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The Digestive Health - Advanced contains the following tests

• C-Reactive Protein (CRP) 
• CBC (includes Differential and Platelets) 
• Comprehensive Metabolic Panel (CMP)
• Fecal Globin by Immunochemistry (InSure®) 
• Ferritin
• Folate, Serum
• Iron and Total Iron Binding Capacity (TIBC)
• QuestAssureD™ 25-Hydroxyvitamin D (D2, D3), LC/MS/MS 
• Sed Rate by Modified Westergren (ESR)
• Transferrin
• Vitamin B12 (Cobalamin) 
• Celiac Disease Comprehensive Panel (w/ Reflexes)

Specimens from children less than 4 years of age (i.e., less than 48 months) are not appropriate for this test. The test for children 4 years of age and younger is the Celiac Disease Comprehensive Panel, Infant (test code 15981).

Includes

Tissue Transglutaminase, IgA with Reflexes; Total IgA with Reflex

IMPORTANT - Note this is Reflex Test which if additional tests are run you will be charged for the specific tests that the lab peforms. Additional test will be run if the following criteria are met.

If the Tissue Transglutaminase IgA is positive, 

1. Endomysial Antibody Screen (IgA) will be performed at an additional charge (CPT code(s): 86255).

If the Endomysial Antibody Screen (IgA) is positive, 

2. Endomysial Antibody Titer will be performed at an additional charge (CPT code(s): 86256).

If the Total IgA is less than the lower limit of the reference range, based on age, 

3. Tissue Transglutaminase IgG will be performed at an additional charge (CPT code(s): 83516).

Clinical Significance

Celiac disease is caused by an immune response to gluten in genetically sensitive individuals. The diagnosis is largely based on a biopsy of the small intestine, but serologic tests also help support a diagnosis and may assist identification of patients who may require biopsy.

Tissue transglutaminase antibodies (tTG, IgA) is a marker with 95% sensitivity and specificity. Total IgA is measured because 2-3% of celiac disease patients are IgA deficient. Because tTG, IgA, and anti-Gliadin IgA tend to decrease in patients on a gluten-free diet, these markers are also used to assess dietary compliance.

The endomysial antibody (EMA, IgA) assay has high specificity for celiac disease and is used to confirm positive anti-tTG results.

Digestive Health - Basic contains the following tests

• CBC (includes Differential and Platelets) 
• Comprehensive Metabolic Panel (CMP)
• Fecal Globin by Immunochemistry (InSure®) 
• Celiac Disease Comprehensive Panel (w/ Reflexes)

Specimens from children less than 4 years of age (i.e., less than 48 months) are not appropriate for this test. The test for children 4 years of age and younger is the Celiac Disease Comprehensive Panel, Infant (test code 15981).

Includes

Tissue Transglutaminase, IgA with Reflexes; Total IgA with Reflex

IMPORTANT - Note this is Reflex Test which if additional tests are run you will be charged for the specific tests that the lab peforms. Additional test will be run if the following criteria are met.

If the Tissue Transglutaminase IgA is positive, 

1. Endomysial Antibody Screen (IgA) will be performed at an additional charge (CPT code(s): 86255).

If the Endomysial Antibody Screen (IgA) is positive, 

2. Endomysial Antibody Titer will be performed at an additional charge (CPT code(s): 86256).

If the Total IgA is less than the lower limit of the reference range, based on age, 

3. Tissue Transglutaminase IgG will be performed at an additional charge (CPT code(s): 83516).

Clinical Significance

Celiac disease is caused by an immune response to gluten in genetically sensitive individuals. The diagnosis is largely based on a biopsy of the small intestine, but serologic tests also help support a diagnosis and may assist identification of patients who may require biopsy.

Tissue transglutaminase antibodies (tTG, IgA) is a marker with 95% sensitivity and specificity. Total IgA is measured because 2-3% of celiac disease patients are IgA deficient. Because tTG, IgA, and anti-Gliadin IgA tend to decrease in patients on a gluten-free diet, these markers are also used to assess dietary compliance.

The endomysial antibody (EMA, IgA) assay has high specificity for celiac disease and is used to confirm positive anti-tTG results.

Digestive Health - Basic Plus contains the followwing tests: 

• C-Reactive Protein (CRP) 
• CBC (includes Differential and Platelets) 
• Comprehensive Metabolic Panel (CMP)
• Fecal Globin by Immunochemistry (InSure®) 
• Ferritin
• Iron and Total Iron Binding Capacity (TIBC)
• Sed Rate by Modified Westergren (ESR)
• Celiac Disease Comprehensive Panel (w/ Reflexes)

 Specimens from children less than 4 years of age (i.e., less than 48 months) are not appropriate for this test. The test for children 4 years of age and younger is the Celiac Disease Comprehensive Panel, Infant (test code 15981).

Includes

Tissue Transglutaminase, IgA with Reflexes; Total IgA with Reflex

IMPORTANT - Note this is Reflex Test which if additional tests are run you will be charged for the specific tests that the lab peforms. Additional test will be run if the following criteria are met.

If the Tissue Transglutaminase IgA is positive, 

1. Endomysial Antibody Screen (IgA) will be performed at an additional charge (CPT code(s): 86255).

If the Endomysial Antibody Screen (IgA) is positive, 

2. Endomysial Antibody Titer will be performed at an additional charge (CPT code(s): 86256).

If the Total IgA is less than the lower limit of the reference range, based on age, 

3. Tissue Transglutaminase IgG will be performed at an additional charge (CPT code(s): 83516).

Clinical Significance

Celiac disease is caused by an immune response to gluten in genetically sensitive individuals. The diagnosis is largely based on a biopsy of the small intestine, but serologic tests also help support a diagnosis and may assist identification of patients who may require biopsy.

Tissue transglutaminase antibodies (tTG, IgA) is a marker with 95% sensitivity and specificity. Total IgA is measured because 2-3% of celiac disease patients are IgA deficient. Because tTG, IgA, and anti-Gliadin IgA tend to decrease in patients on a gluten-free diet, these markers are also used to assess dietary compliance.

The endomysial antibody (EMA, IgA) assay has high specificity for celiac disease and is used to confirm positive anti-tTG results.

Digestive Health - Comprehensive contains the following tests: 

• C-Reactive Protein (CRP) 
• CBC (includes Differential and Platelets) 
• Comprehensive Metabolic Panel (CMP)
• Fecal Globin by Immunochemistry (InSure®) 
• Ferritin
• Folate, Serum
• Gliadin (Deamidated Peptide) Antibody (IgA) 
• Gliadin (Deamidated Peptide) Antibody (IgG) 
• Iron and Total Iron Binding Capacity (TIBC)
• Lipid Panel with Ratios
• Magnesium
• Prealbumin 
• QuestAssureD™ 25-Hydroxyvitamin D (D2, D3), LC/MS/MS 
• Sed Rate by Modified Westergren (ESR)
• Transferrin
• TSH
• Vitamin A (Retinol)
• Vitamin B12 (Cobalamin) 
• Vitamin K
• Celiac Disease Comprehensive Panel (w/ Reflexes)

Specimens from children less than 4 years of age (i.e., less than 48 months) are not appropriate for this test. The test for children 4 years of age and younger is the Celiac Disease Comprehensive Panel, Infant (test code 15981).

Includes

Tissue Transglutaminase, IgA with Reflexes; Total IgA with Reflex

IMPORTANT - Note this is Reflex Test which if additional tests are run you will be charged for the specific tests that the lab peforms. Additional test will be run if the following criteria are met.

If the Tissue Transglutaminase IgA is positive, 

1. Endomysial Antibody Screen (IgA) will be performed at an additional charge (CPT code(s): 86255).

If the Endomysial Antibody Screen (IgA) is positive, 

2. Endomysial Antibody Titer will be performed at an additional charge (CPT code(s): 86256).

If the Total IgA is less than the lower limit of the reference range, based on age, 

3. Tissue Transglutaminase IgG will be performed at an additional charge (CPT code(s): 83516).

Clinical Significance

Celiac disease is caused by an immune response to gluten in genetically sensitive individuals. The diagnosis is largely based on a biopsy of the small intestine, but serologic tests also help support a diagnosis and may assist identification of patients who may require biopsy.

