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Test Handbook
Third Edition 2004
Address for Specimens & Deliveries:
VIDRL
Jane Bell House
10 Wreckyn St
North Melbourne
Victoria, 3051 Australia.
Postal Address:
Victorian Infectious Diseases Reference Laboratory (VIDRL)
Private Bag 815
Carlton South
Victoria, 3053 Australia
Laboratories: Phone
Biochemistry 9342 2640
Electron Microscopy 9342 2678
Haematology 9342 2642
HIV Characterisation 9342 2623
Infectious Diseases Serology 9342 2647
Microbiology 9342 2668
Molecular Microbiology 9342 2615
Mycobacterium Reference 9342 2674
National Polio Reference 9342 2607
Specimen Reception 9342 2644
Virus Identification 9342 2628
Internet:
VIDRL Website http://www.vidrl.org.au
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VIDRL Hours of Operation:
0800 - 2000 Monday to Friday
1000 - 1200 Saturday (urgent specimens only)
For both these services call 0438 599 437 or 0438 599 439.
Page 2
1. Patient and Specimen Identification
Patient Information
Surname and given name(s) (or name code)
Gender
Date of birth
Address
Clinical Details
Presenting signs and symptoms
Date of onset of illness
Any recent travel history
Recent immunisation history
Specimen Information
Type of specimen
Date of specimen
Tests Requested
VIDRL requires that each specimen and its accompanying request card are labelled
with at least two identifiers which together are capable of distinguishing one
individual from another. Some requests may be coded to protect patient
confidentiality. A four-letter code consisting of the first two initials of the surname
and given name is the accepted convention. The full name (or name code) and date
of birth should be written on both the specimen and the request card. Failure to
comply with this procedure may delay specimen processing and reporting.
Some knowledge of the pathogenesis of the suspected viral infection is necessary for
optimal choice of specimens. For example: the duration and site of viral shedding, or
the presence and timing of viraemia. When possible, specimens for virus detection
should be obtained from the suspected site of infection (for example, CSF in
enteroviral meningitis, vesicular material in herpes simplex infection). Viruses are
often shed via the respiratory or gastrointestinal tracts, and occasionally in urine, all
of which are readily accessible. When specimens are difficult to obtain from the
affected organ system, these peripheral sites of viral shedding may provide the only
source of specimens for virus detection. For instance, enteroviruses potentially may
be detected in both faeces and respiratory secretions in a case of meningitis should
CSF not be available. Demonstration of peripheral shedding only provides indirect
evidence of end organ involvement however.
Polymerase Chain Reaction (PCR) is the method of choice at VIDRL for detection of
most viruses. PCR provides high levels of sensitivity, and the ability to detect viral
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nucleic acid irrespective of viral particle viability. However specimen quality still has
a profound effect on rates of detection.
Swabs should be rubbed firmly on the affected site, generally a lesion base or
mucosal surface, to dislodge infected cells and to soak them thoroughly in potentially
infected secretions. Vesicular lesions will require careful “de-roofing” with a small
gauge needle or scalpel blade to provide access to virus-rich vesicular fluid, and the
lesion base. By the time vesicular lesions crust quantities of virus are minimal and
sampling is not generally recommended. Sampling of several lesions and pooling
swabs or vesicle fluid may improve detection rates. Detection rates from the
respiratory tract can potentially be improved by pooling a throat swab and a swab
from one or both nostrils. Swabs should be broken off into viral transport medium
and transported to the laboratory as rapidly as possible.
Body fluids such as CSF or urine are best transported undiluted in a sterile leak-
proof container. Tissue samples should be transported unfixed in a sterile leak-proof
container. A pea-sized sample of tissue is generally ample. Addition of a small
volume of sterile saline to very small specimens may alleviate the risk of drying in
transport.
In general, specimens should be kept cool (4°C - 8°C) when being transported. The
exception is blood for detection or quantitation of HIV nucleic acids, which should be
sent at room temperature.
