CAPTIA HSV 1 IGG TYPE SPECIFIC ELISA KIT

K033105 · Trinity Biotech USA · MXJ · Jul 13, 2004 · Microbiology

Device Facts

• Record ID: K033105
• Device Name: CAPTIA HSV 1 IGG TYPE SPECIFIC ELISA KIT
• Applicant: Trinity Biotech USA
• Product Code: MXJ · Microbiology
• Decision Date: Jul 13, 2004
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 866.3305
• Device Class: Class 2

Intended Use

The Trinity Biotech Captia™ Herpes Simplex Virus (HSV) 1 Type Specific IgG kit is an Enzyme-linked Immunosorbent Assay (ELISA) intended for qualitatively detecting the presence or absence of human IgG class antibodies to HSV-1 in human serum. In conjunction with the Trinity Biotech Captia™ Herpes Simplex Virus (HSV) 2 Type Specific IgG kit, the test is indicated for testing sexually active adults or expectant mothers for aiding in the presumptive diagnosis of HSV infection. Due to the implications of positive results, it is recommended they be confirmed in a low prevalence population with Western blot. The performance of this assay has not been established for use in a pediatric population, for neonatal screening, for testing of immunocompromised patients, or for use with automated equipment. The user is responsible for establishing assay performanace in these populations and with automated equipment

Device Story

The Captia™ HSV 1 Type Specific IgG is an ELISA kit for qualitative detection of human IgG antibodies to HSV-1 in serum. The device uses recombinant HSV-1 glycoprotein g antigen bound to polystyrene microplate wells. Patient serum is added; if specific IgG is present, it binds to the antigen. After washing, goat anti-human IgG conjugated with horseradish peroxidase is added, followed by TMB chromogen/substrate. The enzymatic reaction produces a blue color, turning yellow upon addition of 1N H2SO4 stop solution. The intensity, proportional to antibody concentration, is measured via spectrophotometer at 450 nm (with optional 650 nm reference). Results are calculated as an index value relative to a cutoff calibrator. The test is performed in a laboratory setting by trained personnel. It aids clinicians in the presumptive diagnosis of HSV infection in specific adult populations. It is not for use with automated equipment.

Clinical Evidence

Clinical performance was evaluated using banked/masked sera from expectant mothers (n=210), sexually active adults (n=198), and a low-prevalence population (n=184), compared against Western Blot (WB). Positive agreement with WB ranged from 84.0% to 88.3%; negative agreement ranged from 98.2% to 100.0%. In culture-positive patients (n=53), positive agreement was 75.5% against culture and 85.7% against WB. Analytical precision (intra/inter-assay) was reported with CVs generally <15% for positive samples. CDC panel testing showed 96.0% total agreement.

Technological Characteristics

Enzyme-Linked Immunosorbent Assay (ELISA) using purified recombinant HSV gG1 antigen immobilized on solid-phase microtiter wells. Detection via enzyme-labeled anti-human IgG conjugate and substrate-induced colorimetric reaction measured photometrically. Manual assay format; not established for automated equipment.

Indications for Use

Indicated for sexually active adults and expectant mothers to aid in the presumptive diagnosis of HSV-1 infection. Not established for pediatric populations, neonatal screening, immunocompromised patients, or use with automated equipment.

Regulatory Classification

Identification

Herpes simplex virus serological assays are devices that consist of antigens and antisera used in various serological tests to identify antibodies to herpes simplex virus in serum. Additionally, some of the assays consist of herpes simplex virus antisera conjugated with a fluorescent dye (immunofluorescent assays) used to identify herpes simplex virus directly from clinical specimens or tissue culture isolates derived from clinical specimens. The identification aids in the diagnosis of diseases caused by herpes simplex viruses and provides epidemiological information on these diseases. Herpes simplex viral infections range from common and mild lesions of the skin and mucous membranes to a severe form of encephalitis (inflammation of the brain). Neonatal herpes virus infections range from a mild infection to a severe generalized disease with a fatal outcome.

