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HTLV I/II Antibodies with Reflex to Confirmation

Test Codes

EPIC: LAB6059, Beaker: XHTLV, Mayo: HTLVI

Department

Send Outs

Instructions

Patients with positive results by ELISA will reflex to confirmation by Western Blot.

Specimen Collection Criteria

Collect (preferred specimen): One Gold-top SST tube.
Also acceptable: One plain Red-top tube

Send specimen for processing immediately after collection.

Physician Office/Draw Specimen Preparation

Centrifuge to separate serum from cells within two hours of collection. Transfer serum to a plastic transport tube and freeze (-20°C/-4°F or below) immediately.

Preparation for Courier Transport

Transport: 1.0 mL serum, frozen (-20°C/-4°F or below). (Minimum: 0.6 mL)

Rejection Criteria

• Grossly hemolyzed specimen
• Grossly lipemic specimen
• Grossly icteric specimen
• Specimens not collected and processed as indicated.

In-Lab Processing

Centrifuge to separate serum from cells within two hours of collection. Transfer serum to a plastic transport tube and freeze (-20°C/-4°F or below) immediately.

Transport: 1.0 mL serum, frozen (-20°C/-4°F or below). (Minimum: 0.6 mL)

Storage

Specimen Stability for Testing:

Room Temperature (20-26°C or 68-78.8°F): Unacceptable
Refrigerated (2-8°C or 36-46°F): 7 days
Frozen (-20°C/-4°F or below): 28 days

Specimen Storage in Department Prior to Disposal:

Specimen retention time is determined by the policy of the reference laboratory. Contact the Send Outs Laboratory with any questions.

Laboratory

Sent to Mayo Clinic Laboratories in Rochester, MN.

Performed

Monday – Friday.
Results available in 2-5 days.

Reference Range

Negative.

Test Methodology

Enzyme Immunoassay (EIA).

Interpretation

By report.

Clinical Disease

Human T-Cell Lymphotropic Virus-1 (HTLV-1) has been associated with adult T-cell leukemia (ATL) and may play an indirect role in the pathocenesis of some B-cell chronic lymphocytic leukemia (CLL) cases. HTLV-1 has also been associated with chronic neurologic diseases including tropical spastic paraparesis (TSP) and HTLV-associated myelopathy (HAM). (1)

Disease Reporting

This is a reportable infection and positive results will be reported to the Oakland County Health Department. For more information on reportable diseases, contact the Epidemiology Department at (248) 551-4040.

Epidemiology

HTLV-1 is primarily endemic in southwestern Japan and the Caribbean, however, parts of sub-Saharan Africa and Central and South America also have significant seroprevalence. Increased seropositivity has been observed in the Southwestern United States, the United Kingdom, and in countries with large Caribbean populations. Approximately 0.1% of males and 0.2% of females infected at childhood develop ATL as adults. HTLV-1 appears to have very little genetic variability. (1)

Incubation Period

10-30 years. Infection is assumed to be lifelong. HTLV-1 associated myelopathy sometimes develops just a few years after infection. (1)

Transmission

HTLV-1 is poorly contagious and transmission can occur via blood transfusion, contaminated needles, sexual contact, and from mother to child through breast feeding. (1)

Reference

1. Wiedbrauk D, Johnston SLG. Manual of Clinical Virology, Raven Press, New York, NY, 1993.

CPT Codes

86790, (86689 if indicated for confirmation).

Contacts

Last Updated

10/5/2023