If longer delays in transporting are anticipated, the serum should be separated into a
suitable screw-cap vial and stored at 2-8°C. Plasma can also be used for serological
testing and should be transported to the laboratory at 2-8°C within 24 hrs of
collection. If long transport delays are anticipated, separate the plasma from the red
cells to avoid haemolysis.
The usefulness of serological results for diagnosis is highly dependent on the timing
of the specimens submitted. The appearance of measurable antibody responses may
vary between pathogens and between tests and some knowledge of those factors is
necessary to optimally time serum collection. For example specific IgM to hepatitis A
virus is usually present at symptom onset while measles IgM usually appears
Page 4
between 3-7 days after rash. When attempting to demonstrate a rising titre of total
or IgG antibody it is important to obtain an acute serum specimen early in the course
of an illness and an appropriately timed convalescent serum. Two weeks after
symptom onset is a general rule of thumb for timing of convalescent bleed collection,
but timing of IgG appearance varies. For example C. psittaci complement fixing
antibody may take over 3 weeks to appear, while measles IgG may generally be
detected by enzyme immunoassay from 1 week after rash.
All blood samples should be securely capped, then mixed by gentle inversion. Blood
tubes should be stored at 4oC. If no refrigerator is available, keep the samples in a
cool place. Please ensure that the samples are not exposed to direct sunlight.
5. Bacteriology
Parasitology
Specimen jars are now supplied in kit form (Para-Pak) for the transport of faecal
samples for both culture and parasite preservation. Directions to patients are
included with each kit.
For parasite studies, two specimens should be sent, each collected two days apart to
exploit the intermittent excretion of some parasites. Transport at room temperature
in SAF preservative supplied
Legionella
Page 5
MRL Specimen Collection Data
• A succinct summary of the patient's history and findings. This may be important
for the assessment of significance of non-tuberculous mycobacterial isolates.
• Laboratories referring mycobacterial isolates should also note their smear result
(on ZN or AR staining) on the request slip.
• Further patient information on prior disease, contacts and treatment, country of
birth or extended residence, immunosuppression and other details will be sought
on new positive TB and Leprosy cases.
These specimens are especially useful for recovery of Mycobacterium avium complex.
Special mycobacteria blood culture bottles (Bactec Myco/F lytic) are available from
VIDRL.
General Notes:
The cell wall of Mycobacteria is resistant to chemical attack, and current DNA and
RNA extraction methods for Mycobacteria are less efficient than for other organisms.
False-negative results occur in specimens with low numbers of Mycobacteria present.
Culture is still the most sensitive method for detection of viable MTB at the time of
writing. In addition culture provides an isolate for further study, namely
antimycobacterial drug susceptibility testing, or RFLP fingerprinting for
epidemiological purposes.
A number of biological substances, including blood and faecal material, may interfere
with the assays leading to false negative results.
PCR may detect DNA from non-viable organisms, and is not suitable for monitoring
of therapy at this stage.
For CSF examination by PCR for the presence of MTB, we recommend that at least 1
mL of un-centrifuged CSF be submitted to achieve adequate assay sensitivity.
Please note that PCR type assays for the diagnosis of tuberculosis are not yet
included on the Australian Medicare Benefits schedule, and a charge for the test will
be made in most cases.
Page 6
The Mycobacterium genus PCR, which can identify Mycobacteria to species complex
level is not intended as a routine diagnostic test, and will only be performed if
specifically requested and adequate clinical notes are provided. Requests for
“Mycobacterial PCR” that do not provide adequate information will initially be tested
using the TB PCR.
Requests for the Mycobacterium genus PCR on fixed tissues (unsuitable for culture)
will only be performed if AFB have been seen in the specimen, or there is other
clinical or pathological evidence supporting a mycobacterial infection. From paraffin
embedded fixed tissue specimens, we require at least 6 sections, each 10-20 µm
thick. We strongly recommend discussing the case with VIDRL before submitting
such specimens.