Tissue transglutaminase antibodies (tTG, IgA) is a marker with 95% sensitivity and specificity. Total IgA is measured because 2-3% of celiac disease patients are IgA deficient. Because tTG, IgA, and anti-Gliadin IgA tend to decrease in patients on a gluten-free diet, these markers are also used to assess dietary compliance.

The endomysial antibody (EMA, IgA) assay has high specificity for celiac disease and is used to confirm positive anti-tTG results.

IMPORTANT - Note the Estradiol test included in this panel is not for children that have yet to start their menstrual cycle.  If this test is ordered for a child that has yet to begin their menstrual cycle Quest Diagnostics labs will substitute Estradiol, Free, LC/MS/MS at an additional fee of $290.00

IMPORTANT - Note the Estradiol test included in this panel is not for children that have yet to start their menstrual cycle.  If this test is ordered for a child that has yet to begin their menstrual cycle Quest Diagnostics labs will substitute Estradiol, Free, LC/MS/MS at an additional fee of $290.00

IMPORTANT - Note the Estradiol test included in this panel is not for children that have yet to start their menstrual cycle.  If this test is ordered for a child that has yet to begin their menstrual cycle Quest Diagnostics labs will substitute Estradiol, Free, LC/MS/MS at an additional fee of $290.00

IMPORTANT - Note the Estradiol test included in this panel is not for children that have yet to start their menstrual cycle.  If this test is ordered for a child that has yet to begin their menstrual cycle Quest Diagnostics labs will substitute Estradiol, Free, LC/MS/MS at an additional fee of $290.00

IMPORTANT - Note the Estradiol test included in this panel is not for children that have yet to start their menstrual cycle.  If this test is ordered for a child that has yet to begin their menstrual cycle Quest Diagnostics labs will substitute Estradiol, Free, LC/MS/MS at an additional fee of $290.00

Keto Lab Test Panel - Comprehensive includes the following tests.

• Apolipoprotein B, Cardio IQ™ 
• C-Peptide
• CBC (includes Differential and Platelets) 
• Comprehensive Metabolic Panel (CMP)
• Ferritin
• Hemoglobin A1c (HgbA1C)
• hs-CRP
• Insulin
• Lipid Panel, Cardio IQ™ 
• Lipoprotein (a), Cardio IQ™ 
• Lipoprotein Fractionation, Ion Mobility, Cardio IQ™ 
• Magnesium
• QuestAssureD™ 25-Hydroxyvitamin D (D2, D3), LC/MS/MS 
• T3, Free
• T4 (Thyroxine), Total
• TSH
• Uric Acid
• Urinalysis (UA), Complete
• Vitamin B12 (Cobalamin)

Keto Lab Test Panel - Basic Plus includes the following tests.

• CBC (includes Differential and Platelets)
• Comprehensive Metabolic Panel (CMP)
• Ferritin
• Hemoglobin A1c (HgbA1C)
• Insulin
• Lipid Panel, Cardio IQ™
• Lipoprotein (a), Cardio IQ™
• Lipoprotein Fractionation, Ion Mobility, Cardio IQ™
• QuestAssureD™ 25-Hydroxyvitamin D (D2, D3), LC/MS/MS
• T3, Free
• T4 (Thyroxine), Total
• TSH
• Uric Acid
• Urinalysis (UA), Complete

Keto Lab Test Panel - Basic includes the following tests.

• CBC (includes Differential and Platelets)
• Comprehensive Metabolic Panel (CMP)
• Hemoglobin A1c (HgbA1C)
• Insulin
• Lipid Panel, Cardio IQ™
• Lipoprotein Fractionation, Ion Mobility, Cardio IQ™
• TSH
• Uric Acid
• Urinalysis (UA), Complete

Keto Lab Test Panel - Advanced includes the following tests.

• C-Peptide
• CBC (includes Differential and Platelets)
• Comprehensive Metabolic Panel (CMP)
• Ferritin
• Hemoglobin A1c (HgbA1C)
• hs-CRP
• Insulin
• Lipid Panel, Cardio IQ™
• Lipoprotein (a), Cardio IQ™
• Lipoprotein Fractionation, Ion Mobility, Cardio IQ™
• QuestAssureD™ 25-Hydroxyvitamin D (D2, D3), LC/MS/MS
• T3, Free
• T4 (Thyroxine), Total
• TSH
• Uric Acid
• Urinalysis (UA), Complete

Lactate Dehydrogenase (LD) (LDH)

Elevations in serum lactate dehydrogenase occur from myocardial infarction, liver disease, pernicious and megaloblastic anemia, pulmonary emboli, malignancies, and muscular dystrophy

Measles Antibody IgG - to establish whether you have immunity to measles due to a previous infection or to vaccination.

Measles, also known as rubeola, causes fever, irritability, respiratory illness, and the characteristic skin rash. Immunization has greatly diminished the incidence of measles. The presence of IgG is consistent with immunity or prior exposure. 

Alternate Test Name: Measles Immunity Test

For diagnosis of hypothyroidism and hyperthyroidism.

Note: Free T4 Index (T7) will only be calculated and reported if test code code 861 (T3 Uptake) is ordered as well.

This test is useful in the differential diagnosis of male hypogonadism. For males 18 years of age and older only. Pediatric and Female patients will need to order Testosterone, Total, MS #15983.

Please note: If Testosterone, Total, Males (Adult) Only #873 is ordered for a pediatric or female patient, the lab will automatically change the test to and charge for Testosterone, Total, MS #15983.

Dipstick urinalysis is important in accessing the chemical constituents in the urine and the relationship to various disease states. Microscopic examination helps to detect the presence of cells and other formed elements.

Useful in the diagnosis of hypochromic, microcytic anemias. Decreased in iron deficiency anemia and increased in iron overload.

Measles Immunity Test - to establish whether you have immunity to measles due to a previous infection or to vaccination.

Measles, also known as rubeola, causes fever, irritability, respiratory illness, and the characteristic skin rash. Immunization has greatly diminished the incidence of measles. The presence of IgG is consistent with immunity or prior exposure. 

Alternate Test Name: Measles Antibody IgG

Cardio IQ® ASCVD Risk Panel with Score 

This panel provides the 10-year and lifetime risk of atherosclerotic cardiovascular disease (ASCVD) using lipid results with anthropomorphic data and family history. 
The ASCVD risk assessment is recommended in the 2013 ACC/AHA Guidelines on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults.

IMPORTANT: For risk calculations to be performed, the following patient-specific information must be provided and recorded at the time of specimen collection:

• Age: Years 
• Gender: M (for male) or F (for female) 
• Height Feet: Feet 
• Height Inches: Inches 
• Weight: lbs 
• Race-African American: Y (for yes) or N (for no) 
• Systolic Blood Pressure: mmHg
• Diastolic Blood Pressure: mmHg
• Treatment for High B.P.: Y (for yes) or N (for no) 
• Diabetes Status: Y (for yes) or N (for no)
• Parental History of Diab: Y (for yes) or N (for no) 
• Smoking Status: Y (for Yes) or N (for no)

Employer Wellness Screening Panel 1 contains the following tests:

• CBC (includes Differential and Platelets)
• Comprehensive Metabolic Panel (CMP)

Employer Wellness Screening Panel 2 contains the following tests:

• Comprehensive Metabolic Panel (CMP)
• Lipid Panel with Ratios

Employer Wellness Screening Panel  3 contains the following tests:

• CBC (includes Differential and Platelets)
• Comprehensive Metabolic Panel (CMP)
• TSH

Employer Wellness Screening Panel 4 contains the following tests:

• CBC (includes Differential and Platelets)
• Comprehensive Metabolic Panel (CMP)
• Lipid Panel with Ratios

Employer Wellness Screening Panel 5 contains the following tests:

