Ordering Recommendation

In accordance with the recommended HIV laboratory testing algorithm, this antigen/antibody combination test (fourth generation) detects p24 antigen and antibodies to HIV-1 (groups M and O) and HIV-2. Repeatedly reactive HIV-1/HIV-2 antigen/antibody screening results are tested with an HIV-1/HIV-2 antibody differentiation assay. Negative or indeterminate results for the HIV-1/HIV-2 antibody differentiation assay are reflexed to a qualitative nucleic acid amplification test [Human Immunodeficiency Virus 1 and 2 (HIV-1/HIV-2) by Qualitative NAAT]. 

New York DOH Approval Status

This test is New York state approved.

Specimen Required

Patient Preparation
Collect

Serum separator tube (SST), lavender (EDTA), or pink (K2EDTA).

Specimen Preparation

Separate from cells within 24 hours of collection. Transfer 3 mL serum or plasma into an ARUP standard transport tube. (Min: 2.3 mL) Remove particulate material. This test requires a dedicated transport tube submitted only for the HIV PANEL assay.

Storage/Transport Temperature

Frozen.

Unacceptable Conditions

Heparinized or citrated plasma specimens. Specimens containing particulate material. Severely hemolyzed or heat-inactivated specimens.

Remarks
Stability

After separation from cells: Ambient: 24 hours (CRITICAL: SHIP FROZEN); Refrigerated: 5 days; Frozen: 6 weeks (avoid repeated freeze/thaw cycles)

Methodology

Qualitative Chemiluminescent Immunoassay (CLIA)/Qualitative Immunoassay/Qualitative Polymerase Chain Reaction (PCR)

Performed

Sun-Sat

Reported

1-2 days

Reference Interval

Effective November 12, 2018

Test Number
Components
Reference Interval
  HIV 1,2 Combo Antigen/Antibody Negative

Interpretive Data

This test should not be used for blood donor screening, associated reentry protocols, or for screening human cells, tissues, and cellular- and tissue-based products (HCT/P).

Compliance Category

FDA

Note

The fourth-generation screen test is for the simultaneous qualitative detection of human iImmunodeficiency virus type 1 (HIV-1) p24 antigen and antibodies to HIV type 1 (HIV-1 groups M and O) and HIV type 2 (HIV-2). Results of the screen cannot be used to distinguish between the presence of HIV-1 p24 antigen, HIV-1 antibody (Ab), or HIV-2 Ab.

If the HIV-1,2 combo antigen/Ab screen is repeatedly reactive, then the HIV-1/2 Ab differentiation immunoassay will be performed. Additional charges apply. The HIV-1/2 Ab differentiation immunoassay confirms and discriminates between HIV-1 and HIV-2 Abs. Results for each type are reported.

If the HIV-1/2 Ab differentiation immunoassay is Negative or Indeterminate, then the Human Immunodeficiency Virus 1 and 2 (HIV-1/HIV-2) by Qualitative NAAT will be added. Additional charges apply.

This multitest algorithm is recommended by the Centers for Disease Control and Prevention (CDC) and was adopted by the Clinical Laboratory Standards Institute (CLSI) for the diagnosis of HIV (refer to https://arupconsult.com/content/human-immunodeficiency-virus).

Refer to the following tests for additional information regarding Performed or Reported times, Interpretive Data, and Notes for the reflex tests of this panel:
Human Immunodeficiency Virus Types 1 and 2 (HIV-1/2) Antibody Differentiation, Supplemental with Reflex to HIV-1/HIV-2 Qualitative NAAT (ARUP test code 2012669); Human Immunodeficiency Virus 1 and 2 (HIV-1/HIV-2) by Qualitative NAAT (ARUP test code 3017779).

Hotline History

N/A

CPT Codes

87389; if reflexed, add 86701; 86702; 87535; 87538

Components

Component Test Code* Component Chart Name LOINC
2012675 HIV 1,2 Combo Antigen/Antibody 56888-1
* 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

  • Human Immunodeficiency Virus 1/O/2 (HIV-1/O/2) Antibodies, Preliminary Test With Confirmation
  • 4th generation, Human Immunodeficiency Virus (HIV) Combo Antigen/Antibody
  • Fourth generation HIV
  • HIV 1,2 Combo Antigen/Antibody
  • HIV Diagnosis
  • HIV-1/2 Antigen and Antibodies
  • Human Immunodeficiency Virus 1/O/2 (HIV-1/O/2) Antigen/Antibody (Fourth Generation) Preliminary Test
Human Immunodeficiency Virus (HIV) Combo Antigen/Antibody (HIV-1/O/2) by CIA, Reflexive Panel