Gastric Lavage. This is appropriate when the patient cannot produce expectorated
sputum. These specimens must be neutralised to pH 7 within four hours of
collection to ensure the viability of any mycobacteria present.
Skin and Wound Swabs. Skin biopsies (obtained by excision or punch biopsies)
should be collected in sterile screw capped containers. In the case of wounds it is
advisable to send an aspirate of the exudate in preference to a swab.
Urine. Three single mid-stream specimens voided in the early morning should be
submitted. If delay is unavoidable, specimens should be refrigerated. Note that
microscopy is not routinely performed on urine specimens submitted for examination
for mycobacteria, due to the presence of commensal mycobacteria.
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MRL recommendations for specimen collection for the monitoring of anti-
tuberculous chemotherapy. For further information, please visit the VIDRL
website (http://www.vidrl.org.au) under the MRL section.
For further information on specimen collection and result interpretation, please visit
the VIDRL website (http://www.vidrl.org.au).
The QuantiFERON ® -TB Gold assay detects CMI responses in-vitro to tuberculosis
infection by measuring interferon-gamma (IFN- γ) harvested in plasma from whole
blood incubated with the M. tuberculosis-specific antigens, ESAT-6 & CFP-10.
An IFN- γ response to either ESAT-6 or CFP-10 above the test cut-off is considered
indicative of M. tuberculosis infection
This test should be considered as an alternative to the Mantoux test, but has the
advantages that it can be used to detect latent TB infection in patients who have
been vaccinated with BCG and therefore have a positive Mantoux test. It can also be
used when a Mantoux test is contraindicated.
Please note this test is primarily intended to detect latent infection with M.
tuberculosis, and not for the diagnosis and management of active tuberculosis.
Should active TB be suspected, culture (and/or PCR testing) of appropriate clinical
specimens is still necessary for a definitive diagnosis.
This assay will not detect infection with M. bovis BCG strains used for vaccination or
immunotherapy.
For further information on this test and its interpretation, please visit the VIDRL
website (http://vidrl.org.au) under the MRL section.
Specimens most useful for detection of the above viruses include venous blood
(clotted and unclotted (EDTA), urine and a combined nose/throat swab.
Collection of specimens should be undertaken with extreme care and using personal
protective equipment including gloves, gown, mask and eye protection. Glass
Page 8
containers should not be used. Disposable sharp objects such as scalpel blades
should not be handled unnecessarily after use and should be autoclaved or
incinerated.
Needles used to collect blood should not be recapped, bent, broken, removed from
disposable syringes or otherwise handled. Blood-taking equipment should be placed
in a rigid plastic container filled with disinfectant solution and autoclaved or
incinerated.
Prior to transport, the outside of each specimen container should be swabbed with
disinfectant (sodium hypochlorite, 5000 ppm available chlorine is recommended) and
a label should be attached bearing the patient's name, hospital identification, the
date of collection and the nature of the suspected infection. Specimens should be
double-bagged in secure, airtight and watertight bags which have been similarly
labelled. Bags containing specimens should be swabbed with disinfectant before
they are removed from the patient's room.
Specimens thought to contain Risk Group 4 viruses, or isolates of these viruses, must
be transported under highly regulated conditions, irrespective of whether the
shipment is by air, road, rail or sea. In general, the International Air Transportation
Association (IATA) Dangerous Goods Regulations are the most comprehensive and
cover the requirements of other non-airline organizations. Senders should be aware
of their obligation to satisfy current shipping requirements when they first make
contact with the Pathologist on-call or other senior staff regarding the transport of
possible Risk Group 4 viruses to VIDRL.
Senders should notify VIDRL of shipping details when they become available. These
include the airline, flight departure and arrival times, air waybill number and contact
details of the courier assigned the job of transporting the package between airports.
