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Abstract
BACKGROUND:
It has been known for some time that the antiretroviral drug, efavirenz (EFV), cross-reacts in urine immunoassays for tetrahydrocannabinol (THC). Because published studies investigating this phenomenon are limited, cross-reactivity information for several immunoassays is lacking. Reports of possible false-positive THC results from clinicians conducting workplace testing prompted us to investigate cross-reactivity for assays frequently employed in our own setting. In light of the potentially deleterious consequences of misclassification, information about EFV cross-reactivity should be included in product information to facilitate interpretation of results and assay selection.
METHODS:
Random urine samples from 30 patients on EFV therapy were analysed for THC metabolites by two near-testing devices (THC One Step Marijuana and Rapid Response(®) Drugs of Abuse Test Strips) and two automated immunoassays (Roche Diagnostics Cannabinoids II and Beckman Coulter SYNCHRON(®) Systems THC2). THC confirmatory testing was performed by gas chromatography-mass spectrometry (GC-MS).
RESULTS:
GC-MS failed to detect THC metabolites in any of the samples, as did three of the four immunoassays. However, the Rapid Response(®) test strips yielded positive results in 28 out of 30 samples, which could be reversed on re-testing after sample pretreatment with glucuronidase.
CONCLUSIONS:
Our study supports previous findings that interference is attributable to a glucuronidated EFV metabolite. We postulate that cross-reactivity is influenced by the composition of immunogens used to elicit anti-THC antibodies. Since access to such information is restricted, contributions from scientists in the antibody industry may be enlightening.
Source: Efavirenz interference in urine screening i... [Ann Clin Biochem. 2012] - PubMed - NCBI
BACKGROUND:
It has been known for some time that the antiretroviral drug, efavirenz (EFV), cross-reacts in urine immunoassays for tetrahydrocannabinol (THC). Because published studies investigating this phenomenon are limited, cross-reactivity information for several immunoassays is lacking. Reports of possible false-positive THC results from clinicians conducting workplace testing prompted us to investigate cross-reactivity for assays frequently employed in our own setting. In light of the potentially deleterious consequences of misclassification, information about EFV cross-reactivity should be included in product information to facilitate interpretation of results and assay selection.
METHODS:
Random urine samples from 30 patients on EFV therapy were analysed for THC metabolites by two near-testing devices (THC One Step Marijuana and Rapid Response(®) Drugs of Abuse Test Strips) and two automated immunoassays (Roche Diagnostics Cannabinoids II and Beckman Coulter SYNCHRON(®) Systems THC2). THC confirmatory testing was performed by gas chromatography-mass spectrometry (GC-MS).
RESULTS:
GC-MS failed to detect THC metabolites in any of the samples, as did three of the four immunoassays. However, the Rapid Response(®) test strips yielded positive results in 28 out of 30 samples, which could be reversed on re-testing after sample pretreatment with glucuronidase.
CONCLUSIONS:
Our study supports previous findings that interference is attributable to a glucuronidated EFV metabolite. We postulate that cross-reactivity is influenced by the composition of immunogens used to elicit anti-THC antibodies. Since access to such information is restricted, contributions from scientists in the antibody industry may be enlightening.
Source: Efavirenz interference in urine screening i... [Ann Clin Biochem. 2012] - PubMed - NCBI
