Laboratory Test Reference Guide

Requires dedicated blood tubes (no other tests requested).

Store whole blood at 2-25 degrees for no longer than 24 hours.

Spin sample down and 3/4 fill screw top nunc tubes with plasma and freeze within 24 hours of receipt. Use multiple nunc tubes as required. Specimens separated into thin-walled plastic tubes are unacceptable

Transport at 2 - 8 degrees C if transport time from collection is less than 24 hours. Transport frozen if more than 24 hours.

Choosing Clinical Laboratory Tests Wisely Guidelines:

• Clinicians should try to identify patients with raised LFTs due to chronic  viral hepatitis,
• All HBsAg-positive pregnant women should have their HBV viral load measured,
• All HCV PCR-positive patients should be referred to a specialist, for consideration of treatment with oral direct acting antiviral therapies (DAA).
• New Zealand wide Many HBsAg-positive patients are not being properly followed up or referred, and stand the risk of developing preventable liver disease.

• Anti-HCV antibody is present in almost all those infected with HCV, but depending on the age and sex at acquisition, only 70-80% will have active viral replication.
• A viral load test is needed to identify actively infected patients.
• Like HIV, the antibodies are non-neutralising, i.e. do not control infection.
• The emphasis in Hepatitis C management is to identify patients so they can be treated with oral direct-acting therapies (DAA).
• Do not repeat Hepatitis C virus antibody testing in patients with a previous positive Hepatitis C virus (HCV) test. Instead, order Hepatitis C viral load testing for assessment of active versus resolved infection.
• Do not repeat hepatitis C viral load testing in an individual who has established chronic infection, outside of antiviral treatment.
• Do not repeat HBV or HCV studies without considering the significance of prior testing 

The is standardised against the WHO International Standard NIBSC 97/798

1mL plasma or serum