Diagnostic services

The Special Infectious Disease Laboratories (SIDLs) of the HIV Program at the Children's Memorial Hospital offer both research-based and clinical diagnostic monitoring services to patients infected with human immunodeficiency virus type 1 (HIV-1). SIDLs are CLIA (ID#: 14D0665386) and JCAHO-certified laboratories and have served hospitals throughout Chicagoland and other states since 1989.

For more information about the lab's diagnostic services, please e-mail your inquiry to Bill Kabat.

The main telephone number is: 773.880.4907 or 880.6608; the fax number is 773.880.6609.

The SIDLs are located at 2300 Children's Plaza, #155, Chicago, IL 60614, USA .

The following is a comprehensive list of our services:

1. Detection of HIV-1 infection

Early detection of HIV-1 infection provides an opportunity for the most promising approach in treating and prolonging lives of patients who are infected with HIV-1. It allows immediate therapeutic intervention. Early treatment can slow disease progression and reduce morbidity due to potential opportunistic infections.

1.1. HIV-1 detection in newborn package

Please contact Children's for up-to-date pricing information.

Test code: IMDLA
Test package includes: Detection of HIV-1 proviral DNA by PCR, confirmation of HIV-1 infection by qualitative HIV-1 culture and by ICD-p24 assay.
Specimen requirement: Whole blood (min. 3.0 cc; optimal 4.0); store and transport at room temperature; specimen must be received within 48 hours of collection
Collection tubes: EDTA (lavender top) or ACD (yellow-top)
Test set up: Thursday
Test report time: 24 hours after set up time (for PCR and ICD-p24); 32 days for viral culture.

1.2. HIV-1 Detection in pediatric ( 9 month) or adult patients package

Test code: IMDLB
Test package includes: Detection of HIV-1 proviral DNA by PCR, confirmation of HIV-1 infection by Western blot, Qualitative HIV-1 culture and by ICD-p24 assay.
Specimen requirement: Whole blood (min. 3.0 cc; 4.0 cc optimal) for pediatric patients and 10 cc for adult; store and transport at room temperature; specimen must be received within 48 hours of collection
Collection tubes: EDTA (lavender top) or ACD (yellow-top)
Test set up: Thursday
Test report time: 24 hours after set up time (for PCR, Western blot and ICD-p24) 4 - 32 days (for viral culture)

1.3 HIV-1 Detection by PCR

Test code: IMDLC
Test: Roche Amplicor HIV-1 proviral DNA assay
Specimen requirement: Whole blood, min. 2.0 cc for pediatric patients and 10 cc for adults; store and transport at room temperature; specimen must be received within 48 hours of collection
Collection tubes: EDTA (lavender top) or ACD (yellow-top)
Test set up: Thursday
Test report time: 24 hours after set-up time

1.4 HIV-1 Detection by viral culture

Test code: IRCUB
Test: HIV-1 qualitative culture
Specimen type: Whole blood (min. 3.0 cc)
Collection tubes: EDTA (lavender top) or ACD (yellow-top)
Test set up: Daily
Turn around time: 4-32 days

1.5 Detection of HIV-1 infection by HIV-1 specific antibody assay

Test code: IVABB
Test: Enzyme Immunosorbant Assay (recombinant)
Specimen type: Serum (min. 1.0 cc), plasma acceptable
Collection tubes: Red top
Test set up: Daily
Turn around time: 24 hours

Note: Repeat positive results from this test will be confirmed by reflexive Western Blot, test code: IDWBB. Additional charge will be added.

1.6 Confirmation of HIV-1 infection by HIV-1 Western Blot

Test code: IDWBB
Test: HIV-1 Western blot
Specimen type: Serum (min. 1.0 cc), plasma acceptable
Collection tubes: Red top
Test set up: Daily
Turn around time: 24 hours

2. Tests for monitoring infection status and efficacy of antiviral drug treatment

HIV-1 viral RNA level is one of the virologic markers to prognose disease progression and patient's response to antiviral therapy. When prescribed anti-HIV drugs such as the "cocktail therapy" (also known as highly active antiretroviral therpay (HAART) are effective in fighting the AIDS virus in a patient, typically the viral RNA levels will drop >50% within 1-2 days after drug administration. More than 90% of the viruses will be eliminated after 7-14 days' drug therapy as determined by quantitative measurement of the viral RNA load. RT-PCR is now considered as one the most sensitive methods in measuring the viral RNA load from plasma. By introducing this new method, we can now accurately measure the viral level with a 24 hours turn-around, which offer physicians real-time scenario of the viruses responding to the antiviral therapy, and thus allow them to treat each individual patient accordingly.