Special Controls

*Classification.* Class II (special controls). The device is classified as class II (special controls). The special control for the device is FDA's revised guidance document entitled “Class II Special Controls Guidance Document: Herpes Simplex Virus Types 1 and 2 Serological Assays.” For availability of the guidance revised document, see § 866.1(e).

Predicate Devices

• Western Blot

Submission Summary (Full Text)

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K0331A5

JUL 1 3 2004

Summary of Safety and Effectiveness Information CaptiaTM HSV 1 IgG Type Specific ELISA Test Kit

- I. Trinity Biotech USA 2823 Girts Rd. Jamestown, NY 14701 Contact Person: Bonnie B. DeJoy Telephone: [phone] Date of Preparation: July 9, 2004
#### II. Description of Device

The Captia™ HSV 1 IgG Type Specific kit is an Enzyme-Linked Immunosorbent Assav (ELISA) for the qualitative determination of IgG antibodies in human serum to Herpes simplex Type 1 antigen. The Captia™ HSV 1 IgG Type Specific assay may be used as an aid in the diagnoses of Herpes infection

# For In Vitro Diagnostic Use Only.

The Captia™ HSV 1 IgG Type Specific test is an Enzyme-Linked Immunosorbent assay to detect IgG antibodies to Herpes simplex 1 antigen. Purified recombinant HSV gG1 antigen is attached to a solid phase microtiter well. Diluted test sera is added to each well. If the antibodies are present that recognize the antigen, they will bind to the antigen in the well. After incubation, the wells are washed to remove unbound antibody. An enzyme labeled anti-human IgG is added to each well. If antibody is present, it will bind to the antibody attached to the antigen on the well. After incubation, the wells are washed to remove unbound conjugate. A substrate solution is added to each well. If enzyme is present, the substrate will undergo a color change. After an incubation period, the reaction is stopped and the color intensity is measured photometrically, producing an indirect measurement of specific antibody in the patient specimen.

# III. Predicate Device

The CaptiaTM HSV 1 IgG Type Specific test is substantially equivalent to Western Blot. Equivalence is demonstrated by the following comparative results:

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# Perfomance Characteristics % Agreement Positive and % Agreement Negative with Expectant Motherst

An outside investigator assessed the % agreement negative with consented, coded, unselected, banked and masked sera from expectant mothers (n = 210). The reference method was an HSV 1 Western Blot ( WB) from a Pacific Northwest university. Of 155 WB positives, Trinity ELISA was 136 positive, 18 negative and 1 equivocal. Of 55 WB negatives, Trinity ELISA was 54 negative and 1 positive.

## % Agreement Positive and % Agreement Negative with Expectant Mothers (n = 210)†

| Characteristic | % (EL/WB)* | 95% Confidence Interval (CI) |
|----------------------------|------------------|------------------------------|
| % agreement positive to WB | 87.74% (136/155) | 82.6-92.9%‡ |
| % agreement negative to WB | 98.18% (54/55) | 90.3-100.0% |

† The word "% agreement' refers to comparing this assay's results with those of a similar assay. No attempt was made to correlate the assay results to disence. No judgment can be made on the similar assay's accuracy in predicting disease.

* 95% CI calculated using the normal approximate method.

# % Agreement Positive and % Agreement Negative with Sexually Active Adultst

An outside investigator assessed the % agreement positive and % agreement negative with consented, unselected and masked sera from sexually active adults over the age of 14 (n = 198). The reference method was an HSV 1 Western Blot (WB) from a Pacific Northwest university. Of 116 WB positives, Trinity ELISA was 102 positive and 14 negative. Of 80 WB negatives, Trinity ELISA was 80 negative.