• Comprehensive Metabolic Panel (CMP)
• Hemoglobin A1c (HgbA1C)
• Lipid Panel with Ratios

Employer Wellness Screening Panel 6 contains the following tests:

• T3, Free
• T4, Free
• TSH

Employer Wellness Screening Panel 7 contains the following tests:

• Homocysteine
• hs-CRP
• Lipid Panel with Ratios

Employer Wellness Screening Panel 8 contains the following tests:

• CBC (includes Differential and Platelets)
• Comprehensive Metabolic Panel (CMP)
• Hemoglobin A1c (HgbA1C)
• Lipid Panel with Ratios

Employer Wellness Screening Panel 9 (Women) contains the following tests:

• CBC (includes Differential and Platelets)
• Comprehensive Metabolic Panel (CMP)
• Estradiol
• TSH

Employer Wellness Screening Panel 10 (Male) contains the following tests:

• CBC (includes Differential and Platelets)
• Comprehensive Metabolic Panel (CMP)
• PSA Total
• TSH

Employer Wellness Screening Panel 11 contains the following tests:

• Comprehensive Metabolic Panel (CMP)
• Hemoglobin A1c (HgbA1C)
• hs-CRP
• Lipid Panel with Ratios

Employer Wellness Screening Panel 12 contains the following tests:

• CBC (includes Differential and Platelets)
• Comprehensive Metabolic Panel (CMP)
• Hemoglobin A1c (HgbA1C)
• Lipid Panel with Ratios
• TSH

Employer Wellness Screening Panel 13 (Male) contains the following tests:

• CBC (includes Differential and Platelets)
• Comprehensive Metabolic Panel (CMP)
• PSA Total
• Testosterone, Total, Males
• TSH

Employer Wellness Screening Panel 14 contains the following tests:

• CBC (includes Differential and Platelets)
• Comprehensive Metabolic Panel (CMP)
• Hemoglobin A1c (HgbA1C)
• hs-CRP
• Lipid Panel with Ratios
• TSH

Employer Wellness Screening Panel 15 (Female) contains the following tests:

• CBC (includes Differential and Platelets)
• Comprehensive Metabolic Panel (CMP)
• Estradiol
• FSH (Follicle Stimulating Hormone)
• LH
• TSH

Employer Wellness Screening Panel 16 contains the following tests:

• CBC (includes Differential and Platelets)
• Comprehensive Metabolic Panel (CMP)
• Hemoglobin A1c (HgbA1C)
• hs-CRP
• Iron and Total Iron Binding Capacity (TIBC)
• Lipid Panel with Ratios
• TSH

Employer Wellness Screening Panel 17 contains the following tests:

• CBC (includes Differential and Platelets)
• Comprehensive Metabolic Panel (CMP)
• Hemoglobin A1c (HgbA1C)
• hs-CRP
• Iron and Total Iron Binding Capacity (TIBC)
• Lipid Panel with Ratios
• TSH
• Vitamin D, 25-Hydroxy, Total, Immunoassay

Epstein-Barr Virus (EBV) Antibody Panel

Includes: Epstein-Barr Virus VCA Antibody (IgM), Epstein-Barr Virus VCA Antibody (IgG), Epstein-Barr Virus Nuclear Antigen (EBNA) Antibody (IgG)

Clinical Significance: Primary infection by EBV causes infectious mononucleosis, usually a self-limiting disease in children and young adults. Infection with EBV can cause lymphoproliferative disorders including tumors. VCA-IgM is typically detectable at clinical presentation, then declines to undetectable levels within a month in young children and within 3 months in other individuals. VCA-IgG is typically detectable at clinical presentation, and persists for life. EBNA IgG typically appears during convalescence (3-4 months after clinical presentation) and remains detectable for life.

EBV-VCA IgG/IgM (viral capsid antigen): A positive IgG means you’ve had or currently have the infection; A positive IgM means the virus has been reactivated.

EBV-EBNA IgG (nuclear antigen): A positive test result is usually associated with past infections.

Reference Range(s)

Epstein-Barr Virus VCA Antibody (IgM)

U/mLInterpretation

• <36.00 Negative
• 36.00-43.99Equivocal
• >43.99Positive

Epstein-Barr Virus VCA Antibody (IgG)

U/mLInterpretation

• <18.00 Negative
• 18.00-21.99Equivocal
• >21.99Positive

Epstein-Barr Virus Nuclear Antigen (EBNA) Antibody (IgG)

U/mLInterpretation

• <18.00 Negative
• 18.00-21.99Equivocal
• >21.99Positive

Alternative Name(s)

EBV Comprehensive,Infectious Mononucleosis Panel

Clinical Significance

Primary infection by EBV causes infectious mononucleosis, usually a self-limiting disease in children and young adults. Infection with EBV can cause lymphoproliferative disorders including tumors. IgG recognizing Early Antigen D typically appears within a month after clinical presentation and is transient, lasting only 3-4 months. Persistently elevated levels suggest reactivation or persistence of EBV infection.

The Epstein-Barr EBV Early Antigen D Ab IgG test that will let one know if the virus is actively replicating.

For the most comprehensive look at your biomarkers for Epstein-Barr (EBV), we recommend the Epstein-Barr (EBV) Comprehensive Panel, as only one may come out positive:

• EBV-VCA IgG/IgM (viral capsid antigen): A positive IgG means you’ve had or currently have the infection; A positive IgM means the virus has been reactivated.
• EBV-EBNA IgG (nuclear antigen): A positive test result is usually associated with past infections.
• EBV-EA-D IgG (early antigen): A positive EA IgG may mean you have an active or reactivated infection.

• The Epstein-Barr EBV Early Antigen D Ab IgG test that will let one know if the virus is actively replicating.

Epstein-Barr (EBV) is a virus that causes mononucleosis, also known as the kissing disease, is a viral infection that is thought to be transmitted through the saliva of those who are infected. The Epstein-Barr virus creates an inactive infection in the body where it lies dormant. It can awaken and reactivate itself, even many years after its initial activation.

The reactivated virus has the potential to induce many debilitating autoimmune symptoms. In some, the infection may not be adequately suppressed and may cause or exacerbate autoimmune diseases. 

The Epstein-Barr (EBV) tests are used to figure out if a person has a reactivated infection. 

Reference Range(s)

Epstein-Barr Virus VCA Antibody (IgM)

U/mLInterpretation

• <36.00 Negative
• 36.00-43.99 Equivocal
• >43.99 Positive

Epstein-Barr Virus VCA Antibody (IgG)

U/mLInterpretation

• <18.00 Negative
• 18.00-21.99 Equivocal
• >21.99 Positive

Epstein-Barr Virus Nuclear Antigen (EBNA) Antibody (IgG)

U/mLInterpretation

• <18.00 Negative
• 18.00-21.99 Equivocal
• >21.99 Positive

Epstein-Barr Virus Early Antigen D Antibody (IgG)

U/mLInterpretation

• <9.00 Negative
• 9.00-10.99 Equivocal
• >10.99 Positive

IMPORTANT - Note the Estradiol test included in this panel is not for children that have yet to start their menstrual cycle.  If this test is ordered for a child that has yet to begin their menstrual cycle Quest Diagnostics labs will substitute Estradiol, Free, LC/MS/MS at an additional fee of $290.00

IMPORTANT - Note the Estradiol test included in this panel is not for children that have yet to start their menstrual cycle.  If this test is ordered for a child that has yet to begin their menstrual cycle Quest Diagnostics labs will substitute Estradiol, Free, LC/MS/MS at an additional fee of $290.00

IMPORTANT - Note the Estradiol test included in this panel is not for children that have yet to start their menstrual cycle.  If this test is ordered for a child that has yet to begin their menstrual cycle Quest Diagnostics labs will substitute Estradiol, Free, LC/MS/MS at an additional fee of $290.00

IMPORTANT - Note the Estradiol test included in this panel is not for children that have yet to start their menstrual cycle.  If this test is ordered for a child that has yet to begin their menstrual cycle Quest Diagnostics labs will substitute Estradiol, Free, LC/MS/MS at an additional fee of $290.00

MMR (IgG) Panel (Measles, Mumps, Rubella) Titers - Includes Measles Antibody (IgG), Mumps Antibody (IgG), Rubella Immune Status

This panel provides presumptive evidence of immunity to measles, mumps, and rubella for purposes of routine vaccination, for students at post-high school educational institutions, and for international travelers.

