Test Code HTLLC Human T-Cell Lymphotropic Virus Types 1 and 2 (HTLV-1/-2) Antibody Confirmation, Spinal Fluid
Ordering Guidance
This confirmatory assay should be ordered only on spinal fluid specimens that are consistently reactive by an antihuman T-cell lymphotropic virus 1 and 2 (HTLV-1/-2) screening immunoassay. For an evaluation that includes both screening and confirmation, order HTLVC / Human T-Cell Lymphotropic Virus Types 1 and 2 (HTLV-1/-2) Antibody Screen with Confirmation, Spinal Fluid.
For testing serum specimens, order HTLVL / Human T-Cell Lymphotropic Virus Types I and II (HTLV-I/-II) Antibody Confirmation, Serum.
Necessary Information
Date of collection is required.
Specimen Required
Collection Container/Tube: Sterile vial
Specimen Volume: 0.5 mL
Useful For
Confirmatory detection of human T-cell lymphotropic virus types 1 and 2 (HTLV-1 and HTLV-2)-specific IgG antibodies in spinal fluid specimens that are consistently reactive by initial screening tests
Differentiating between HTLV-1- and HTLV-2-specific IgG antibodies present in spinal fluid
Method Name
Line Immunoassay (LIA)
Reporting Name
HTLV -1/-2 Ab Confirmation, CSFSpecimen Type
CSFSpecimen Minimum Volume
0.2 mL
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
CSF | Frozen (preferred) | 30 days | |
Refrigerated | 14 days |
Reference Values
Negative
Interpretation
Negative confirmatory test results indicate the absence of both human T-cell lymphotropic virus types 1 and 2 (HTLV-1 and HTLV-2)-specific IgG antibodies in spinal fluid and a low probability of an HTLV-1/-2-associated neurologic disorder.
A reactive screening (enzyme immunoassay) result with a negative or indeterminate confirmatory (line immunoassay) test result suggests either a false-reactive screening test result or a seroconverting HTLV infection. Repeat testing with a new specimen can clarify the final infection status. Persistently indeterminate confirmatory test results indicate an absence of HTLV infection.
Positive results for HTLV-1 antibodies indicate the confirmed presence of HTLV-1 IgG antibodies in spinal fluid, based on 2 visible antibody bands that include gp21-I/-II band, or 3 or more bands, and the sum of the gp46-I and p19-I band intensity is greater than the gp46-II band intensity.
Positive results for HTLV-2 antibodies indicate the confirmed presence of HTLV-2 IgG antibodies in spinal fluid, based on 2 visible antibody bands that include gp21-I/-II band, or 3 or more bands, and the gp46-II band intensity is a) greater than the gp46-I band intensity and b) greater than or equal to the sum of the gp46-I and p19-I band intensity.
Indeterminate results indicate the presence of the gp21-I/-II band only or combination of any 2 bands without a detectable gp21-I/-II band. Patients with indeterminate test results with known risk factors for HTLV-1 or HTLV-2 infection should undergo repeat confirmatory antibody testing with a new specimen to determine final infection status.
Differentiation of HTLV-1 and HTLV-2 infection is not possible (ie, nontypeable HTLV antibodies) when the band intensity pattern does not meet the criteria of positive HTLV-1 or HTLV-2 antibody band intensity pattern.
Unreadable results indicate the presence of nonspecific background reactivity that is inhibiting the visualization of specific bands on the test strip. Repeat testing with a new specimen is recommended.
Invalid results indicate that nonspecific band reactivity is present. Submit another specimen for retesting if clinically indicated.
Clinical Reference
1. Mahieux R, Gessain A. Adult T-cell leukemia/lymphoma and HTLV-I. Curr Hematol Malig Rep. 2007;2(4):257-264. doi:10.3390/v8060161
2. Yamano Y, Sato T. Clinical pathophysiology of human T-lymphotropic virus-type I-associated myelopathy/tropical spastic paraparesis. Front Microbiol. 2012;3:389. doi:10.3389/fmicb.2012.00389
3. Marrero Rolon RM, Yao JDC. Laboratory diagnosis of HTLV-1-associated myelopathy. Clin Microbiol Newslett. 2020;42(16)129-134. doi:10.1016/j.clinmicnews.2020.07.004
Day(s) Performed
Tuesday
Report Available
2 to 15 daysPerforming Laboratory
Mayo Clinic Laboratories in RochesterTest Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
86689
LOINC Code Information
Test ID | Test Order Name | Order LOINC Value |
---|---|---|
HTLLC | HTLV -1/-2 Ab Confirmation, CSF | 93744-1 |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
604935 | HTLV-1/-2 Ab Confirmation, CSF | 93745-8 |
604945 | HTLV-1/-2 Bands | 93743-3 |
604946 | HTLV-1/-2 Discrimination | 93742-5 |
Forms
If not ordering electronically, complete, print, and send Infectious Disease Serology Test Request (T916) with the specimen.