MOH HIV/TB ECHO

Viral load sample handling

17th July 2023
Powell Choonga – Laboratory Advisor
Ministry of Health
 Learning Objectives
1. Understand the correct viral load specimen
collection procedure
2. Understand the correct viral load specimen
storage and transport
3. Understand the importance of quality
specimen handling.
4. Understand the viral load laboratory specimen
rejection criteria

The speaker has no significant financial conflicts of interest to disclose.

Viral load specimen collection procedure

Materials Collection
Required Procedure
 Tourniquet  Gently clean vein puncture
 Gloves site
 Alcohol swab  Collect 5mls of venous
 Needle and syringe blood
 Labelled EDTA specimen  Transfer blood to EDTA
collection tube container
 Gauze sponges  Gently shake/mix the
 Sharps disposing blood in the tube
container
 Viral load specimen – Storage
Specimen storage facility need to have proper equipment and consumables.

Store plasma specimens at 2-8C for up to 5 days, or frozen at -20 to -70 C

or colder.

Plasma specimens can be stored for only up to 24 hours at 15-30 C.

Plasma specimens are stored at -70 C if longer storage is required

Viral load specimen – Transport
Outer Packaging
• Protects secondary packaging from physical
damage while in transit
• Contains specimen data forms, letters, and other
types of information that identify or describe the
specimen and identify the shipper and receiver,
and any other documentation required.
• Must be a sturdy container with a latch or able to
be taped shut
Secondary Packaging
• Encloses and protects the primary receptacle.
• Must be watertight and leak proof.
• Several wrapped primary receptacles may be
placed in a single secondary packaging.

Primary Package
• Contains the specimen.
• Must be watertight and leak proof.
• Must be appropriately labeled as to content.
• Wrapped in enough absorbent material to
absorb all fluid in case of breakage or
leakage.
Importance of quality specimen collection
CORRECT DIAGNOSIS Correct samples aids in giving the correct
diagnosis to patients for correct treatment

Quick turn around time Correct samples give aids in quick results
return to patients

Consumables cost Use of correct consumables saves cost that

saving comes with repeat sample collection.

Correct specimen collection, handling and

Builds patient confidence
processing builds patient confidence and
in health care personnel
trust.
Viral load specimen – Biosafety
All individuals handling blood specimens in any of the collection,
processing and transportation steps must follow standard safety
practices for dealing with potentially infectious biological
material

In the event of an accidental spill, the sample transporter should

manage the spill using standard protocols for biohazard
management

The reduction of biohazard exposure is achieved through the

combination of safe practices and procedures, safe facilities,
and safety equipment that allows the containment of
biohazards.
 Viral load specimen rejection criteria

• Insufficient sample volume

• Sample is clotted
• Poor separation of plasma
• Plasma samples are NOT separated within 24 hours
after collection
• Specimens collected with non-EDTA anticoagulation
(HEPARIN or ACD)
• No/poorly labeled specimen tube
• Missing sample or lab request form
Viral load specimen rejection criteria

Valid serum and Lipemic specimen

plasma specimen

Hemolyzed Contaminated
specimen specimen
 Question
Nurse Mulenga collected only one VL sample on ART day,
she used a purple EDTA tube, correctly wrote the patient
information and identifiers on the request form. However,
she did not write the patient's name on the tube. She
assumed since its just one sample going to the laboratory,
they will use the form to identify the patient's name.
1. Is she correct to assume this?
2. What will happen to the sample sent to the laboratory?
3. Have you encountered any unlabeled specimen in your
department?
 Summary of Key Points
• All viral load specimen should be collected in
Purple top EDTA containers.
• Ensure all documentation accompanying the
specimen is correctly labelled, including the
specimen.
• Ensure yours and patients' safety when
handling biohazard specimen.
 References
• Zambia integrated courier guidelines
• Laboratory viral load specimen collection standard
operating procedures

• Contact – Your facility laboratory personnel for any

assistance.