HIV-1 Genotype

Centralized Core Laboratory - Mayo Clinic Laboratories : Send Out

PATIENT INFO

Patient Name:

Medical Record #:

BD: / / Sex: F M

PHYSICIAN INFO

Physician Name :

Address:

Ph: ( ) - Fax: ( ) -

Additional Report to:

Ph: ( ) - Fax: ( ) -

TESTS REQUESTED
Test Name:	ICD9 Code: (required)
1. HIV-1 Genotype
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SPECIMEN INFO

Collection Date & Time:

Collected By:

Hospital:

Test ID :

HVGEN

Test Workstation :

MAYO

Specimen Type:

Plasma

Tube Type:

Purple top (EDTA) tube

Collection Volume:

6.0 mL (minimum 3.0 mL)

Cause for Rejection:

Drawn in Greentop (heparin) tube

Storage:

Frozen

Availability:

Sent to Reference Laboratory

Methodology:

Reverse Transcription Polymerase Chain Reaction (RT-PCR) followed by Targeted Next-Generation Sequencing (NGS)

Special Instructions:

Centrifuge and separate plasma from cells within 2 hours of collection. If collected at an offsite location, send by a STAT Courier to Hospital lab Specimens submitted for HIV1 genotyping must contain 1000 copies/mL or more of HIV1 RNA.

Lab/Phone:

330-543-8418

TAT:

3-10 days

Additional Info:

Reference range is available on patient report

This test is intended to be used to monitor known HIV-positive infections. It is not intended for primary detection of HIV infections. Specimens submitted for HIV-1 genotyping should contain > or =1000 copies/mL of HIV-1 RNA.

CPT Code:

0219U