Ordering Recommendation

Evaluate the ability of a patient to produce antibody to pure protein vaccines (diphtheria and tetanus) and protein conjugated bacterial (H. influenzae) vaccines after vaccination to rule out antibody deficiency.

Mnemonic
DTH
Methodology

Quantitative Multiplex Bead Assay

Performed

Sun-Sat

Reported

1-2 days

New York DOH Approval Status
This test is New York DOH approved.
Specimen Required
Patient Preparation
Collect

Serum separator tube.

Specimen Preparation

Transfer 1.5 mL serum to an ARUP Standard Transport Tube. (Min: 0.45 mL) Acute and convalescent specimens must be labeled as such. Clearly mark specimens as "Pre-Vaccine" or "Post-Vaccine". Parallel testing is preferred and convalescent specimens must be received within 30 days from receipt of the acute specimens.

Storage/Transport Temperature

Refrigerated.

Unacceptable Conditions

Plasma or other body fluids. Contaminated, hemolyzed, or severely lipemic specimens.

Remarks
Stability

After separation from cells: Ambient: 48 hours; Refrigerated: 2 weeks; Frozen: 1 year (avoid repeated freeze/thaw cycles)

Reference Interval

Diphtheria and tetanus:
Antibody concentration of  > 0.1 IU/mL is usually considered protective for diphtheria or tetanus.

Haemophilus influenzae type B:
< 1.0 µg/mL = Antibody concentration not protective.
> 1.0 µg/mL = Antibody to H. influenzae type B detected.  Suggestive of protection.

Interpretive Data

Responder status is determined according to the ratio of a one-month, post-vaccination sample to pre-vaccination concentration of IgG antibodies as follows:

Diphtheria and tetanus:
1.  If the post-vaccination concentration is less than 1.0 IU/mL, the patient is considered a nonresponder.
2.  If the post-vaccination concentration is greater than or equal to 1.0 IU/mL, a patient with a ratio of less than 1.5 is a nonresponder, and a ratio of 1.5 to less than 3.0 is a weak responder, and a ratio of 3.0 or greater is a good responder.
3.  If the pre-vaccination concentration is greater than 1.0 IU/mL, it may be difficult to assess the response based on a ratio alone.  A post-vaccination concentration above 2.5 IU in this case is usually adequate.

Haemophilus influenza B:
1.  If the post-vaccination concentration is < 3.0 µg/mL, the patient is considered to be a nonresponder.
2.  If the post-vaccination concentration is 3.0 µg/mL, a patient with a ratio of 4 is a good responder, a ratio of 2-4 is weak responder, and a ratio of < 2 is considered a nonresponder.

Compliance Category

Laboratory Developed Test (LDT)

Note
Hotline History
N/A
CPT Codes

86317 x3

Components
Component Test Code* Component Chart Name LOINC
0050210 Diphtheria Antibody, IgG 13227-4
0050535 Tetanus Antibody, IgG 53935-3
0050542 Haemophilus influenzae b Antibody, IgG 11256-5
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.
Aliases
  • Anti-tetanus toxoid
  • C. tetani
  • Clostridium tetani
  • Corynebacterium diphtheriae Antitoxin
  • Diphtheria Antitoxoid
  • HIB
  • Tetanus Immune Response
  • Tetanus toxoid antibodies
  • Tetanus/Diphtheria Antibody Panel
Diphtheria, Tetanus, and H. Influenzae b Antibodies, IgG