Which tests at ARUP Labs?

[Sinclair]

ARUP Labs are widely known for their enteroviruses testing.

What other additional viral/immunological testing do you recommend at this Lab?

HHV 6, CMV, VZV are the ones suggested.

I got in touch with ARUP and want to know what is the most cost-effective package I can get from them.

The only final feedback they gave me was to check their website with my GP, and then define.

In my country, viral testing does not include titers, for instance. People from ARUP told me I can send the samples from here.

I have had good response with the protocol in my signature. In defining it I have mainly followed the enterovirus theory of ME/CFS ethiology. (by good response I mean maintaining myself on the moderate rather than the severe side of the spectrum, but I have been there too)

So, I'd appreciate any feedback regarding experiences with ARUP testing, on enteroviruses and other viral/immunological tests.

Thanks in advance!
Sinclair

 

[halcyon]

If you're not happy with the testing available in your country and ARUP is willing to accept your samples I'd take advantage of it and get whatever testing you haven't had yet. I had read here that people had trouble previously getting them to accept samples from outside the US, it's nice to hear that policy might have changed.

As I'm sure you've read already, they are known for their Coxsackie B and echovirus test panels as they are one of the few (only?) commercial labs in the US that offer the quantitative neutralization assay. Don't bother with their Coxsackie A panel though as it does not use the same method and isn't accurate for chronic infections.

I tested negative by complement fixation for Coxsackie A+B and echovirus at Focus Diagnostics here in the US. I tested positive for echovirus 30 at ARUP a few months later with a titer of 1:320.

 

[Hip]

@Sinclair

If you find out that ARUP are now accepting blood samples from outside the US, please let us know. The last time I checked with them, a few years ago, they were not accepting blood samples from abroad.

I was interested in doing the ARUP Lab coxsackievirus B and echovirus tests that @halcyon linked to above.

Does anyone know the cost of these two tests, by the way?

 

[halcyon]

So I was looking at my results a little closer and I noticed that my echovirus panel wasn't done by ARUP. It was done by a lab called Cambridge Biomedical and they appear to only have the echovirus panel, no Coxsackie. My blood was drawn by LabCorp using test codes that were provided by Dr. Chia so I'm not sure if Chia or LabCorp switched up where they are sending their echovirus panel. I'll ask Chia about this when I see him in January. Perhaps Cambridge Biomedical will accept samples from outside the US?

I tried to look at my insurance claim for the prices but they're all listed generically as "Lab Immunology" and I had HHV6 and C. pneumonia tested at the same time. If it helps it's somewhere between $83.00 and $314.00.

 

[Sinclair]

Yes, I was told by people at ARUP that they were receiving samples from abroad.
However, I have not received any additional feedback regarding logistics yet.

 

[halcyon]

Well that's good news. I believe the lab that does the draw has to open an account with ARUP and they have very specific packaging requirements. I believe ARUP requires the submitting lab to use their collection tubes and packaging. There is some information here.

 

[Hip]

I just enquired whether ARUP now accept blood samples from abroad, and if so, asked the price of the coxsackievirus B and echovirus antibody tests. They did not answer my first question, but quoted me some prices:

Coxsackie B Virus Antibodies
Price: US$ 438.00
Orderable Test Num: 0060055
Methodology: Semi-Quantitative Serum Neutralization
Reported: 6-9 days
Collection: Serum separator tube or plain red. OR CSF.
Specimen Preparation: Separate serum from cells within 2 hours of collection. Transfer 1 mL serum or CSF to an ARUP Standard Transport Tube. (Min: 0.3 mL) Parallel testing is preferred and convalescent specimens must be received within 30 days from receipt of acute specimens. Mark specimens plainly as "acute" or "convalescent."
Storage/Transport Temperature: Refrigerated.
Unacceptable Conditions: Contaminated, hemolyzed, or severely lipemic specimens.
Stability (collection to initiation of testing): Ambient: 48 hours; Refrigerated: 2 weeks; Frozen: 1 year (avoid repeated freeze/thaw cycles)

Echovirus Antibodies
Price: US$ 445.00
Orderable Test Num: 0060053
Methodology: Semi-Quantitative Serum Neutralization
Reported: 6-9 days
Collection: Serum separator tube or plain red. OR CSF.
Specimen Preparation: Separate serum from cells within 2 hours of collection. Transport 1 mL serum or CSF. (Min: 0.3 mL) Parallel testing is preferred and convalescent samples must be received within 30 days from receipt of acute samples. Mark samples plainly as "acute" or "convalescent."
Storage/Transport Temperature: Refrigerated.
Unacceptable Conditions: Plasma.
Stability (collection to initiation of testing): Ambient: 48 hours; Refrigerated: 2 weeks; Frozen: 1 year (avoid repeated freeze/thaw cycles)

This seems very expensive. I am certainly not going to get tested at that price. I was hoping that these tests would be under $100 each.

This is much more expensive than Dr Chia's stomach biopsy test, which costs $250.

 

[halcyon]

That is pretty darn expensive. They must give LabCorp a discount on the test as the most expensive one was $314 on my claim. The next most expensive test was $129 and I assume that was the echovirus test with Cambridge Biomedical.

 

[Hip]

Interestingly, Dr Chia found the combination of interferon and ribavirin was effective against coxsackievirus B3 infections, but found these drugs were not effective against coxsackievirus B4 infections. Chia said this in a video from the Invest in ME London 2009 ME/CFS Conference (timecode 42:30).

Thus the antiviral efficacy of drugs and supplements can depend on which particular serotype of coxsackievirus B or echovirus you have, and so it would be useful to know which serotypes you have.

 

[Hip]

They must give LabCorp a discount on the test as the most expensive one was $314 on my claim. The next most expensive test was $129 and I assume that was the echovirus test with Cambridge Biomedical.

I wrote to Cambridge Biomedical recently, and they told me their echovirus neutralization test costs $390, so it's not much cheaper than the ARUP Lab echovirus test. They told me they do accept blood sample from abroad for this test.


I really wish there was a more economical test for CVB and echovirus, which patients could use to see whether antiviral or immunomodulatory interventions such as the oxymatrine treatment are having an effect on viral loads.

I did recently come across pathology lab in South Africa called Lancet Labs, who provide a coxsackievirus B neutralization test for $190.

Lancet's test is not a plaque reduction neutralization test, but rather a cytopathic effect neutralization test (CPE).