The packaging required for transport to and from VIDRL of Risk Group 4 viruses is
stringent, and must comply with NZ/CAA 38281-1. Such packaging is available
commercially (eg. LabPak-1, LabServ). A diagnostic specimen or virus isolate
reasonably expected to fall within the category of a Risk Group 4 pathogen must be
identified as UN No. 2814 (infectious substance affecting humans) and should
comply with Packaging Instruction No. 602. The maximum allowable shipment
quantity under these regulations is 50 ml (passenger aircraft) or 4 litres (cargo
plane).
Page 9
Test List
Test Albumin
Specimen Required Serum (clotted blood)
When Tested Daily
See also: Liver Function Tests
References Ranges 35-52
Units gm/L
Contact 9342 2640
Page 10
Test Alkaline phosphatase (ALP)
Specimen Required Serum (clotted blood)
When Tested Daily
See also: Liver Function Tests
Reference Ranges Male 0-2y: 25-95
2-24y: 25-250
>24y: 25-95
Female 0-2y: 25-95
2-19y: 25-250
>19y: 25-95
Units U/L
Contact 9342 2640
Page 11
Test Astrovirus by Electron Microscopy
Specimen Required Faeces (not frozen)
Contact 9342 2678
Page 12
Test Blood Culture (Bacterial)
Specimen Required 8-10 ml/’Bactec plus’ aerobic & anaerobic
bottles
When Tested Daily
Notes Please provide clinical details. Extended
incubation is required for query
endocarditis, brucellosis or fungal infection.
Contact 9342 2670
Page 13
Test Brucella spp Serology
Assay Rose Bengal (RB) agglutination (total)
Standard agglutination Test (SAT)
Anti-human globulin (Coombs) (IgG)
Specimen Required Serum (clotted blood)
When Tested Weekly
Notes A negative RB test generally excludes a
diagnosis of Brucellosis. The SAT detects
IgM and complete IgG in acute disease.
The Coombs test detects ‘incomplete’ IgG
in chronic disease.
Contact 9342 2649/9342 2650
Test Calcium
Specimen Required Serum (clotted blood)
When Tested Daily
Reference Ranges Serum: 2.00 – 2.63
Units mmol/L
Contact 9342 2640
Test Carbamazepine
Specimen Required Serum (clotted blood)
When Tested On request
Reference Ranges 17 – 42
Units µmol/L
Contact 9342 2640
Notes The reference range applies to a trough
specimen collected just prior to the
morning dose. Serum peak level is
reached 6-12 hours after oral dose
administration.
Page 14
Units U/L
Contact 9342 2640
Test Chlamydia Group Antigen
Assay or Procedure IgG
Specimen Required Serum (clotted blood)
When Tested Daily
Notes Primary screening test for chlamydia
Contact 9342 2628
Page 15
Test Chloride
Specimen Required Serum (clotted blood) or blood
heparinised)
When Tested Daily
Reference Ranges 101 – 111 mmol/L
Contact 9342 2640
Test Cholesterol
Specimen Required Serum (clotted blood)
When Tested Daily
See also: Lipids
Normal Ranges <5.5
Units mmol/L
Contact 9342 2640
Notes For accurate lipid determinations, the
patient should fast for 12 hours prior to
specimen collection.
Page 16
Test Coronavirus PCR
Specimen Required Any respiratory specimen. Sputum.
When Tested On request
Notes Tests available for common cold associated
coronaviruses OC43 and 229E and the
SARS-related coronavirus. Ring laboratory
before requesting SARS PCR.
Contact 9342 2628
Test Creatinine
Specimen Required Serum (clotted blood) or blood
(heparinised)
When Tested Daily
See also: U&E
Reference Ranges 0.02 – 0.12
Units mmol/L
Contact 9342 2640
Page 17
Test Crimean-Congo haemorrhagic fever virus
Serology
Specimen Required Serum (clotted blood)
When Tested On request
Notes This is a PC4 level pathogen. Requests for
testing must be discussed with the
laboratory in advance.