Varicella-Zoster Virus (VZV) causes chicken pox and when reactivated, potentially decades later, causes shingles. Twenty percent of adults will develop shingles, a rash or blister of the skin that may cause severe pain. Varicella-Zoster IgG, EIA reliably measures immunity due to previous infection, but is unsuitable for detection of post-vaccination immune status.

The Varicella Zoster Virus Antibodies, IgG test is typically done to check for immunity to the virus which causes chickenpox.  Varicella Zoster Virus is a member of the Herpes Virus family.  This test measures the level of antibodies produced by the immune system in response to the virus.  Results provide a numerical value for the antibody level which can be compared to a reference interval to determine immune status.  IgG antibodies are typically detectable a few weeks after the initial infection.  In the United States, many people are vaccinated against Varicella when they are young.  In most cases those who contract the virus and recover develop a natural immunity which protects them from catching it again. 

The most common condition which results from infection with Varicella is Chickenpox.  The infection causes an outbreak of an itchy rash and the development of small fluid-filled blisters.  During the primary infection, chickenpox is highly contagious and spread through coughing, sneezing or touching fluid from the blisters.  Most people recover without treatment and the virus remains latent in their system.  There is a possibility for the virus to reactivate later in life, especially in those with weakened immune systems.  This can cause shingles, a condition characterized by a painful burning or itching sensation on one or more areas of the body.  Shingles typically clear up after a few weeks as the virus becomes latent again.

The Varicella IgG Antibody Titer is usually ordered when someone is required to show proof of immune status for work or school.  It may also be done for organ transplant patients or pregnant women.

The Varicella Titer is also available as part of our Immunity Panel which includes other common titer tests.

Tetanus Antitoxoid (Titer)

Clinical Significance

Tetanus is caused by Clostridium tetani. Immunization with Tetanus Antitoxoid is effective with boosters in immunocompetent individuals. Antibody levels > or = to 0.10 IU/mL are considered protective. However, tetanus can still occur in some individuals with such antibody levels. These results should not be used to determine the necessity to administer antitoxin when clinically indicated. For Pre and Post vaccination testing to assess normal immune response, please refer to Test Code 91424, Tetanus Antitoxoid, Pre and Post Vaccination.

Diphtheria and Tetanus Antitoxoid (Titer)

Clinical Significance

Used to evaluate diphtheria immunization response. Antibody levels of > or = to 0.10 IU/mL are considered protective. For Pre and Post vaccination testing to assess normal immune response, please refer to Test Code 10680, Diphtheria Antitoxoid, Pre and Post Vaccination.

Tetanus is caused by Clostridium tetani. Immunization with Tetanus Antitoxoid is effective with boosters in immunocompetent individuals. Antibody levels of > or = to 0.10 IU/mL are considered protective. However, tetanus can still occur in some individuals with such antibody levels. These results should not be used to determine the necessity to administer antitoxin when clinically indicated. For Pre and Post vaccination testing to assess normal immune response, please refer to Test Code 91424, Tetanus Antitoxoid, Pre and Post Vaccination.

Diphtheria Antitoxoid (DPT Titer)

Clinical Significance

Used to evaluate diphtheria immunization response. Antibody levels of > or = to 0.10 IU/mL are considered protective. For Pre and Post vaccination testing to assess normal immune response, please refer to Test Code 10680, Diphtheria Antitoxoid, Pre and Post Vaccination.

Alternative Name(s)

DPT Titer,Anti Diphtheria

Hepatitis A & B Titer Test

• Hepatitis A Antibody, Total
• Hepatitis A IgM Antibody
• Hepatitis B Surface Antigen with Reflex Confirmation
• Hepatitis B Surface Antibody Immunity, Quantitative
• Hepatitis B Core Antibody, Total

The Hepatitis A & B Titer Test is ordered when a person needs proof of immunity to Hepatitis A and B or just want to check their immune status.

The Hepatitis Titer Test includes immunity testing for both Hepatitis A and B.  Hepatitis is a viral disease which affects the liver.  Vaccinations for Hepatitis A and B can provide protective antibodies which immunize a person from catching the virus.  Additionally, a person who has been affected by Hepatitis A or B and recovers can develop natural immunity.  Titer testing looks for the antibodies which typically indicate that a person is immune to a particular virus or infection.

Hepatitis B Immunity

Not Immune and no active or prior infection; may be a good candidate for vaccine

• Hepatitis B Surface Antigen (HBsAg) = Negative
• Hepatitis B Surface Antibody (Anti-HBs) = Negative
• Hepatitis B Core Antibody, Total (Anti-HBc IgG+IgM) = Negative

Immunity due to vaccination

• Hepatitis B Surface Antigen (HBsAg) = Negative
• Hepatitis B Surface Antibody (Anti-HBs) = Positive
• Hepatitis B Core Antibody, Total (Anti-HBc IgG+IgM) = Negative

HEPATITIS B INFECTION

• Hepatitis B Surface Antigen (HBsAg) = Positive  A positive result indicates an infection, usually with symptoms; contagious; could also be a flare of a chronic infection

Hepatitis A immunity

Immunity

• Hepatitis A Antibody, Total = Positive
• Hepatitis A IgM Antibody = Negative

No active infection but previous HAV exposure; has developed immunity to HAV or recently vaccinated for HAV

No Immunity

• Hepatitis A Antibody, Total= Negative
• Hepatitis A IgM Antibody = Negative

No current or previous HAV infection; vaccine may be advised if at risk

HEPATITIS A INFECTION

• Hepatitis A IgM Antibody = Positive   A positive result indicates an acute or recent infection

Hepatitis A Titer Test Panel

• Hepatitis A Antibody, Total
• Hepatitis A IgM Antibody

The Hepatitis A Titer Test is ordered when a person needs proof of immunity to Hepatitis A or just want to check their immune status.

The Hepatitis A Titer Test includes immunity testing for Hepatitis A.  Hepatitis is a viral disease which affects the liver.  Vaccinations for Hepatitis A can provide protective antibodies which immunize a person from catching the virus.  Additionally, a person who has been affected by Hepatitis A and recovers can develop natural immunity.  Titer testing looks for the antibodies which typically indicate that a person is immune to a particular virus or infection.

Hepatitis A immunity

Immunity

• Hepatitis A Antibody, Total = Positive
• Hepatitis A IgM Antibody = Negative

No active infection but previous HAV exposure; has developed immunity to HAV or recently vaccinated for HAV

No Immunity

• Hepatitis A Antibody, Total= Negative
• Hepatitis A IgM Antibody = Negative

No current or previous HAV infection; vaccine may be advised if at risk

HEPATITIS A INFECTION

• Hepatitis A IgM Antibody = Positive   A positive result indicates an acute or recent infection

Hepatitis B Titer Test

• Hepatitis B Surface Antigen with Reflex Confirmation
• Hepatitis B Surface Antibody Immunity, Quantitative
• Hepatitis B Core Antibody, Total

The Hepatitis B Titer Test is ordered when a person needs proof of immunity to Hepatitis B or just want to check their immune status.

The Hepatitis Titer Test includes immunity testing for Hepatitis B.  Hepatitis is a viral disease which affects the liver.  Vaccinations for Hepatitis B can provide protective antibodies which immunize a person from catching the virus.  Additionally, a person who has been affected by Hepatitis B and recovers can develop natural immunity.  Titer testing looks for the antibodies which typically indicate that a person is immune to a particular virus or infection.

