Adenovirus Quantitative Real-time PCR
Specimen and Container/Tube
Collect 4-5 mL whole blood in EDTA
Collection Instructions
For POSITIVE patients only.
Specimen Type: Plasma
Note: Avoid using gel separator tubes; samples collected in gel separator tubes have increased rate of PCR inhibition.
Specimen Handling and Transport Instructions
Offsite Instructions:
- Centrifuge and transfer 2 mL plasma to sterile, screw top tube.
- Freeze aliquot
- Transport to Main Lab
NOTE: If aliquot is not frozen by the last courier pick-up, it is best to send on the first pick-up the next day to avoid rejected samples.
Reference Values
190 copies/mL to 1x1010 copies/mL
Clinical Indications
Adenovirus is an important cause of morbidity and mortality in the transplant setting, causing pneumonia, hemorrhagic cystitis, hepatitis, encephalitis, pancreatitis, enteritis, and disseminated disease with the mortality rate reaching 60% in some especially high risk situations such as pediatric hematopoietic stem cell transplantation. Since proper management is dependent upon early diagnosis, quantitative adenovirus DNA PCR is useful for detecting the virus, tracking the course of infection, and monitoring response to treatment. Treatment of adenovirus in immunocompromised patients presents challenges, including drug toxicity, delayed onset of disease after discontinuing therapy, and emergence of mutations that may affect the ability of diagnostic assays to detect them efficiently.
Methodology
Extraction of adenovirus DNA from specimen followed by amplification and detection of known adenovirus strains using real-time, quantitative PCR.
Additional Information
Severe morbidity and mortality due to adenovirus infection affect both hematopoietic stem cell transplant and solid organ transplant recipients.1 Common illnesses due to adenovirus infection include hemorrhagic cystitis/nephritis, pneumonitis, hepatitis, liver failure, and gastroenteritis, particularly during the acute post-transplant period prior to engraftment. Symptoms of adenovirus infection vary widely, depending on the organ involved. Adenovirus nephritis is associated with acute renal failure in 90% of infected patients.2 Also, adenovirus infection is associated with graft-versus-host-disease (GvHD) and allograft failures.1
Detects all known serotypes in one assay. The primers and probes used in this assay are specific for known adenovirus strains based on similarity search algorithms. Additionally, no cross reactivity was detected when tested against BKV, CMV, EBV, HSV-1, HSV-2, HHV-6 variant A, HHV-6 variant B, HHV-7, HHV-8, JCV, Parvovirus B19, SV-40, and VZV.
CPT Code(s)
87799
Turnaround Time
Same day (within 8 - 12 hours from receipt of specimen), Monday through Saturday
Volume
Specimen Volume: 2 mL of plasma
Specimen Minimum Volume: 0.5 mL of plasma
Performing Laboratory
Eurofins Viracor, LLC
18000 W 99th St., Ste.#10
Lenexa, KS 66219
Rejection Criteria
Wood shafted swab, calcium alginate swab, specimens received in trap containers, grossly hemolyzed plasma/serum specimens, specimens beyond their acceptable length of time from collection as listed in the specimen handling, or specimen types other than those listed.