abia HIV AgAb

ref DK.003.01.3 ivd

ref DK.003.05.3
0483

Note: Changes highlighted

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 Intended use Principle of the test
abia HIV AgAb is an enzyme immunoassay for the qualitative detection of antibodies to human abia HIV AgAb is a “sandwich” assay based on microwells coated with recombinant antigens
immunodeficiency virus types 1 and 2 (HIV-1 and HIV-2), HIV-1 group O and HIV-1 p24 antigen in representing immunodominant regions of HIV-1, HIV-1 (O), HIV-2 proteins and antibodies to
human serum or plasma. HIV-1 p24 (p24 mAb). The conjugate is a mixture of biotin and HRP-labeled viral epitopes and
biotin-labeled antibodies against p24.
The assay is intended for screening for potentially infectious samples to prevent their use as
donor materials. For professional use only. Serum or plasma samples are added to the wells and if p24 antigen and/or antibodies specific
for HIV-1, HIV-1 (O) and HIV-2 are present in a sample, they form stable complexes with the HIV
antigens or antibodies immobilized on the wells.
Clinical value
Then the antigen-antibody complexes are identified by the addition of:
Detection of antibodies to HIV proteins or simultaneous detection of antibodies and p24 core (1) biotinylated antigens and antibodies and
protein is the most prevalent method of HIV laboratory diagnostics. (2) HRP streptavidin conjugate and HRP labeled antigens (for minimization of „hook effect“).
HIV antigens and antibodies appear and are detectable at different stages of the seroconversion The unbound components are removed by washing. After addition of the solution containing
and the infection. TMB and hydrogen peroxide, the wells with bound conjugate develop a blue colour which is
converted to yellow after the reaction has been stopped with sulphuric acid.
Use of a highly sensitive kit for simultaneous detection of antibodies and p24 antigen allows
reducing a phase of serological window on the average to 4-6 days due to the detection of the The colour intensity is directly proportional to the concentration of HIV antigens/antibodies in
earliest marker of HIV infection p24 antigen. the specimen and can be read at 450 nm or 450/620 nm.
The diagnostic significance of p24 antigen is important also at last stage of an infection, when
functional ability of immune system is low.

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 Kit contents
S XL
HIV AgAb coated plate 1 5 polystyrene plate 12 × breakable 8-well strips coated with recombinant HIV Ag and p24 mAb
Conjugate 1 (concentrated 11-fold) 1 × 1.2 ml 1 × 2.5 ml mixture of biotinylated recombinant HIV Ag and p24 mAb; colourless or pale yellow liquid
Conjugate 2 (concentrated 11-fold) 1 × 1.4 ml 1 × 3.5 ml mixture of HRP labeled recombinant HIV Ag and streptavidin; colourless or pale yellow liquid
HIV Ag positive control (inactivated) 1 × 2.5 ml 1 × 2.5 ml ready to use; purified recombinant HIV-1 p24 Ag in human plasma; crimson-red liquid
HIV Ab positive control (inactivated) 1 × 2.5 ml 1 × 2.5 ml ready to use; human plasma positive for HIV Ab; orange liquid
Negative control 1 × 2.5 ml 2 × 2.5 ml ready to use; negative human plasma; green liquid
Washing solution (concentrated 25-fold) 1 × 50 ml 2 × 120 ml phosphate saline buffer; colourless or pale yellow liquid
Conjugate 1 diluent 1 × 12 ml 1 × 25 ml sodium caseinate, NaCl; orange liquid
Conjugate 2 diluent 1 × 14 ml 2 × 18 ml phosphate saline buffer; blue liquid
TMB (concentrated 11-fold) 1 × 2.5 ml 2 × 3.5 ml solution containing TMB; colourless liquid
Substrate buffer 1 × 25 ml 1 × 70 ml citric acid and sodium acetate solution, containing H2O2; colorless liquid
Stopping reagent 0.2M H2SO4 1 × 25 ml 1 × 90 ml ready to use; 0.20 M/L sulphuric acid solution; colourless liquid
Protective film 2 10
Plastic dish 2 –
Zip-lock plastic bag 1 5