#### % Agreement Positive and % Agreement Negative with Sexually Active Adults (n = 198)†

| Characteristic | % (EL/WB)* | 95% Confidence Interval (CI) |
|----------------------------|------------------|------------------------------|
| % agreement positive to WB | 87.93% (102/116) | 82.0-93.9%‡ |
| % agreement negative to WB | 100.00% (80/80) | 95.5-100.0% |

* Excludes two atypical Western Blots.

* The word "% agreement" refers to comparing this assay's results with those of a similar assay. No attempt was made to correlate the assay results to disence. No judgment can be made on the similar assay's accuracy in predicting disease,

\$ 95% CI calculated using the normal approximate method.

# % Agreement Positive and % Agreement Negative with a Low Prevalence Population (n = 184)†

An outside investigator assessed the % agreement negative with unselected, banked and masked sera from a low prevalence population (n = 184). The reference method was an HSV 1 Western Blot (WB) from a Pacific Northwest university. Of 131 WB negatives, Trinity ELISA was 128 negative, 1 positive and 2 equivocal. Of 53 WB positives, Trinity ELISA was 42 positive, 8 negative and 3 equivocal.

### % Agreement Positive and % Agreement Negative with a Low Prevalence Population (n = 184)†

| Characteristic | % (EL/WB)* | 95% Confidence Interval (CI) |
|----------------------------|------------------|------------------------------|
| % agreement positive to WB | 79.25% (42/53) | 65.9-89.2% |
| % agreement negative to WB | 97.71% (128/131) | 93.5-99.5% |

f The word "% agreement" refers to comparing this assay's results with those of a similar assay. No attempt was nade to correlate the assay results to disence. No judgment can be made on the similar assay's accuracy in predicting disease.

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# % Agreement Positive with Culture Positivest

An outside investigator assessed the % agreement positive using unselected, retrospective and masked sera from patients that were at least six weeks but not more than one year post clinical presentation and culture (n = 53). Reference methods included culture (infection) and an HSV 1 Western Blot (WB) (antibody) from a Pacific Northwest university. Of 53 culture positives: 1) Trinity ELISA was 37 positive and 4 equivocal and, 2) WB was 44 positive and 9 negative. Of 44 WB positives: Trinity ELISA was 36 positive, and 2 equivocal.

| Characteristic | % (EL/WB or Culture) | 95% Confidence Interval (CI) |
|---------------------------------|----------------------|------------------------------|
| % agreement positive to culture | 69.81% (37/53) | 55.7-81.7% |
| % agreement positive to WB | 81.82% (36/44) | 67.3-91.8% |

### % Agreement Positive with Culture Positives (n = 53)t

† The word "% agreement" refers to comparing this assay's results with those of a similar assay. No attempt was made to correlate the assay results to disence. No judgment can be made on the similar assay's accuracy in predicting disease.

# % Agreement Positive and % Agreement Negative to Alternate HSV 1 Type Specific IgG ELISA

An outside investigator at a Pacific Northwest University assessed the 10 % agreement negative of the Trinity Biotech Captia™ HSV 1 Type Specific IgG kit and an alternate HSV 1 type specific IgG ELISA test with 200 prospective, unselected, sequentially submitted specimens.

| | Prospectively Collected, Sequential Sera | Alternate HSV 1 Type Specific IgG | | |
|-----------------------------------------------|------------------------------------------|-----------------------------------|----|---|
| | | + | - | E |
| Trinity Biotech Captia<br>HSV 1 Type Specific | + | 92 | 3 | 0 |
| | - | 6 | 99 | 0 |
| | E | 0 | 0 | 0 |

| Characteristic | % (TBU ELISA / Alt.<br>ELISA) | 95% Confidence<br>Interval (CI) |
|-------------------------------|-------------------------------|---------------------------------|
| Percent Positive<br>Agreement | 93.88% (92 / 98) | 87.2 - 97.7% |
| Percent Negative<br>Agreement | 97.06% (99 / 102) | 91.6 - 99.4 % |
| Percent Agreement | 95.50% (191 / 200) | 91.6 - 97.9 % |