Hepatitis B Immunity

Not Immune and no active or prior infection; may be a good candidate for vaccine

• Hepatitis B Surface Antigen (HBsAg) = Negative
• Hepatitis B Surface Antibody (Anti-HBs) = Negative
• Hepatitis B Core Antibody, Total (Anti-HBc IgG+IgM) = Negative

Immunity due to vaccination

• Hepatitis B Surface Antigen (HBsAg) = Negative
• Hepatitis B Surface Antibody (Anti-HBs) = Positive
• Hepatitis B Core Antibody, Total (Anti-HBc IgG+IgM) = Negative

HEPATITIS B INFECTION

• Hepatitis B Surface Antigen (HBsAg) = Positive  A positive result indicates an infection, usually with symptoms; contagious; could also be a flare of a chronic infection.

Varicella-Zoster Virus Antibody (Immunity Screen), ACIF

Clinical Significance

A positive titer (≥1:4) by anticomplement immunofluorescence (ACIF) indicates a history of past infection by Varicella-Zoster virus (VZV). This antibody is usually detectable within 2 days after the onset of rash and is, thereafter, detectable for life. Conversely, the absence of detectable antibody can be used as evidence of susceptibility to varicella (chickenpox).

Immunity Panel

The Immunity Panel combines several common titer immunity tests for additional savings.  These tests are often ordered when someone needs proof of their immune status to common infectious diseases for work or school.  It may also be ordered for pregnant women as part of their prenatal testing. 

This package includes titers for: 

• Hepatitis B Surface Antibody, Quantitative
• MMR (IgG) Panel (Measles, Mumps, Rubella)
• Varicella-Zoster Virus Antibody (IgG)

For a testing package which also includes Hepatitis A, please see our Immunity Panel Plus.

Immunity Panel Plus

The Immunity Panel Plus combines several common titer immunity tests for additional savings.  These tests are often ordered when someone needs proof of their immune status to common infectious diseases for work or school.  It may also be ordered for pregnant women as part of their prenatal testing. 

This package includes titers for:

• Hepatitis A Antibody, Total
• Hepatitis B Surface Antibody, Quantitative
• MMR (IgG) Panel (Measles, Mumps, Rubella)
• Varicella-Zoster Virus Antibody (IgG)

Please note that the Hepatitis A Total Antibodies test included in this package does not provide numerical results.  Results for this test will be positive or negative only.

Tuberculosis (TB) Test - The QuantiFERON-TB Blood Test is used to aid in the diagnosis of both latent and active infections with the bacteria that causes Tuberculosis (TB). This test has been updated to offer the Quantiferon Gold Plus which has the same high level of specificity as the previous generation of testing along with an increased sensitivity of 94%.  This test is one of only 2 blood tests for TB approved by the FDA.  Tuberculosis is a bacterial disease that typically affects the lungs.  TB Bacteria is spread through the air from one person to another. While TB is not as common in the United States as it once was, there is the still a risk posed by TB infection.  It is estimated that 11 million people in the US have a latent Tuberculosis infection (LTBI).

Tuberculosis is a communicable disease caused by infection with M. tuberculosis complex. Infection results in either acute disease or Latent TB Infection (LTBI), a non-communicable asymptomatic condition. The main purpose of diagnosing the latent stage is to consider medical treatment for preventing overt disease. Until recently, the tuberculin skin test was the only available method for diagnosing LTBI.

QuantiFERON®-TB gold eliminates false positive skin test due to BCG vaccination and most Non-Tuberculous Mycobacteria (NTM) and is an objective, reproducible qualitative test. There are no side effects or adverse reactions due to patient hypersensitivity, and no "booster effect", whereby the first test induces a false positive response on re-testing. There is no need for follow-up patient visits to obtain test results.

The TB blood test has several advantages over a skin test.  Blood testing requires only one visit to the lab while skin testing requires multiple visits to a doctor's office.  Blood testing for Tuberculosis is typically more accurate than a skin test.  Skin testing has a higher likelihood of false positive results, especially if a person has been previously vaccinated for TB. 

Measles, Mumps, Rubella (MMR) Immunity Profile

MMR (IgG) Panel (Measles, Mumps, Rubella) Titers - Includes Measles Antibody (IgG), Mumps Antibody (IgG), Rubella Immune Status

This panel provides presumptive evidence of immunity to measles, mumps, and rubella for purposes of routine vaccination, for students at post-high school educational institutions, and for international travelers.

Measles Immunity Test - to establish whether you have immunity to measles due to a previous infection or to vaccination.

Measles, also known as rubeola, causes fever, irritability, respiratory illness, and the characteristic skin rash. Immunization has greatly diminished the incidence of measles. The presence of IgG is consistent with immunity or prior exposure. 

Alternate Test Name: Measles Antibody IgG

Bacterial Vaginosis/Vaginitis Panel (Trichomoniasis)

G. vaginalis is associated (in concert with other organisms) with bacterial vaginosis. Trichomonas and candida species are known agents of vaginitis.

Preferred Specimen(s)

Vaginal swab from the posterior fornix and the vaginal wall. Place swab immediately in the AFFIRM™ VPIII Ambient Temperature Transport System (ATTS).

One BD AFFIRM™ ATTS swab

Chlamydia trachomatis is associated with infections of the mucous membranes of the urogenital system, the upper respiratory tract, and the eye. In industrialized countries, C. trachomatis usually causes sexually transmitted disease. In developing countries, it is the major cause of preventable blindness (trachomatis). Sexually transmitted diseases caused by C. trachomatis include nongonococcal urethritis, cervicitis, salpingitis, epididymitis, proctitis and Lymphogranuloma venereum. Infections are often asymptomatic. Thus, infected individuals may unknowingly transmit chlamydial disease to others. Coinfection with C. trachomatis and Neisseria gonorrhoeae is common, with multiple chlamydial infections of the upper respiratory tract occurring primarily in newborns exposed at parturition through an infected birth canal. Approximately 10-20% of such infants develop pneumonia and 50% develop inclusion conjunctivitis. In adults, eye disease is often transmitted by the hands from genital secretions or from eye secretion of infected babies. Isolation in tissue culture remains the reference method for diagnosis of chlamydial infection, especially when testing individuals under the age of 13 years. The usefulness of serological tests depends on the site of infection, duration of disease, infecting serovars and pre-vious exposure to chlamydial antigens. Because C. trachomatis is ubiquitous, there is a high prevalence of antibodies in sexually active populations. Antibodies may persist even after treatment, making assessment of a single IgG titer difficult. Consequently, serological diag-nosis is seldom used to diagnose active, superficial genital tract infections.

Chlamydia trachomatis RNA, TMA

Patient Preparation 

Urine specimens: The patient should not have urinated for at least one hour prior to specimen collection. Female patients should not cleanse the labial area prior to providing the specimen.

Urine: Patient should not have urinated within one hour prior to collection. Female patients should not cleanse the labial area prior to providing the specimen. Direct patient to provide a first-catch urine (a maximum of 20-30 mL of the initial urine stream) into a urine collection cup free of any preservatives. 2 mL of urine specimen must be transferred into the APTIMA® specimen transport within 24 hours of collection and before being assayed. Use tube provided in the urine specimen collection kit for urine specimens. The fluid (urine plus transport media) level in the urine tube must fall within the clear pane on the tube labe

Clinical Significance

C. trachomatis infections are the leading cause of sexually transmitted diseases in the united states. C. trachomatis is known to cause cervicitis, pelvic inflammatory disease (PID), epididymitis and proctitis. It is also the most frequent cause of non-gonococcal urethritis in men. Among women, the consequences of chlamydial infections are severe if left untreated. Approximately half of chlamydial infections are asymptomatic.

Chlamydia/Neisseria gonorrhoeae RNA, TMA

Patient Preparation 

Urine specimen: The patient should not have urinated for at least one hour prior to specimen collection. Female patients should not cleanse the labial area prior to providing the specimen.

Urine: Patient should not have urinated within one hour prior to collection. Female patients should not cleanse the labial area prior to providing the specimen. Direct patient to provide a first-catch urine (a maximum of 20-30 mL of the initial urine stream) into a urine collection cup free of any preservatives. 2 mL of urine specimen must be transferred into the APTIMA® specimen transport within 24 hours of collection and before being assayed. Use tube provided in the urine specimen collection kit for urine specimens. The fluid (urine plus transport media) level in the urine tube must fall within the clear pane on the tube label.