All components are stable until expiration date of the kit when stored at 2–8 ºC in a tightly sealed package
Expiration date is indicated on the package
Concentration of preserving agents: <0.1 %

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 Materials and equipment required but not provided –– all materials contacted with specimens or reagents, including liquid and solid waste, should
be inactivated by validated procedures (autoclaving or chemical treatment) and disposed in
–– purified water
accordance with applicable local law regulations
–– automatic or semiautomatic, adjustable or preset pipettes or multipipettes
–– disposable pipette tips
–– microplate incubator or shaker thermostatically set at 37.0 ± 1.0 °C
Precautions
–– automatic microplate washer
–– microplate reader equipped with 450 nm or with 450/620–680 nm filters –– do not use reagents without label or with damaged label/package
–– do not use expired reagents
–– do not change the assay procedure; perform all subsequent steps without interruption
Safety notes​ –– do not mix reagents from different lots
–– do not mix the caps of vials
–– human origin material used in the preparation of the negative control and Ag positive control
–– do not run the EIA test in the presence of reactive vapours (acid, alkaline, aldehyde), dust or
has been tested by CE-marked tests and found non reactive for hepatitis B surface antigen
metals
(HBsAg), antigen p24 HIV-1, antibodies to hepatitis C virus and antibodies to human immuno-
–– do not let the wells dry once the assay has been started
deficiency virus (HIV-1 and HIV-2)
–– do not use the same container and tips for different liquid components of the kit and samples
–– human origin material used in the preparation of the Ab positive control has been tested by
–– do not reuse the coated plates
CE-marked tests and found nonreactive for hepatitis B surface antigen (HBsAg), antigen p24
–– do not reuse the removed protective film
HIV-1 and antibodies to hepatitis C virus
–– do not expose the reagents to excessive heat or sunlight during storage and test procedure
–– as no known test method can offer complete assurance that infections agents are absent,
–– do not freeze the reagents
handle reagents and samples as if capable of transmitting infections disease; any equipment
directly in contact with samples and reagents should be considered as contaminated
–– do not eat, drink, smoke, or apply cosmetics in the laboratory
–– do not pipette by mouth
–– avoid any contact of the reagents and samples with the skin and mucosa; wear lab coats and
disposable gloves when handling them; thoroughly wash your hands after work
–– avoid spilling samples or solutions containing samples. Wipe spills immediately and deconta-
minate affected surfaces

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 Collection and handling of specimens Procedural notes
–– collect blood specimens according to the current practices –– before use wait 30 minutes for the reagents to stabilize to room temperature (18–24 °C)
–– use undiluted heparin/EDTA/citrate plasma or serum for testing; test performances of the test –– check appearance of the reagents
have not been evaluated on other biological fluids –– lost vacuum in the bag of the coated plate will not affect the performance of the test
–– separate the clot or red cells from serum or plasma as soon as possible to avoid any –– check the pipettes and other equipment for accuracy and correct operation
haemolysis –– the washing procedure is a critical step; for the detailed washer settings see section “Washing
–– do not use sera or plasma preserved with sodium azide procedure”
–– do not use contaminated, hyperlipaemic and hyperhaemolysed specimens –– for the description of test procedure with the automated analyzers see section “Automated
–– the samples with hyperproteinaemia and hyperbilirubinaemia were not specially tested analyzers”
–– pooled specimens must not be used since the accuracy of test with such specimens has not
been validated
–– before testing samples with observable particulate matter should be clarified by centrifuga- Washing procedure
tion
Please contact your representative for protocols for recommended washers and procedures.
–– suspended fibrin particles or aggregates may yield reactive results
In general the following protocol is recommended:
–– do not heat the samples
–– samples can be stored at 2–8 °C within 48 hours or deep-frozen at -20 °C –– flow-through washing with a volume not less than 400 µl per well is used. When using a
–– no more than three freeze/thaw cycles are allowed microplate washer for which this is not possible, ensure that the well is completely filled with
a slight positive meniscus without overflow
–– allow a soaking time of at least 40 seconds
–– repeat 4 times
–– do not allow the wells to become dry during the assay procedure
–– ensure that no liquid is left in the well (use double aspiration in the final step where possible)
–– avoid to tap out the plate
–– residual volume lower than 10 µl is not critical for following steps of the test procedure
–– when using a microplate washer clean the wash head frequently to prevent contamination