Contact 9342 2628
Page 18
Test Cytomegalovirus (CMV) Serology
Assay or Procedure IgG and IgM
IgG Avidity Index
Latex agglutination (total antibodies)
Specimen Required Serum (clotted blood)
When Tested Weekly
Contact 9342 2649/9342 2650
Test Digoxin
Specimen Required Serum (clotted blood)
When Tested Request
Normal Ranges 1.0 – 2.8
Units nmol/L
Notes Preferred sampling time is at the end of a
24 hr dosing interval.
Contact 9342 2640
Page 19
Test Echovirus PCR (see Enterovirus PCR)
Page 20
Test Erythrocyte sedimentation rate (ESR)
Specimen Required Blood (EDTA) or vacu-tec tube
When Tested Daily
Normal Ranges Male: <10 mm
Female: 20 mm in first hour
Contact 9342 2644
Test Estradiol
Specimen Required Serum (clotted blood)
When Tested Tue (am)
Fri (am)
Reference Ranges Male: <200
Female: foll: <420
Mid-Cy: 300 – 1500
Lut: 200 – 1000
Post m/pausal: <175
Contact 9342 2640
Page 21
Test Faecal parasites (see parasite detection
(enteric))
Test Ferritin
Specimen Required Serum (clotted blood)
When Tested x2 weekly
See also: Iron studies
Reference Ranges Male: 30 – 284
Female: 10 – 186
Units ng/mL
Contact 9342 2640
Page 22
Test Flavivirus Serology
Assay or Procedures Total antibodies and IgM (IF)
Specimen Required Serum (clotted blood)
When Tested x2 weekly
Notes Procedure detects antibodies to flaviviruses
including Murray Valley encephalitis,
dengue and Kunjin viruses. An assay
specific for antibodies to Murray Valley
encephalitis virus is also available.
Contact 9342 2649/9342 2650
Page 23
Test Gamma-glutamyl transferase (GGT)
Specimen Required Serum (clotted blood)
When Tested Daily
See also: Liver Function Tests
Reference Ranges Male: <50
Female: <40
Units U/L
Contact 9342 2640
Test Glucose
Specimen Required Blood (NaF)
When Tested Daily
Reference Ranges Fasting: 3.3 – 6.0
Random: 3.3 – 7.8
Units mmol/L
Notes The specimen should be identified as a
fasting or random collection.
Contact 9342 2640
Page 24
Test Gonorrhoea PCR
Specimen Required Urine, endocervical, urethral, pharyngeal or
rectal swabs
When Tested Daily
Notes Transport at room temperature. Culture is
preferred for pharyngeal specimens.
Contact 9342 2670
Page 25
Test Hendra virus PCR (see Equine morbillivirus
(EMV) PCR)
Page 26
Test Hepatitis B virus Serology
Assay or Procedure core antibody total
core antibody IgM
e antibody
e antigen
surface antibody
surface antigen
Specimen Required Serum (clotted blood)
When Tested x2 or x3 weekly
Contact 9342 2649/9342 2650
Page 27
Test Hepatitis D virus Serology
Assay or Procedures Antigen
Antibody
Specimen Required Serum (clotted blood)
When Tested Weekly
Contact 9342 2649/9342 2650
Page 28
Test Herpes simplex virus Serology (HSV)
Assay IgG
IgM
Specimen Required Serum (clotted blood)
When Tested x2 weekly
Contact 9342 2649/9342 2650
Page 29
Test Human immunodeficiency virus Serology
Confirmation
Assay Procedure Western Blot
Specimen Required Serum (clotted blood)
When Tested x2 weekly
Notes Performed on repeatedly reactive samples
detected in the screening test and
specimens found to be reactive by other
laboratories.