Clinical Significance

C. trachomatis infections are the leading cause of sexually transmitted diseases in the United States. C. trachomatis is known to cause cervicitis, pelvic inflammatory disease (PID), epididymitis and proctitis. It is also the most frequent cause of non-gonococcal urethritis in men. Among women, the consequences of Chlamydialinfections are severe if left untreated. Approximately half of Chlamydial infections are asymptomatic.
Neisseria gonorrhoeae (gonococci) is the causative agent of gonorrhea. In men, this disease generally results in anterior urethritis accompanied by purulent exudate. In women, the disease is most often found in the cervix, but the vagina and uterus may also be infected.

Syphilis FTA-ABS (Confirmation for Syphilis RPR test)

FTA-ABS - Treponema pallidum Ab

Clinical Significance

The FTA-ABS is a specific treponemal assay to detect antibody to t. Pallidum. The FTA-ABS becomes reactive 4-6 weeks after infection. Unlike the nontreponemal tests, once the FTA-ABS test becomes reactive, it will remain reactive for many years. Since the reactivity found with the FTA-ABS does not indicate response to therapy, it is not suitable for monitoring treatment. The FTA-ABS test does not distinguish between syphillis and other treponematoses such as yaws, pinta and bejil.

The treponemal antibody test (FTA-ABS) is often used as an initial test. A positive result indicates the presence of syphilis antibodies in the blood, but since treponemal antibodies remain positive even after an infection has been treated, it does not indicate whether the person has a current infection or was infected in the past. Conversely, nontreponemal antibodies as detected with an RPR typically disappear in an adequately treated person after about 3 years. Thus, if an initial treponemal test is positive, an RPR can be performed to differentiate between an active or past infection. In this case, a positive RPR would confirm that the person has been exposed to syphilis and, if not treated previously, has an active infection or, if treatment had occurred more than 3 years ago, possible re-infection.

Alternative Name(s) 

Treponemal pallidum, Fluorescent Treponemal Antigen, Syphilis

Hepatitis C Antibody with Reflex to HCV, RNA, Quantitative, Real-Time PCR 

IMPORTANT: If Hepatitis C Antibody is reactive, then the Hepatitis C Viral RNA, Quantitative, Real-Time PCR test will be performed at an additional charge of $129.00.

Limitations

Results obtained from immunosuppressed patients should be interpreted with caution. Patients receiving mouse antibody therapy may produce false-negative results.

Reference Range(s)

Hepatitis C Antibody  Non-Reactive

Signal to Cut-off<1.00

Clinical Significance

Hepatitis C Virus (HCV) is a major cause of hepatitis. The clinical symptoms of an HCV infection are variable. Infection with HCV results in a chronic infection in 50 to 80% of cases. The "window" between HCV acquisition and seroreactivity is highly variable; up to six months.

Alternative Name(s)

HCV with Reflex,HCV Antibody,Anti HCV

Includes

Hepatitis A Antibody, Total; Hepatitis B Surface Antibody, Qualitative; Hepatitis B Surface Antigen with Reflex Confirmation; Hepatitis B Core Antibody, Total; Hepatitis C Antibody with Reflex to HCV, RNA, Quantitative, Real-Time PCR

Hepatitis B Surface Antigen with Reflex Confirmation: Positive samples will be confirmed based on the manufacturer's FDA approved recommendations at an additional charge (CPT code(s): 87341).

If Hepatitis C Antibody is reactive, Hepatitis C Viral RNA, Quantitative, Real-Time PCR will be performed at an additional charge (CPT code(s): 87522).

Neisseria gonorrhoeae RNA, TMA 

Patient Preparation 

Urine specimen: The patient should not have urinated for at least one hour prior to specimen collection. Female patients should not cleanse the labial area prior to providing the specimen.

2 mL urine using APTIMA® Urine Specimen Collection Kit.

Alternative Specimen(s) 

Urine (no preservatives): 2 mL of urine, specimen must be transferred into the APTIMA® Urine Transport Medium within 24 hours of collection and before being assayed • ThinPrep® vial • SurePath™ vial

Urine: Patient should not have urinated within one hour prior to collection. Female patients should not cleanse the labial area prior to providing the specimen. Direct patient to provide a first-catch urine (a maximum of 20-30 mL of the initial urine stream) into a urine collection cup free of any preservatives. 2 mL of urine specimen must be transferred into the APTIMA® specimen transport within 24 hours of collection and before being assayed. Use tube provided in the urine specimen collection kit for urine specimens. The fluid (urine plus transport media) level in the urine tube must fall within the clear pane on the tube label.

Transport Container 

APTIMA® Transport tube

Hepatitis A Antibody Test to diagnose the Hepatitis A Virus (HAV) in the blood. The hepatitis A test looks for antibodies to the HAV virus in the blood. These antibodies are proteins made by the body in response to the presence of the hepatitis A virus. Our type- specific hepatitis A antibody test is used to determine whether a person is or has been infected with the hepatitis A virus.

Hepatitis A Antibody, Total

This test is used to help diagnose a liver infection due to the hepatitis A virus. There are several causes of hepatitis and the accompanying symptoms, so this test may be used to determine if the symptoms are due to hepatitis A.

The total Hepatitis A antibody test detects both IgM and IgG antibodies and thus may be used to identify both current and past infections. This test will also be positive after receiving the vaccine, so sometimes it may be used to determine whether a person has developed immunity after vaccination.

A positive result Hepatitis A Antibody, Total that is not accompanied with Hepatitis A IgM test indicates  exposure to hepatitis A vairus but does not rule out acute infection. 

A Negative result Hepatitis A Antibody, Total that is not accompanied with Hepatitis A IgM test indicates no current or previous HAV infection; vaccine may be recommended if at risk.

The Hepatitis B test detects acute hepatitis B infections, and can also be used to help diagnose chronic hepatitis B infections. Detecting an early hepatitis B infection is important to avoid health complications. If the HBV test positive returns a positive result for hepatitis B, our labs will automatically run a confirmation test at no additional cost– This ensures that you receive the most sensitive and accurate results.

Hepatitis B Surface Antigen with Reflex Confirmation: Positive samples will be confirmed

Hepatitis B surface antigen (HBsAG) Detects protein that is present on the surface of the virus.  It is used to screen for, detect, and help diagnose acute and chronic hepatitis B virus (HBV) infections; earliest routine indicator of acute hepatitis B and frequently identifies infected people before symptoms appear; undetectable in the blood during the recovery period; it is the primary way of identifying those with chronic infections, including "hepatitis B virus (HBV) carrier" state.

Clinical Significance

Surface antigen usually appears in the serum after an incubation period of 1 to 6 months following exposure to Hepatitis B virus and peaks shortly after onset of symptoms. It typically disappears within 1 to 3 months. Persistence of Hepatitis B surface antigen for greater than 6 months is a prognostic indicator of chronic Hepatitis B infection.

Hepatitis A & B Titer Test

• Hepatitis A Antibody, Total
• Hepatitis A IgM Antibody
• Hepatitis B Surface Antigen with Reflex Confirmation
• Hepatitis B Surface Antibody Immunity, Quantitative
• Hepatitis B Core Antibody, Total

The Hepatitis A & B Titer Test is ordered when a person needs proof of immunity to Hepatitis A and B or just want to check their immune status.

The Hepatitis Titer Test includes immunity testing for both Hepatitis A and B.  Hepatitis is a viral disease which affects the liver.  Vaccinations for Hepatitis A and B can provide protective antibodies which immunize a person from catching the virus.  Additionally, a person who has been affected by Hepatitis A or B and recovers can develop natural immunity.  Titer testing looks for the antibodies which typically indicate that a person is immune to a particular virus or infection.

