Welcome to the Virology & Immunology Department, LabPlus!

We hold a unique position in New Zealand medical laboratories having effectively combined diagnostic virology and immunology into one integrated discipline. Our diagnostic range includes immunochemistry, allergy testing, viral isolation and the serologic diagnosis of infectious and autoimmune diseases. Molecular-based techniques are a particularly successful component of our diagnostic work, with application both in the diagnosis of viral diseases and in the monitoring of infected patients undergoing treatment.

Our laboratory is well supplied with modern processing equipment. Work practices and test systems are constantly under review to ensure prompt and efficient delivery of test results. The accuracy and clinical relevance of our results are ensured by ongoing participation and high level performance in international quality assurance programs.

Our department is supported by highly qualified and experienced clinical and technical staff.

• ANA testing is now uses a Hep-2000 cell line which hyper-expresses SSA antigen.

• Testing for tissue transglutaminase (ttG) antibody as a marker for coeliac disease. Our routine test looks for IgA antibodies to ttG, with testing for IgG antibodies available for patients who are IgA deficient. Antibodies to ttG have replaced the triad of gliadin, endomysial and reticulin antibodies.

• Use of myeloperoxidase (ANCA-MPO) and proteinase 3 (ANCA-PR3) specific ELISA's to improve the diagnosis of autoimmune vasculidities such as Wegeners granulomatosis. 

• Use of specific ELISA's for antibody against thyroglobulin and thyroid peroxidase in the diagnosis of autoimmune thyroiditis. 

• Testing for antibody to soluble liver antigen to enable positive identification of autoimmune liver disease.

• Other services include testing for cardiolipin antibody (a-PL syndrome), intrinsic factor (pernicious anaemia), intercellular / basement zone antibody (pemphigus / pemphigoid disease) and glomerular basement antibody (Goodpastures' syndrome). Cardiac and striated muscle antibody testing are also offered.

Queries regarding any aspect of the Serology service should be directed initially to one of the Technical Specialists identified in the departmental senior staff listing.
Contact extensions: 6110 and 6108.

Protein electrophoresis is the mainstay of the diagnosis of myeloma and other monoclonal gammopathies. Monoclonal bands which are found are quantitated by densitometry and the type of immunoglobulin is identified using immunofixation electrophoresis. Serial quantitations provide accurate information about whether a monoclonal component is changing with time or not in a patient.

Quantitation of immunoglobulins and many other plasma proteins such as ceruloplasmin, alpha-1 antitrypsin, haptoglobin, beta-2 microglobulin, apoproteins A1 and B, prealbumin and complement, is performed using immunonephelometry on the Beckman Immage analyzer. Immunoglobulin quantitation is important in the diagnosis of immune deficiency syndromes, and changes in immunoglobulin levels after incubation of serum at low temperatures permits the identification of the presence of cryoglobulins.

Alpha-1 antitrypsin phenotyping is done by isoelectric focussing, which provides valuable information for counselling of patients and family members with alpha-1 antitrypsin deficiency. This technique is also used for the detection of oligoclonal bands in cerebrospinal fluid, which is a diagnostic marker of multiple sclerosis. Isoelectric focussing is also used for the detection of beta-2 transferrin, a useful as a marker to identify the presence of a cerebrospinal fluid leak, in cases of skull fracture or after neurosurgery.

The Allergy section offers a wide range of both blood and skin testing. All skin testing is carried out under clinical supervision with emergency equipment on hand.

Skin Prick testing is available using commercially produced extracts for foods and inhalants, including plant pollens, animal hair/dander and moulds. Fresh food prick testing is also available after consultation with our Immunologist.

Intradermal testing is available for Venoms, some antibiotics and both local and general anaesthetic agents. Anaesthetic testing is arranged through Anne Wills of the Anaesthetic Department.

Blood tests are also available for Total IgE, specific IgE antibodies and Tryptase levels.

Timing of specimens for Tryptase are important and a series of specimens at 30 minutes, 60 minutes and greater than 6 hours after an acute event will give the best chance of detection of an anaphylactic attack.

Rapid techniques generally involve detection of viral antigens using fluorescein tagged antibodies. This is useful for acute respiratory specimens, where nasopharyngeal aspirates can be examined directly for a battery of viruses. Scrapings from blisters can likewise permit the rapid diagnosis of herpes simplex or chickenpox. Turnaround time for scrapings is 1 to 2 hours.

Isolation of virus in tissue culture is a more sensitive technique and provides the opportunity for precise characterisation of the isolated virus. This is important in the long term control of eg influenza, where vaccine formulation depends on accurate and detailed information on influenza variants prevailing in the community. Culture of virus may also be successful where titre of virus in the clinical specimen is low, as in resolving infections or in infections which are inherently less florid. Respiratory viruses, herpes viruses, enteroviruses and the occasional mumps virus would be our most common culture requests.

A wide range of specimens may be suitable for viral culture. We are happy to discuss the options including optimal methods of collection and transport.

The unit has expanded to 9 scientists, supported by state-of-the-art technology including thermal cyclers, real time PCR apparatus, and facilities for measuring viral load. HPLC and sequencer.

Areas of special interest include the human herpes viruses (all eight varieties!); hepatitis viruses B, C, D and E; HIV, with data on NZ genotypes; papillomaviruses and their role in cervical cancer; polyomaviruses JC and BK; rapid diagnosis of influenza (pandemic preparedness!); and SARS coronavirus; adenovirus (particularly relevant in the heavily immunosuppressed); viruses causing encephalitis i.e. HSV, VZV, enteroviruses, measles, rubella, JC; and infections that in particular may affect the foetus eg CMV, parvovirus and toxoplasmosis. 

Measurement of viral load is available for HIV, hepatitis B and CMV and, in each case, is complemented by detection of drug resistant mutants where relevant. EBV viral load is available for monitoring of PTLD, likewise quantitative BK viraemia in renal transplant recipients.

We are happy to discuss the best diagnostic options for your clinical problems. In many instances, a sequential analytical approach may achieve the broadest coverage with maximum conservation of resources.