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 Preparation of reagents
Number of strips to be used 1 2 3 4 5 6 7 8 9 10 11 12
Working washing solution: mix the reagents thoroughly by inversion
Stability: 14 days at 18–24 ºC or 28 days at 2–8 ºC
Washing solution (concentrated 25-fold), ml 3.0 6.0 9.0 12.0 15.0 18.0 21.0 24.0 27.0 30.0 33.0 40.0
Purified water, ml 72.0 144.0 216.0 288.0 360.0 432.0 504.0 576.0 648.0 720.0 792.0 960.0
Working solution of conjugate 1: mix the reagents thoroughly until diluted, avoid foaming
Note: before use keep the working solution of conjugate 1 at least within 10 min at 18–24 ºC
Stability: 12 hours at 18–24 ºC in a dark place
Conjugate 1 (concentrated 11-fold), ml 0.03 0.06 0.09 0.12 0.15 0.18 0.21 0.24 0.27 0.30 0.33 0.5
Conjugate 1 diluent, ml 0.3 0.6 0.9 1.2 1.5 1.8 2.1 2.4 2.7 3.0 3.3 5.0
Working solution of conjugate 2: mix the reagents thoroughly until diluted, avoid foaming
Note: before use keep the working solution of conjugate 2 at least within 10 min at 18–24 ºC
Stability: 12 hours at 18–24 ºC in a dark place
Conjugate 2 (concentrated 11-fold), ml 0.05 0.10 0.15 0.20 0.25 0.30 0.35 0.40 0.45 0.50 0.55 0.7
Conjugate 2 diluent, ml 0.5 1.0 1.5 2.0 2.5 3.0 3.5 4.0 4.5 5.0 5.5 7.0
Substrate mixture: mix the reagents thoroughly until dilution
Note: substrate mixture should be colorless!
Stability: 10 hours at 18–24 ºC in a dark place
TMB (concentrated 11-fold), ml 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1.0 1.1 1.2
Substrate buffer, ml 1.0 2.0 3.0 4.0 5.0 6.0 7.0 8.0 9.0 10.0 11.0 12.0