Contact 9342 2649/9342 2650
Page 30
Test Infectious mononucleosis (see Paul Bunnell
assay and Epstein-Barr virus testing
procedures)
Test Iron
Specimen Required Serum (clotted blood)
When Tested Iron studies: daily
Reference Ranges Male: 10.0 – 30.0
Female: 9.0 – 27.0
mmol/L
Contact 9342 2640
Page 31
Test JC virus PCR (see Polyomavirus PCR)
Page 32
Test Legionella PCR
Specimen Required Sputum, bronchial washings, aspirates and
lavages, pleural and other sterile-site body
fluids, and fresh biopsy specimens.
When Tested Weekly
Notes Duplex LightCycler real-time PCR to directly
detect L pneumophila and other Legionella
species by 16s rRNA gene sequence.
Contact 9342 2670
Page 33
Test Lipids: (cholesterol, triglycerides, HDL,
LDL)
Specimen Required Serum (clotted blood)
When Tested Daily
See also: Individual tests
Normal Ranges HDL:
LDL: <3.5
C: <5.5
T: 0.4 – 1.9
Units mmol/L
Contact 9342 2640
Test Magnesium
Specimen Required Serum (clotted blood)
When Tested Daily
Reference Ranges 0.62 – 1.03
Units mmol/L
Contact 9342 2640
Page 34
Test Marburg haemorrhagic fever virus PCR
Specimen Required Blood, respiratory swabs
When Tested On request
Notes This is a PC4 level pathogen. Requests for
PCR must be discussed with the laboratory
in advance.
Contact 9342 2628
Page 35
Test Measles virus PCR
Specimen Required Blood, NTS, urine, CSF
When Tested On request
Notes Request when measles diagnosis is
required.
Contact 9342 2628
Page 36
Test Mycobacterial blood Culture
Specimen Required 1-5 mL of blood collected into a Myco/F
lytic blood culture bottle available from
MRL.
When Tested Daily
Notes See text (MRL section) for further details
Contact 9342 2674
Page 37
Test Mycobacterium genus PCR
Specimen Required Tissue biopsies, dry swabs, AFB positive
paraffin-embedded fixed tissue sections,
smear positive respiratory specimens which
are negative for M.tuberculosis
When Tested On request
Notes See text (MRL section) for further
information. It is advisable to contact the
laboratory to check suitability prior to
submitting a specimen. Method; Nested
ITS region PCR and sequencing.
Contact 9342 2674
Page 38
Test Norwalk virus – (see Norovirus)
Page 39
Test Parvovirus B19 PCR
Specimen Required Blood (ACD or EDTA), amniotic fluid
When Tested Weekly, Friday
Contact 9342 2628
Test Phenytoin
Specimen Required Serum (clotted blood)
When Tested Request
Reference Ranges 33 – 67
Units µmol/L
Notes Preferred sampling time is immediately
before the first morning dose
Contact 9342 2640
Test Phosphate
Specimen Required Serum (clotted blood)
When Tested Daily
Reference Ranges Serum: 0.80 – 1.50
Units mmol/L
Contact 9342 2640
Page 40
Test Pneumocystis carinii detection
Specimen Required Induced sputum, bronchial washing, BAL
(cytospin preparation – contact lab first)
When Tested On request
Notes Methods: Toluidine Blue O Stain, Direct
Immunofluorescence
Contact 9342 2670
Test Potassium
Specimen Required Serum (clotted blood) or blood
(heparinised)
When Tested Daily
See also: U&E
Normal Ranges Serum 3.5 – 4.8
Units mmol/L
Notes The specimen must not be haemolysed
and there should be minimal statis before
and during blood collection.
Contact 9342 2640
Page 41
Test Poxvirus PCR
Specimen Required Vesicle fluid/swab
When Tested On request
Notes Assay detects ‘old world’ pox viruses
including variola (smallpox), vaccinia,
monkey pox, cowpox, buffalo pox and
camel pox. Requests for PCR must be
discussed in advance with the laboratory.