Hepatitis B Immunity

Not Immune and no active or prior infection; may be a good candidate for vaccine

• Hepatitis B Surface Antigen (HBsAg) = Negative
• Hepatitis B Surface Antibody (Anti-HBs) = Negative
• Hepatitis B Core Antibody, Total (Anti-HBc IgG+IgM) = Negative

Immunity due to vaccination

• Hepatitis B Surface Antigen (HBsAg) = Negative
• Hepatitis B Surface Antibody (Anti-HBs) = Positive
• Hepatitis B Core Antibody, Total (Anti-HBc IgG+IgM) = Negative

HEPATITIS B INFECTION

• Hepatitis B Surface Antigen (HBsAg) = Positive  A positive result indicates an infection, usually with symptoms; contagious; could also be a flare of a chronic infection

Hepatitis A immunity

Immunity

• Hepatitis A Antibody, Total = Positive
• Hepatitis A IgM Antibody = Negative

No active infection but previous HAV exposure; has developed immunity to HAV or recently vaccinated for HAV

No Immunity

• Hepatitis A Antibody, Total= Negative
• Hepatitis A IgM Antibody = Negative

No current or previous HAV infection; vaccine may be advised if at risk

HEPATITIS A INFECTION

• Hepatitis A IgM Antibody = Positive   A positive result indicates an acute or recent infection

Hepatitis C Antibody, HCV RNA & Liver Panel

• Hepatitis C Antibody
• Hepatitis C Virus RNA, Quantitative, Real-Time PCR
• Hepatic Function Panel

Hepatitis C antibody tests are used to screen individuals for the infection, including, people with no signs or symptoms but with risk factors, people who have symptoms associated with hepatitis or liver disease, or those who have been exposed to the virus.

Since the antibody test can remain positive for most people even if they have cleared the infection, this panel includes a hepatitis C RNA test, which detects the genetic material of the virus. A positive result on the RNA test means the virus is present, the infection has not resolved, and the person may require treatment. The liver panel is included to assess the health of the liver.

An HCV antibody test is typically reported as "positive" or "negative."

Results of Hepatitis C Virus RNA testing are reported as a number if virus is present. If no virus is present or if the amount of virus is too low to detect, the result is often reported as "negative" or "not detected."

Interpretation of the HCV screening and follow-up tests is shown below. In general, if the HCV antibody test is positive, then the individual tested is infected or has likely been infected at some time with hepatitis C. If the Hepatitis C Virus RNA test is positive, then the person has a current infection. If no Hepatitis C Virus RNA is detected, then the person either does not have an active infection or the virus is present in very low numbers.

HCV Antibody = Negative

No infection or too early after exposure for the test to be accurate; if suspicion remains high, retesting at a later time may be required.

_________________________

HCV Antibody = Positive or Indeterminate

HCV RNA = Negative

Past infection or no infection (false-positive screen); additional testing if indicated

_____________________

HCV Antibody = Positive or Weak or Indeterminate

HCV RNA = Positive

Current infection

Herpes Simplex Virus 1 (IgG), Type-Specific Antibody (HerpeSelect®) 

Tests for HSV 1 IGG, TYPE SPECIFIC AB to diagnose HSV-1 infection when lesions are absent. A positive HSV-1 IgG antibody test indicates a previous infection.

Reference Range(s)

Index Interpretation

• <0.90 Negative 
• 0.90-1.09 Equivocal 
• >1.09 Positive 

This assay utilizes recombinant type-specific antigens to differentiate HSV-1 from HSV-2 infections. A index positive result cannot distinguish between recent and past infection. If recent HSV infection is suspected but the results are negative or equivocal, the assay should be repeated in 4-6 weeks. The performance index characteristics of the assay have not been established for pediatric populations, immunocompromised patients, or neonatal screening.

Limitations

Individuals infected with HSV may not exhibit detectable IgG antibody in the early stages of infection.

Clinical Significance

Herpes Simplex Virus (HSV) is responsible for several clinically significant human viral diseases, with severity ranging from inapparent to fatal. Clinical manifestations include genital tract infections, neonatal herpes, meningoencephalitis, keratoconjunctivitis, and gingivostomatitis. There are two HSV serotypes that are closely related antigenically. HSV type 2 is more commonly associated with genital tract and neonatal infections, while HSV type 1 is more commonly associated with infections of non-genital sites. Specific typing is not usually required for diagnosis or treatment. The mean time to seroconversion using the type specific assay is 25 days. The performance of this assay has not been established for use in a pediatric population, for neonatal screening, or for testing of immunocompromised patients.

Herpes Simplex Virus 2 (IgG), Type-Specific Antibody (HerpeSelect®) 

HSV 2 IGG, TYPE SPECIFIC AB - Diagnose HSV-2 infection when lesions are absent.

Reference Range(s)

Index Interpretation

• <0.90 Negative
• 0.90-1.09 Equivocal
• >1.09 Positive

This assay utilizes recombinant type-specific antigens to differentiate HSV-1 from HSV-2 infections. A index positive result cannot distinguish between recent and past infection. If recent HSV infection is suspected but the results are negative or equivocal, the assay should be repeated in 4-6 weeks. The performance index characteristics of the assay have not been established for pediatric populations, immunocompromised patients, or neonatal screening.

Limitations

Individuals infected with HSV may not exhibit detectable IgG antibody in the early stages of infection.

Clinical Significance

Herpes Simplex Virus (HSV) is responsible for several clinically significant human viral diseases, with severity ranging from inapparent to fatal. Clinical manifestations include genital tract infections, neonatal herpes, meningoencephalitis, keratoconjunctivitis, and gingivostomatitis. There are two HSV serotypes that are closely related antigenically. HSV type 2 is more commonly associated with genital tract and neonatal infections, while HSV type 1 is more commonly associated with infections of non-genital sites. Specific typing is not usually required for diagnosis or treatment. The mean time to seroconversion using the type specific assay is 25 days. The performance of this assay has not been established for use in a pediatric population, for neonatal screening, or for testing of immunocompromised patients.

Herpes Simplex Virus 1/2 (IgG), Type-Specific Antibodies (HerpeSelect®) 

1. HSV 1 IGG, TYPE SPECIFIC AB
2. HSV 2 IGG, TYPE SPECIFIC AB

Diagnose HSV infection when lesions are absent; determine HSV type

Reference Range(s)

Index Interpretation

• <0.90 Negative
• 0.90-1.09 Equivocal
• >1.09 Positive

This assay utilizes recombinant type-specific antigens to differentiate HSV-1 from HSV-2 infections. A index positive result cannot distinguish between recent and past infection. If recent HSV infection is suspected but the results are negative or equivocal, the assay should be repeated in 4-6 weeks. The performance index characteristics of the assay have not been established for pediatric populations, immunocompromised patients, or neonatal screening.

Limitations

Individuals infected with HSV may not exhibit detectable IgG antibody in the early stages of infection.

Clinical Significance

Herpes Simplex Virus (HSV) is responsible for several clinically significant human viral diseases, with severity ranging from inapparent to fatal. Clinical manifestations include genital tract infections, neonatal herpes, meningoencephalitis, keratoconjunctivitis, and gingivostomatitis. There are two HSV serotypes that are closely related antigenically. HSV Type 2 is more commonly associated with genital tract and neonatal infections, while HSV Type 1 is more commonly associated with infections of non-genital sites. Specific typing is not usually required for diagnosis or treatment. The mean time to seroconversion using the type specific assay is 25 days. The performance of this assay has not been established for use in a pediatric population, for neonatal screening, or for testing of immunocompromised patients.

Syphilis (RPR + FTA-ABS)

• FTA-ABS - Treponema pallidum Ab (Confirmation for Syphilis RPR test).
• Syphilis RPR ( RPR (Monitor) with Reflex to Titer)

FTA-ABS - Treponema pallidum Ab

Clinical Significance

The FTA-ABS is a specific treponemal assay to detect antibody to t. Pallidum. The FTA-ABS becomes reactive 4-6 weeks after infection. Unlike the nontreponemal tests, once the FTA-ABS test becomes reactive, it will remain reactive for many years. Since the reactivity found with the FTA-ABS does not indicate response to therapy, it is not suitable for monitoring treatment. The FTA-ABS test does not distinguish between syphillis and other treponematoses such as yaws, pinta and bejil.