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 Test procedure
Attention! Incubation is possible as two alternative procedures. During test performance follow the same incubation mode. The combination of incubation modes is not supposed.
Procedure 1 - microplate incubator Procedure 2 - microplate thermoshaker
1 Take the required number of coated strips. Place the unused strips back into the bag; reseal the foil-lined package in zip-lock plastic bag. Do not remove desiccant.
2 Add 30 µl of working solution of conjugate 1 in each well.
3 Add 70 µl of HIV Ab positive control in well A1.
Add 70 µl of HIV Ag positive control in well B1.
Add 70 µl of negative control in well C1, D1 and E1.
Add 70 µl of samples to be tested in rest of the wells.
Depending on the used system and the number of used strips, it is possible to modify the position of controls or the order of distribution.
The total time should not exceed 15 min. Orange colour of the working solution of conjugate 1 should change to pink.
The colour may change to yellow in case of specimens with acid pH, or not change in case of specimens with neutral pH.
Mix the contents of the wells by careful tapping on the edge of the plate, then cover the plate with protective film.
4 Incubate in microplate incubator for 60 minutes at 37.0 ± 1.0 °C. Incubate during 45 minutes in shaker at 500 rpm at 37.0 ± 1.0 °C.
5 Remove the protective film slowly and carefully to prevent splashes. Without removing the contents of the wells and washing the wells, add 50 µl of working solution of conjugate 2 into each well.
The pink colour should change to green. Mix the contents of the wells by careful tapping on the edge of the plate, then cover the plate with protective film.
6 Incubate in microplate incubator for 30 minutes at 37.0 ± 1.0 °C. Incubate during 20 minutes in shaker at 500 rpm at 37.0 ± 1.0 °C.
7 Remove the protective film slowly and carefully to prevent splashes. Aspirate the contents of all wells into a container for biohazardous waste (containing disinfectant).
Add not less than 400 µl of working washing solution into each well. Allow a soaking time of at least 40 seconds and aspirate. Perform this procedure 4 times.
8 Add 100 µl of substrate mixture to all the wells. Keep the plates in a dark place for 20 minutes at 18–24 °C.
9 Add 150 µl of stopping reagent into each well.
10 Read the optical density at 450/620-680 nm using a plate reader. Reading the absorbance at 450 nm only is possible. Test results remain stable for reading within at least 10 minutes.

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 Automated analyzers Calculation and interpretation of the results
Validated protocols for automated analyzers can be obtained from your representative. Assay validation
For the instrumentation without established validated protocol follow section “Test procedure”
Results of an assay are valid if the following criteria for the controls are met.
and ensure all requirements described in section “Precautions” are followed.
All protocols for automated analyzers must be fully validated prior usage. The absorbance (OD) of each negative control should be less than 0.200.
If one negative control does not respect this norm, disregard and recalculate the mean value
using the two remaining values. Only one value may be eliminated by this way.
The absorbance (OD) of HIV Ab positive control should be greater than 0.800.
The absorbance (OD) of HIV Ag positive control should be greater than 0.800.

Calculate cut-off value

Mean OD value of the negative control = (OD value C1 + OD value D1 + OD value E1)/3
Cut-off = mean OD value of negative control + 0.400

Interpretation of the results

Non-reactive sample: sample OD value < cut-off
Samples with absorbance values less than the cut-off value are considered to be negative by the
abia HIV AgAb test.
Reactive sample: sample OD value ≥ cut-off
Samples with absorbance values more than the cut-off value are considered to be positive by the
abia HIV AgAb test.
No “grey zone” is contemplated.

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 Performance characteristics Diagnostic specifity
Number of
tested samples Specificity, %
The performance of the abia HIV AgAb has been determined by testing samples from random
blood donors, from patients with confirmed HIV-1 (including group O) and HIV-2 infection and Unselected blood donors 12 776 99.70
patients in other clinical categories. In addition, its performance on commercially available Pregnant women 364 100.00
seroconversion panels has been evaluated. Hospitalized patients with non-infectious diseases 273 100.00
HIV Ag sensitivity limit has been tested using WHO International Standard (NIBSC Code: 90/636).
Patients with infectious diseases (Hepatitis A, B, C, syphilis, 182 99.45
Number of chlamydiosis, herpetic and cytomegalovirus infections)
Diagnostic sensitivity
tested samples Sensitivity, % Patients with rheumatoid factor 182 100.00
HIV-1 positive samples 497 100.00
incl. identified subtypes 95 100.00 Analytical sensitivity
HIV-2 infected patients 132 100.00 The analytical sensitivity was evaluated with “HIV-1 p24 ANTIGEN 1st International Reference
WWRP 302 (M), world wide performance panel 28 100.00 Reagent” (NIBSC Code: 90/636) and defined at 1.0 IU/ml.
1st International reference panel, NIBSC code: 02/210 6 100.00
BBI PRZ206, anti-HIV 1/2 combo performance panel 11 100.00 Precision
BBI PRB204 (M), anti-HIV 1 mixed titer performance panel 23 100.00 The repeatability within one plate was evaluated by testing 3 positive samples 25 times each.
BBI PRB601, HIV 1 incidence/prevalence performance panel 15 100.00 The CV did not exceed 5 %.
The repeatability between different plates was evaluated by testing 3 positive samples 25 times
BBI QRZ761, anti-HIV 1/2 qualification panel 5 100.00
each using 3 different lots. The CV did not exceed 5 %.
The reproducibility between different lots, operators, days, laboratories was evaluated by testing
56 commercial seroconversion panels (Seracare, ZeptoMetrix) were evaluated and compared 3 positive samples 25 times each using 3 different lots. The CV did not exceed 5 %.
against a commercially available CE marked 4th generation assay.