Contact 9342 2628
Test Progesterone
Specimen Required Serum (clotted blood)
When Tested x2 weekly
Reference Ranges Male: 0.5 – 3.0
Female: foll: 1.0 – 4.9
Lut: 16.5 – 60.0
Post m/pausal: 0.0 – 2.5
Pregnant (1st Tri) 150 – 162.0
Units mmol/l
Contact 9342 2640
Test Prolactin
Specimen Required Serum (clotted blood)
When Tested x2 weekly
Reference Ranges Male: 40 – 275
Female: 40 – 420
Units mlU/L
Contact 9342 2640
Page 42
Test Prothrombin time/ratio (PTT, PR, INR)
Specimen Required Blood (sodium citrate 3.8%)
When Tested Daily
Normal Ranges Ratio: <1.2 INR:
Therapeutic range
INR: 2.0 – 4.0
Contact 9342 2644
Page 43
Test Respiratory Syncytial virus PCR (see
Respiratory virus PCR)
Test Reticulocytes
Specimen Required Blood (EDTA)
When Tested Daily
Normal Ranges 0.5 – 2.5%
Contact 9342 2644
Page 44
Test Rickettsia spp screen Serology
Assay or Procedure Total Ab
IgM
Specimen Required Serum (clotted blood)
When Tested Weekly
Notes Testing detects response to Spotted Fever,
Typhus and Scrub Typhus groups.
Contact 9342 2649/9342 2650
Page 45
Test Rubella virus Serology
Assay IgG
IgM
HI Total Ab
HI IgM
Specimen Required Serum (clotted blood)
When Tested Daily
Daily
X1 weekly
Request (confirmatory)
Contact 9342 2649/9342 2650
Page 46
Test Sodium
Specimen Required Serum (clotted blood) or Blood heparinised
When Tested Daily
See also: U&E
Reference Ranges Serum: 130 – 145
Units mmol/L
Contact 9342 2640
Page 47
Test T cells counts (reference range)
Reference Range CD3 (Total T Cells) 760-2480/µl
CD4 (Helper T Cells) 400-1630/µl
CD8 (Suppressor T Cells) 175-900/µl
CD19 (B Cells) 80-560/µl
CD56/16 (NK Cells) 90-500/µl
CD4:CD8 Ratio 0.8-5.3 (no units)
Specimen Required Blood (EDTA or heparin)
When Tested Daily
Contact 9342 2644
Test Testosterone
Specimen Required Serum (clotted blood)
When Tested x2 weekly
Reference Ranges Male: 6.0 – 27.0
Female: 0.6 – 3.0
Units nmol/L
Contact 9342 2640
Page 48
Test Toxoplasma Serology
Assay or Procedure IgG
IgM
IF Total Ab
IF IgM
Specimen Required Serum (clotted blood)
When Tested x2 weekly
x2 weekly
(Confirmatory)
(Confirmatory)
Contact 9342 2649/9342 2650
Test Transferrin
Specimen Required Serum (clotted blood)
When Tested Daily
See also: Iron studies
Reference Ranges 1.7 – 3.4
Units G/L
Contact 9342 2640
Test Triglycerides
Specimen Required Serum (clotted blood)
When Tested Daily
See also: Lipids
Reference Ranges 0.4 – 1.9
Units mmol/L
Contact 9342 2640
Page 49
Test Urate/Uric acid
Specimen Required Serum (clotted blood)
When Tested Daily
Normal Ranges Male: 0.21 – 0.45
Female: 0.15 – 0.40
Units mmol/L
Contact 9342 2640
Test Urea
Specimen Required Serum (clotted blood)
When Tested Daily
See also: U&E
Normal Ranges 2.0 – 7.8
Units mmol/L
Contact 9342 2640
Page 50
Test Valproate
Specimen Required Serum (clotted blood)
When Tested On request
Normal Ranges 277 – 346 (trough)
300 – 600 (peak)
Units µmol/L
Notes Both trough and peak levels are
recommended.
Contact 9342 2640
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