. Value Ab Value Ag Circle test result Cut-off: (do not use >,,, Units: <) HIV Ag/Ab Combination No. Value Ab Value Ag Circle test result Cut-off: (do not use >,,, Units: <) If your kit provides a combined result value for HIV antigen and HIV antibody, please enter this value at BOTH the Value Ab and Value Ag result entry fields. RS17-HIV Page 1 of 5

2 HIV Antibody 1 & 2 ONLY Testing HIV Antibody 1 & 2 ONLY (Screening Assay) HIV Antibody 1 & 2 ONLY No. Value Circle test result No. Value Circle test result Cut-off: (do not use >,,, <) Units: Cut-off: (do not use >,,, <) Units: HIV Antibody 2 ONLY Testing HIV Antibody 2 ONLY No. Value Circle test result Cut-off: (do not use >,,, <) Units: HIV Antigen ONLY Testing HIV Antigen ONLY HIV Antigen ONLY No. Value Circle test result No. Value Circle test result Cut-off: (do not use >,,, <) Units: Cut-off: (do not use >,,, <) Units: RS17-HIV Page 2 of 5

3 HIV Antibody Confirmatory Testing HIV 1/2 Antibody Please NOTE Result options: neg (negative), pos (positive), HIV-1 Pos, HIV-2 Pos, ind (indeterminate), ind+hiv-2, insuff (insufficient), HIV-2 indicated or not tested. BioRad Geenius HIV gp41 p24 gp160 p31 gp140 gp36 MP Biomedicals BLOT gp160 gp120 p66 p55 p51 gp41 p39 p31 p24 p17 HIV-2 Fujirebio Inno-LIA HIV sgp120 gp41 p31 p24 p17 sgp105 gp36 RS17-HIV Page 3 of 5

4 HIV Antibody Confirmatory Testing (continued) HIV 1 Only Antibody BioRad New LAV HIV-1 gp160 gp110/120 p68/66 p55 p52/51 gp41 p40 p34/31 p24/25 p18/17 MP Biomedicals BLOT gp160 gp120 p66 p55 p51 gp41 p39 p31 p24 p17 HIV 2 Only Antibody BioRad New LAV HIV-II gp140 gp105 p68 p56 gp36 p34 p26 p16 MP Biomedicals -Blot gp125 gp80 p68 p56 p53 gp36 p26 RS17-HIV Page 4 of 5

5 Interpretative Comment For the purposes of data management, please use the comments provided. It is acceptable to tick more than one comment per specimen. Interpretative Comment for HIV A B 1 No evidence of HIV 1/2 infection, suggest repeat testing if clinically indicated 2 No evidence of HIV 1/2 infection, HIV p24 Ag testing should be performed if the individual is suspected to be at risk of acute HIV infection or have seroconversion illness 3 Refer for HIV Ag testing and subsequent neutralisation testing as required 4 Refer for HIV Ab confirmatory immunoblot testing Serology is consistent with acute HIV infection, please send another serum sample to confirm result Serology is consistent with HIV infection, please send another serum sample to confirm result Serology results are inconclusive, please send another serum sample for repeat testing 8 Perform HIV Ab or HIV Ag/Ab combination screening testing 9 Refer for HIV-2 Ab supplementary and/or confirmatory immunoblot testing 10 Refer for HIV nucleic acid testing 11 Send to HIV Reference Laboratory 12 Serology is consistent with HIV-2 infection, please send another serum sample to confirm result 13 No comment or Not tested RS17-HIV Page 5 of 5