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 Limitations of test References
–– a sample should not be defined as positive for anti-HIV-1,2 or antigen p24 HIV-1 based on a 1. Bernard Weber. Screening of HIV infection: role of molecular and immunological assays.
single reactive result. Reactive results should be re-tested; and in case of repeated reactive Expert Rev. Mol. Diagn. 6:3, 2006
result confirmed by supplemental assays. 2. Niel T. Constantine & Holly Zink. HIV Testing technologies after two decades of evolution.
–– non-reactive results can occur if the concentration of marker present in the sample is below Indian J Med Res 121: 519-538, 2005.
the detection limit of the assay, or if the marker to be detected is not present during the stage 3. Andre Tehe. Quantification of HIV-1 by a highly improved ELISA: An alternative to HIV-1
of disease when a sample has been collected. RNA based treatment monitoring in patients from Abidjan, Cote d‘ Ivoire. Journal of Clinical
–– the variability of HIV virus doesn’t allow to exclude the possibility of false negative results. No Virology 37: 199-205, 2006.
known test method can offer complete assurance that the HIV virus is absent. 4. Ulf-Hakan Stenman. Immunoassay Standardization: Is It Possible, Who Is responsible, Who Is
Capable. Clinical Chemistry 47: 815-820, 2001.
5. G. Stevens. Evaluation of Two Commercially Available, Inexpensive Alternative Assay Used for
Assessing Viral Load in a Cohort of Human Immunodeficiency Virus Type 1 Subtype C-Infected
Patients from South Africa. Journal of Clinical Microbiology 43: 857-861, 2005.
6. Feredoun Mahboudi. A serological screening assay of human immunodeficiency virus type 1
antibodies based on recombinant protein p24-gp41 as a fusion protein expressed in Escheri-
chia coli. Journal of Biotechnology 125: 295-303, 2006.

10

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 Key to symbols used Hazard and precautionary statements for certain kit components
Stopping reagent
Manufacturer
H315 Causes skin irritation.

ivd For in vitro diagnostic use H319 Causes serious eye irritation.
P264 Wash hands thoroughly after handling.
ref Catalogue number P280 Wear protective gloves/protective clothing/eye
Warning protection/face protection.
lot Batch code P302 + P352 IF ON SKIN: Wash with plenty of soap and water.
P305 + P351 + IF IN EYES: Rinse cautiously with water for several
YYYY-MM-DD Expiry date P338 minutes. Remove contact lenses, if present and easy to
do. Continue rinsing.
8°C
Storage temperature limitation TMB
2°C
H317 May cause an allergic skin reaction.
Do not use if package is damaged
H360D May damage the unborn child.

Do not reuse P201 Obtain special instructions before use.

P281 Use personal protective equipment as required.
n Sufficient for [n] tests P308 + P313 IF exposed or concerned: Get medical advice/attention.

Consult Instructions for use

Caution, consult documents Danger!

Changes highlighted

11

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 2017-01-19 IU.003.00.3/2
AB Diagnostic Systems GmbH +49 30 208 987 160
Sportfliegerstraße 4 +49 30 208 987 199
12487 Berlin [email protected]
Germany www.ab-ds.de

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