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Product Description Varicella zoster virus IgG ELISA Kit is for detection IgG antibodies to varicella zoster virus in serum.

Intended Use Varicella zoster virus IgG ELISA assay is intended for in vitro diagnosis of VZV associated diseases, namely varicella and herpes zoster. The diagnostic kit can also be utilized for differential diagnosis of neuroinfections, infections of eye and skin exanthematous diseases.

Test Principle Varicella zoster virus IgG ELISA assay is a solid-phase immunoanalytical test. The polystyrene strips are coated with a native antigen containing immunodominant epitopes of VZV. Anti- VZV antibodies from serum samples bind to the immobilized antigens. The other serum antibodies do not bind and are washed away, those that formed complexes with the antigens are later on recognised by animal anti-human IgG antibodies labelled with horseradish peroxidase. The presence of the labelled antibodies is revealed by an enzymatic reaction with a chromogenic substrate. Negative sera do not react and the mild change in colour, if present, may be attributed to the reaction background.

Kit Components ELISA break-away strips (blue) coated with specific antigens 96 wells 1.3 mL Positive control serum, r.t.u. 1 vial 1.3 mL Negative control serum, r.t.u. 1 vial 1.3 mL Calibrator, r.t.u. 1 vial 0.2 mL Anti-human IgG antibodies labelled with horseradish peroxidase 101x concentrated (Px-conjugate) 1 vial 125 mL Wash buffer concentrate, 10x concentrated 1 vial 125 mL Dilution buffer (DB), r.t.u. 1 vial 15 mL Chromogenic substrate (TMB substrate), r.t.u. 1 vial 30 mL Stop solution, r.t.u. 1 vial Sealable pouch for unused strips Instruction manual Certificate of quality 1) (ready to use)

Material Required but Not Provide With the Kit a. Distilled or deionised water for dilution of the Wash buffer concentrate. b. Appropriate equipment for pipetting, liquid dispensing and washing. c. Spectrophotometer/colorimeter (microplate reader – wavelenght 450 nm).

Varicella zoster virus IgG ELISA Kit ( Cat # KA1455 V.01 ) For research use only www.abnova.com

Preparation of Reagents and Samples a. Allow all kit components to reach room temperature. b. Vortex samples (sera), Calibrator and Control sera in order to ensure homogeneity and mix all solutions well prior use. c. Dilute serum samples 1:100 in Dilution buffer and mix (e.g. 5 µL of serum sample +,500 µL of Dilution buffer). Do not dilute the Calibrator, Positive and Negative control, serum, they are ready to use. d. Prepare Wash buffer by diluting the Wash buffer concentrate 10x with an appropriate volume of distilled or deionised water (e.g. 100 mL of the concentrated Wash buffer + 900 mL of distilled water). If there are crystals of salt present in the concentrated Wash buffer, warm up the vial to 32 to 37°C in a water bath. Diluted Wash buffer is stable for one week if stored at 2 to 10°C. e. Dilute the concentrated Px-conjugate 1:100 with Dilution buffer (e.g. 0.1 mL Pxconjugate + 10 mL Dilution buffer). (Note: For one microtitre plate you will need approx. 12 mL of the diluted Px-conjugate., i.e. 0,12 mL of the concentrated Px-conjugate + 12 mL of Dilution buffer). f. Do not dilute TMB substrate and Stop solution, they are ready to use.

Assay Procedure a. Allow the microwell strips sealed inside the aluminium bag to reach room temperature. Withdraw an adequate number of strips and put the unused strips into the provided pouch and seal it carefully with the desiccant kept inside. b. Pipette Calibrator, Controls and samples according to the pipetting scheme (page 3, fig 1). Start with filling the first well with 100 µl of Dilution buffer (DB) to estimate the reaction background. Fill the next wells with 100 µl of Negative and Positive control sera, Calibrator apply into triplet of the wells. Fill the remaining wells with 100 µl of serum samples (S1, S2, S3,...). It is sufficient to apply samples as singlets, however, if you wish to minimize laboratory error apply the samples in doublets. Incubate 60 minutes (±5 min) at room temperature. c. Aspirate the liquid from wells into a waste bottle containing an appropriate disinfectant (see Safety Precautions). Wash and aspirate the wells four times with 250 µl/well of Wash buffer. Avoid cross-contamination between wells! If any liquid stays trapped inside the wells, invert the plate and tap it on an adsorbent paper to remove the remaining drops. d. Add 100 µL of diluted Px-conjugate into each well. e. Incubate 60 minutes (±5 min) at room temperature. f. Aspirate and wash four times with 250 µl/well of Wash buffer. g. Dispense 100 µl of TMB substrate into each well. h. Incubate 10 minutes (+/-5 seconds) at room temperature. The time measurement must be started at the beginning of TMB dispensing. Keep the strips in the dark during the incubation with TMB substrate. i. Stop the reaction by adding 100 µL of Stop solution. Use the same pipetting rhythm as with the TMB substrate to ensure the same reaction time in all wells. Tap gently the microplate few times to ensure