2.1 HIV-1 viral level monitoring package:

(This package measures viral burden in both the plasma and cellular compartments)

Test code: IMDLD
Test package includes: Quantitation of HIV-1 viral RNA by RT-PCR, ICD-p24 antigen and quantitative HIV-1 culture.
Specimen type: Whole blood (min. 3.0 cc; 4.0 cc optimal) for pediatric patients and 10 cc for adults
Collection tubes: EDTA (lavender top) or ACT (yellow top).
Test set up: Tuesday
Test Report Time: 24 hours after set up time (for RT-PCR and ICD-p24) 18 days (for viral culture)

2.2 HIV-1 infection status monitoring package

Test code: IMDLE
Test package includes: Quantitation of HIV-1 viral RNA by RT-PCR, Immunodeficiency T-cell panel and HIV-1 MT-2 Phenotyping
Specimen type: Whole blood (min. 4.0 cc for pediatric patients and 10 cc for adults)
Collection tubes: EDTA (lavender top) or ACT (yellow top)
Test Set Up: Tuesday (RT-PCR), Daily (T-cell panel)
Test Report Time: 24 hours after set up time (for PCR and T-cell panel) 32 days (for MT-2 phenotyping)

2.3 Quantitation of plasma HIV-1 by viral RNA level

Test code: IMDLF
Test: Quantitative HIV-1 RNA PCR by Roche Monitor assay1
Specimen type: Whole blood (min. 3.0 cc for pediatric patients and 6 cc for adults)
Collection tubes: EDTA (lavender top) or ACT (yellow top)
Test Set Up: Tuesday
Test Report Time: 24 hours

2.4 Quantitation of cellular HIV-1 by viral culture

Test code: IRCQB
Test: Quantitative HIV-1 culture
Specimen type: Whole blood (min. 3.0 cc; 4.0 cc optimal) for pediatric patients and 10 cc for adults
Collection tubes: ACD (yellow top) or Heparin (green top)
Test set up: Daily
Turn around time: 18 days

2.5 Quantitation of plasma HIV-1 by viral culture

Test code: IRPLB
Test: Quantitative HIV-1 plasma culture
Specimen type: Whole blood (min. 4.0 cc for pediatric and 10 cc for adult patients)
Collection tubes: ACD (yellow top) preffered, or Heparin (green top)
Test set up: Daily
Turn around time: 18 days

2.6 Quantitation of HIV-1 p24 antigen level by standard assay

Test code: IRAGB
Test: Quantitative p24 antigen (standard)
Specimen type: Serum/plasma (min. 2.0 cc)
Collection tubes: ACD (yellow top) or Red top
Test set up: Tuesday and Thursday
Turn around time: 24 hours

2.7 Quantitation of HIV-1 p24 antigen level by ICD assay

Test code: IRICB
Test: Quantitative p24 Antigen (ICD)
Specimen type: Serum/plasma (min. 2.0 cc)
Collection tubes: ACD (yellow top) or Red top
Test set up: Tuesday and Thursday
Turn around time: 24 hours

2.8 Characterization of HIV-1 viral phenotype

Test code: IRMTB
Test: HIV-1 MT-2 Phenotype
Turn around time: 18 days
Comment: Requires previously isolated viral strains. If isolate is not available, qualitative viral culture is performed prior to this test adding 32 days.

2.9 HIV-1 immunodeficiency panel (quantitation of CD4/CD8 lymphocyte subsets by flow cytometry)

Test code: ITSS
Test: Flow Cytometry
Specimen type: Whole blood (min. 3.0 cc)
Collection tubes: EDTA (lavender top)
Test set up: Daily
Turn around time: 24 hours

3.0 Quantitation of HIV-1 proviral DNA in PBMC 5

Test code: IDNAQ
Test: Quantitative HIV-1 DNA by Real-time TaqMan PCR
Specimen type: PBMC (min. 2 x 10 6 ) or purified DNA
Collection tubes: EDTA (lavender top) or ACT (yellow top)
Test Set Up: Monday
Test Report Time: 48 hours

Note:

  1. Test results will include: Total T-cell (CD3%), (CD3+/CD4+ percent (T-helper subset); CD3+/CD8+ percent (T-suppressor), CD3+/CD19+ percent (B cells); CD3+/CD56+ + CD16+ (NK cells) and CD4:CD8 ratio.
  2. This panel provides the standard measure of CD4/CD8 ratio and includes B and NK subset numbers. This addition of B and NK subsets allows for optimal internal quality control for each specimen and provides information of reliable B and NK lymphocyte sub-populations.
  3. For absolute counts, a WBC must be performed at the time of T-cell draw. Submit WBC and % lymphocyte numbers and we will calculate absolute numbers for the client.
  4. A modified panal is available upon request at lesser charge. Please inquire for details.
  5. For research use only. Not for diagnostic purpose.

Monitoring and detection of HIV antiviral resistant mutations

During the antiviral drugs therapy, inevitably, the drugs will lose their effectiveness because of mutations within the viruses. With our AZT drug resistant RT codon 215 detection and phenotypic drug susceptibility methods, we can determine whether drug-resistant viruses are present in the patients. Through this detection, the physician can prepare for changes by switching treatments and drug therapies that will continue to battle the virus.

3.1 HIV-1 drug resistance assay

Test code: RCQB
Test: Drug susceptibility test in culture
Comment: Culture assay requires previously isolated viral stains
Turn around time: 21 days

3.2 HIV-1 genotyping of reverse transcriptase and protease genes 1

Test code: IGENO
Test: HIV-1 Genotyping
Collection tubes: EDTA (lavender top) or ACT (yellow top)
Test Set Up: First week of each month
Test Report Time: 4 days

1. For research only. Not for diagnostic purpose.