• Test Code:
    3040
  • Department:
  • Test Synonyms:
    adenovirus PCRadenovirus viral loadadenovirus DNAadenovirus quantitation
  • CPT Code(s):
    87799
Background:

Human adenoviruses are a common cause of self-limited respiratory, gastrointestinal, or ocular infections in immunocompetent children and adults. In immunocompromised patients, however, adenovirus can cause severe, life-threatening infections including cystitis/nephritis, pneumonitis, hepatitis, and gastroenteritis, and sepsis. Polymerase chain reaction (PCR) assays used to detect adenovirus DNA in peripheral blood have demonstrated a strong correlation between viremia and the risk of disseminated adenovirus disease (1-4).

Clinical Utility:
The rapid detection and quantitation of adenovirus DNA by a sensitive PCR technique will aid in the diagnosis and treatment monitoring of adenovirus infections, particularly in immunocompromised patients.

Methodology:

This assay utilizes fluorescent real-time PCR (adenovirus hexon gene target) to quantitatively detect the presence and amount of adenovirus DNA.  An internal control PCR ensures adequate DNA extraction and PCR efficiency. All known serotypes of adenovirus (>50) from each of the 7 adenoviral species (A to G) are detected by this assay. Viral load quantitation is accomplished with well-characterized external calibration standards with reporting units of adenoviral DNA copies per mL.

Sensitivity:
The low-level analytical detection limit is 250 adenovirus DNA copies per mL. The reportable range of this viral load assay extends from 250 - 100,000,000,000 copies of adenovirus DNA per mL.

Specimen Requirements:

  • CSF (minimum 0.5 mL): deliver to lab (ambient) within 8 hours of collection; or freeze and transport frozen.
  • Blood: one 5 mL purple (EDTA) or yellow (ADC) tube; deliver to lab (ambient; unspun) within 4 hours (for separation into plasma).
  • Plasma: spin within 4 hours of phlebotomy.  Store and transport on cold pack to lab within 48 hours.
  • Urine: 1-2 mL sample collected in a sterile urinalysis container, then transferred to sterile, screw top tube for shipment.  Store and transport refrigerated.  Do not freeze.

Pediatric Minimums:

  • CSF: 200µL
  • Plasma: 200µL
  • Urine: 200µL

A REQUISITION FORM MUST ACCOMPANY ALL SAMPLES.  Please include detailed clinical information.

Test Performed (Days):

Mon, Wed, Fri

Turn Around Time:

1 – 3 days

Shipment Sensitivity Requirements:

Package and ship whole blood or swab specimens to remain cold, but not frozen.  Package frozen specimens in dry ice.  Contact Client Services at (855) 535-1522 for shipping supplies and instructions.  Ship via overnight express, using the FedEx priority overnight label provided.

References:

  1. Echavarria M. Adenoviruses in immunocompromised hosts. Clinical Microbiology Reviews. Oct 2008;21(4):704-715.

  2. Lindemans CA, Leen AM, Boelens JJ. How I treat adenovirus in hematopoietic stem cell transplant recipients. Blood. Dec 16 2010;116(25):5476-5485.

  3. Gustafson I, Lindblom A, Yun Z, et al. Quantification of adenovirus DNA in unrelated donor hematopoietic stem cell transplant recipients. Journal of Clinical Virology. Sep 2008;43(1):79-85.

  4. Erard V, Huang ML, Ferrenberg J, et al. Quantitative real-time polymerase chain reaction for detection of adenovirus after T cell-replete hematopoietic cell transplantation: viral load as a marker for invasive disease. Clinical Infectious Diseases. Oct 15 2007;45(8):958-965.

Additional Info:

The Knight Cancer Institute at Oregon Health & Science University is a pioneer in the field of precision cancer medicine. The institute's director, Brian Druker, M.D., helped prove it was possible to shut down just the cells that enable cancer to grow. This breakthrough has made once-fatal forms of the disease manageable and transformed how cancer is treated. The OHSU Knight Cancer Institute is the only National Cancer Institute-designated Cancer Center between Sacramento and Seattle – an honor earned only by the nation's top cancer centers. It is headquarters for one of the National Cancer Institute's largest research collaboratives, SWOG, in addition to offering the latest treatments and technologies as well as hundreds of research studies and clinical trials.

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