Varicella zoster virus IgG ELISA Kit ( Cat # KA1455 V.01 ) For research use only www.abnova.com

complete mixing of the reagents. j. Measure the absorbance at 450 nm with a microplate reader within 10 minutes. It is recommended to use a reference reading at 630 nm.

Figure 1: Pippetting scheme

Qualitative and semiquantitative method 1 2 3 4 5 6 7 8 9 10 11 12

a DB S3 b NCS atd c PCS d Cal e Cal f Cal g S1 h S2

Processing of Results Begin the processing with subtraction of the absorbance of the DB well (background absorbance) from the absorbances in all other wells.

A. Processing of results for the Qualitative interpretation 1. Compute the absorbance mean of the three wells with Calibrator (Cal). If any of the three parallels absorbance is different from the mean in more than 20% then exclude the deviating well from the calculation and compute a new absorbance mean with using the other two wells. 2. Compute the cut-off value by multiplying the mean absorbance of Calibrator (Cal) with a Correction factor. The Correction factor is 0.xx. 3. Serum samples with absorbances lower than 90% of the cut-off value are considered negative and samples with absorbances higher than 130% of the cut-off value are considered positive. Serum samples with absorbance in the range 0.9-1.3 cut-off are equivocal (grey-zone, see note, 8.2.).

B. Processing of results for Semiquantitative interpretation Determine Positivity Index for each serum sample as follows: 1. Compute the cut-off value (see the previous paragraph) 2. Compute the Positivity Index according to the following formula: sample absorbance sample Positivity Index = cut - off value

Varicella zoster virus IgG ELISA Kit ( Cat # KA1455 V.01 ) For research use only www.abnova.com

3. Express a serum reactivity according to Table 1 (Semiquantitative interpretation of results)

Table 1 Semiquantitative interpretation of results Positive Index Interpretation < 0.9 negative 0.9 - 1.30 +/- 1.31 - 2.50 + 2.51 - 5.00 ++ > 5.00 +++

Note : An indifferent sample reactivity, i.e. interpreted as +/-, requires repetition of the sample testing. If the result is again indifferent then it is recommended to use an alternative testing method or to obtain another sample from the patient, usually withdrawn 1-2 weeks later.

Validity, Specificity and Sensitivity of the Test A. Validity of the test The test is valid if: a. The background absorbance (the absorbance of the Dilution buffer) is less than 0.1 b. The Calibrator mean is higher than 1.0. c. The ratio of mean absorbance of Positive control / cut-off is higher than 1.4 d. The ratio of mean absorbance of Negative control / cut-off is lower than 0.8

B. Precision of the test The intraassay variability (within the test) and the interassay variability (between tests) were performed with samples of variable absorbance values.

1. Intraassay variability (N = number of parallels, SD = standard deviation): N Mean absorbance SD CV% 14 2.005 0.053 2.7 % 16 0.611 0.053 8.7 %

2. Interassay variability N = 12: mean absorbance (OD): 1.530 ± 0.149 (± δ) i.e. 9.7 % tj. 1.421 – 1.730 0.531 ± 0.53 (± δ) i.e. 10 % tj. 0.443 – 0.616 C. Diagnostic sensitivity and specificity The diagnostic sensitivity of the test is 96.6% and the specificity is 96.9%. Evaluation was performed by the comparing the VIDITEST kit with two other commercial ELISA tests and with indirect immunofluorescence test.

Varicella zoster virus IgG ELISA Kit ( Cat # KA1455 V.01 ) For research use only www.abnova.com

VZV status Total Positive Equivocal Negative Negative 90 3 2 85 specificity: 96.9% Positive 134 127 3 4 sensitivity: 96.6%

D. Interference Haemolytic and lipemic samples have no influence on the test results up to concentration of 50 mg/mL of haemoglobin, 5 mg/mL of bilirubin and 50 mg/mL of triglycerides.