The treponemal antibody test (FTA-ABS) is often used as an initial test. A positive result indicates the presence of syphilis antibodies in the blood, but since treponemal antibodies remain positive even after an infection has been treated, it does not indicate whether the person has a current infection or was infected in the past. Conversely, nontreponemal antibodies as detected with an RPR typically disappear in an adequately treated person after about 3 years. Thus, if an initial treponemal test is positive, an RPR can be performed to differentiate between an active or past infection. In this case, a positive RPR would confirm that the person has been exposed to syphilis and, if not treated previously, has an active infection or, if treatment had occurred more than 3 years ago, possible re-infection.

Alternative Name(s) 

Treponemal pallidum, Fluorescent Treponemal Antigen, Syphilis

Syphilis RPR ( RPR (Monitor) with Reflex to Titer)

Reference Range(s)

Non-Reactive

Clinical Significance

This is a non-treponemal screening test for syphilis. False positive results may occur due to systemic lupus erythematosus, leprosy, brucellosis, atypical pneumonia, typhus, yaws, pinta, or pregnancy. Monitoring of RPR is helpful in assessing effectiveness of therapy.

IMPORTANT

A positive RPR screen and a positive result on the FTA-ABS confirms the screening result and the affected person is diagnosed with syphilis.

A negative result on the treponemal test may mean that the initial RPR test was falsely positive. Further testing and investigation may be done to determine the cause of the false positive.

Limitations

False-positive results have been associated in patients with infections, pregnancy, autoimmune disease, old age, Gaucher disease, and malignancy.

Alternative Name(s) 

Syphilis

Syphilis RPR ( RPR (Monitor) with Reflex to Titer)

Reference Range(s)

Non-Reactive

Clinical Significance

This is a non-treponemal screening test for syphilis. False positive results may occur due to systemic lupus erythematosus, leprosy, brucellosis, atypical pneumonia, typhus, yaws, pinta, or pregnancy. Monitoring of RPR is helpful in assessing effectiveness of therapy.

IMPORTANT

A positive RPR screen must be followed by a specific treponemal antibody test (e.g., FTA-ABS):

A positive result on the second method confirms the screening result and the affected person is diagnosed with syphilis.

A negative result on the treponemal test may mean that the initial RPR test was falsely positive. Further testing and investigation may be done to determine the cause of the false positive.

Limitations

False-positive results have been associated in patients with infections, pregnancy, autoimmune disease, old age, Gaucher disease, and malignancy.

Alternative Name(s) 

Syphilis

The STD - Comprehensive panel contains the following tests:

• Chlamydia/Neisseria gonorrhoeae RNA, TMA
• RPR (Monitor) with Reflex to Titer
• Herpes Simplex Virus 1/2 (IgG), Type-Specific Antibodies (HerpeSelect®)
• Hepatitis Panel, General

Due to the consultation and reporting requirements, we are unable to offer HIV testing at this time.

Chlamydia/Neisseria gonorrhoeae RNA, TMA

Patient Preparation 

Urine specimen: The patient should not have urinated for at least one hour prior to specimen collection. Female patients should not cleanse the labial area prior to providing the specimen.

Urine: Patient should not have urinated within one hour prior to collection. Female patients should not cleanse the labial area prior to providing the specimen. Direct patient to provide a first-catch urine (a maximum of 20-30 mL of the initial urine stream) into a urine collection cup free of any preservatives. 2 mL of urine specimen must be transferred into the APTIMA® specimen transport within 24 hours of collection and before being assayed. Use tube provided in the urine specimen collection kit for urine specimens. The fluid (urine plus transport media) level in the urine tube must fall within the clear pane on the tube label.

Clinical Significance

C. trachomatis infections are the leading cause of sexually transmitted diseases in the United States. C. trachomatis is known to cause cervicitis, pelvic inflammatory disease (PID), epididymitis and proctitis. It is also the most frequent cause of non-gonococcal urethritis in men. Among women, the consequences of Chlamydialinfections are severe if left untreated. Approximately half of Chlamydial infections are asymptomatic.
Neisseria gonorrhoeae (gonococci) is the causative agent of gonorrhea. In men, this disease generally results in anterior urethritis accompanied by purulent exudate. In women, the disease is most often found in the cervix, but the vagina and uterus may also be infected.

Herpes Simplex Virus 1/2 (IgG), Type-Specific Antibodies (HerpeSelect®) 

HSV 1 IGG, TYPE SPECIFIC AB

HSV 2 IGG, TYPE SPECIFIC AB

Diagnose HSV infection when lesions are absent; determine HSV type

Reference Range(s)

Index Interpretation

<0.90 Negative

0.90-1.09 Equivocal

>1.09 Positive

This assay utilizes recombinant type-specific antigens to differentiate HSV-1 from HSV-2 infections. A index positive result cannot distinguish between recent and past infection. If recent HSV infection is suspected but the results are negative or equivocal, the assay should be repeated in 4-6 weeks. The performance index characteristics of the assay have not been established for pediatric populations, immunocompromised patients, or neonatal screening.

Limitations

Individuals infected with HSV may not exhibit detectable IgG antibody in the early stages of infection.

Clinical Significance

Herpes Simplex Virus (HSV) is responsible for several clinically significant human viral diseases, with severity ranging from inapparent to fatal. Clinical manifestations include genital tract infections, neonatal herpes, meningoencephalitis, keratoconjunctivitis, and gingivostomatitis. There are two HSV serotypes that are closely related antigenically. HSV Type 2 is more commonly associated with genital tract and neonatal infections, while HSV Type 1 is more commonly associated with infections of non-genital sites. Specific typing is not usually required for diagnosis or treatment. The mean time to seroconversion using the type specific assay is 25 days. The performance of this assay has not been established for use in a pediatric population, for neonatal screening, or for testing of immunocompromised patients.

Syphilis RPR ( RPR (Monitor) with Reflex to Titer)

Reference Range(s)

Non-Reactive

Clinical Significance

This is a non-treponemal screening test for syphilis. False positive results may occur due to systemic lupus erythematosus, leprosy, brucellosis, atypical pneumonia, typhus, yaws, pinta, or pregnancy. Monitoring of RPR is helpful in assessing effectiveness of therapy.

IMPORTANT

A positive RPR screen must be followed by a specific treponemal antibody test (e.g., FTA-ABS):

A positive result on the second method confirms the screening result and the affected person is diagnosed with syphilis.

A negative result on the treponemal test may mean that the initial RPR test was falsely positive. Further testing and investigation may be done to determine the cause of the false positive.

Limitations

False-positive results have been associated in patients with infections, pregnancy, autoimmune disease, old age, Gaucher disease, and malignancy.

Hepatitis Panel, General

Hepatitis A Antibody, Total; Hepatitis B Surface Antibody, Qualitative; Hepatitis B Surface Antigen with Reflex Confirmation; Hepatitis B Core Antibody, Total; Hepatitis C Antibody with Reflex to HCV, RNA, Quantitative, Real-Time PCR

Hepatitis B Surface Antigen with Reflex Confirmation: Positive samples will be confirmed based on the manufacturer's FDA approved recommendations at an additional charge (CPT code(s): 87341).

If Hepatitis C Antibody is reactive, Hepatitis C Viral RNA, Quantitative, Real-Time PCR will be performed at an additional charge (CPT code(s): 87522).

The ionized calcium is determined by an ion selective electrode methodology. The result that is generated is pH adjusted. The result is empirically based on a measured pH and ionized calcium concentration normalized to a pH of 7.40. This calculation compensates for in vitro changes in pH due to loss of CO2 through specimen handling. Ionized calcium represents the true "bioavailable" calcium in the circulation. In situations where the total calcium is normal but does not fit the clinical picture, e.g., hyperparathyroidism, a determination of the ionized calcium will, many times, show an elevation in the "bioavailable" calcium component. This may be due to alterations in protein concentrations, especially albumin, that binds most of the calcium in the circulation.