Safety Precautions All ingredients of the kit are intended for laboratory use only. Controls contain human sera that has been tested negative for HBsAg, anti-HIV-1,2 and anti-HCV. However they should be regarded as contagious and handled and disposed of according to the appropriate regulations. Autoclave all reusable materials that were in contact with human samples for 1 hour at 121°C, burn disposable ignitable materials, decontaminate liquid wastes and nonignitable materials with 3% chloramine. Liquid wastes containing acid (Stop solution) should be neutralized in 4% sodium bicarbonate solution. Handle Stop solution with care. Avoid contact with skin or mucous membranes. In case of contact with skin, rinse immediately with plenty of water and seek medical advice. Do not smoke, eat or drink during work. Do not pipette by mouth. Wear disposable gloves while handling reagents or samples and wash your hands thoroughly afterwards. Avoid spilling or producing aerosol.

Handling Precautions Manufacturer guarantees performance of the entire ELISA kit. Follow the assay procedure indicated in the Instruction manual. Controls, TMB substrate, Dilution buffer and Px-conjugate contain preservative ProClin 300 ® Wash solution, TMB substrate, Stop solution and Dilution buffer are compatible and interchangeable between all the ELISA sets except Mycoplasma pneumoniae IgA ELISA; Borrelia IgM ELISA. Avoid microbial contamination of serum samples and kit reagents. Avoid cross-contamination of reagents. Avoid contact of the TMB substrate with oxidizing agents or metal surfaces. Variations in the test results are usually due to: * Insufficient mixing of reagents and samples * Inaccurate pipetting and inadequate incubation times * Poor washing technique or spilling the rim of well with sample or Px-conjugate * Use of identical pipette tip for different solutions

Storage and Expiration Store the kit and the kit reagents at 2 to 10°C, in a dry place and protected from the light. Store unused strips in the sealable pouch and keep the desiccant inside.

Varicella zoster virus IgG ELISA Kit ( Cat # KA1455 V.01 ) For research use only www.abnova.com

Store serum samples at 2 to 10°C up to one week. For longer period make aliquots and keep them at -20°C. Avoid repeated thawing and freezing. Do not store diluted samples and a diluted Px-conjugate. Always prepare fresh. Kits are shipped in cooling bags, the transport time of 72 hours have no influence on expiration. If you find damage at any part of the kit, please inform the manufacturer immediately. Expiration date is indicated at the ELISA kit label and at all reagent labels.

Varicella zoster virus IgG ELISA Kit ( Cat # KA1455 V.01 ) For research use only www.abnova.com

Flow Chart Step 1. Prepare reagents and samples ↓ Step 2. Dispense 100 µL/well Dilution buffer, Calibrator, Controls and samples ↓ Incubate 60 minutes at room temperature ↓ Wash 4 times (250 µL/well), aspirate ↓ Step 3. Dispense 100 µL/well of Px-conjugate ↓ Incubate 60 minutes at room temperature ↓ Wash 4 times (250 µL/well), aspirate ↓ Step 4. Dispense 100 µL/well of TMB substrate ↓ Incubate 10 minutes at room temperature ↓ Step 5. Dispense 100 µL/well of Stop solution ↓ Step 6. Read the absorbance at 450 nm within 10 min.

References 1. Provost PJ, Krah DL, Kuter BJ, Morton DH et al. Antibody assays suitable for assesing immune response to live varicella vaccine. Vaccine 1991; 9: 111 2. Wasmuth EH, Miller WJ. Sensitive enzyme-linked immunosorbent assay for antibody to varicella zoster virus using purified VZV glycoprotein antigen. J med Virol 1990; 32: 189-93. 3. Leung J, Harpaz R, Baughman AL, Heath K et al. Evaluation of laboratory methods for diagnosis of varicella. Clin Infect Dis 2010; 51: 23-32. 4. Landry ML, Cohen SD, Mayo DR, Fong,CKY et al. Comparison of fluorescent antibody to membrane antigen test, indirect immunofluorescence assay and commercial enzyme linked immunoassay for determination of antibody to varicella zoster virus. J Clin Microbiol 1987; 25: 832-835. 5. Gershon AA, Steinberg SP. Antibody response to varicella zoster and the role of antibody in host defense. Amer J Med Sci 1981;282: 12-17

Varicella zoster virus IgG ELISA Kit ( Cat # KA1455 V.01 ) For research use only