#### Type Specificity with HSV 2 Western Blot Positives

An outside investigator at a Pacific Northwest University assessed the type specificity using HSV 2 Western Blot positive and HSV 1 Western Blot negative sera from the above described populations (n = 56): expectant mothers, sexually active adults, low prevalence persons, and HSV 2 culture positives. Of 56 HSV 2 Western Blot positive and HSV 1 Western Blot negative samples, Trinity ELISA was 54 negative and 2 positive.

| Characteristic | % (EL/WB) | 95% Confidence Interval (CI) |
|--------------------------------------|---------------|------------------------------|
| Type-specificity relative to WB | 96.4% (54/56) | 87.7-99.6% |
| Type cross-reactivity relative to WB | 3.6% (2/56) | 0.43-12.3% |

#### Type Specificity with HSV 2 Western Blot Positives (n = 56)

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DEPARTMENT OF HEALTH & HUMAN SERVICES

Public Health Service

Image /page/3/Picture/2 description: The image shows the seal of the U.S. Department of Health & Human Services. The seal features a stylized eagle with three tail feathers, representing the department's mission to protect the health of all Americans and provide essential human services. The eagle is encircled by the words "DEPARTMENT OF HEALTH & HUMAN SERVICES U.S.A."

Food and Drug Administration 2098 Gaither Road Rockville MD 20850

JUL 1 3 2004

Ms. Bonnie B. DeJoy Director of Quality Systems Trinity Biotech USA 2823 Girts Road Jamestown, NY 14701

Re: k033105

Trade/Device Name: CaptiaTM HSV 1 IgG Type Specific ELISA Regulation Number: 21 CFR 866.3305 Regulation Name: Herpes Simplex Virus Serological Reagents Regulatory Class: Class III Product Code: MXJ Dated: April 20, 2004 Received: April 21, 2004

Dear Ms. DeJoy:

We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to such additional controls. Existing major regulations affecting your device can be found in Title 21, Code of Federal Regulations (CFR), Parts 800 to 895. In addition, FDA may publish further announcements concerning your device in the Federal Register.

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Parts 801 and 809); and good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820).

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This letter will allow you to begin marketing your device as described in your Section 510(k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and thus, permits your device to proceed to the market.

If you desire specific information about the application of labeling requirements to your device, or questions on the promotion and advertising of your device, please contact the Office of In Vitro Diagnostic Device Evaluation and Safety at [phone]. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). You may obtain other general information on your responsibilities under the Act from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number [phone] or [phone] or at its Internet address http://www.fda.gov/cdrh/dsma/dsmamain.html.

Sincerely yours,

Salartys

Sally A. Hojvat, M.Sc., Ph.D. Director Division of Microbiology Devices Office of In Vitro Diagnostic Device Evaluation and Safety Center for Devices and Radiological Health

Enclosure

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### 510(k) Number: K033105 Device Name: Captia™ HSV 1 IgG Type Specific ELISA

#### Indications for Use:

The Trinity Biotech Captia™ Herpes Simplex Virus (HSV) 1 Type Specific IgG kit is an Enzyme-linked Immunosorbent Assay (ELISA) intended for qualitatively detecting the presence or absence of human IgG class antibodies to HSV-1 in human serum. In conjunction with the Trinity Biotech Captia™ Herpes Simplex Virus (HSV) 2 Type Specific IgG kit, the test is indicated for testing sexually active adults or expectant mothers for aiding in the presumptive diagnosis of HSV infection. Due to the implications of positive results, it is recommended they be confirmed in a low prevalence population with Western blot. The performance of this assay has not been established for use in a pediatric population, for neonatal screening, for testing of immunocompromised patients, or for use with automated equipment. The user is responsible for establishing assay performanace in these populations and with automated equipment

Prescription Use (Part 21 CFR 801 Subpart D)

------------------

AND/OR

Over-The Counter Use (21 CFR 801 Subpart C)

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

Reeder Jr. Poole

Division Sign Off

Division Sign-Off

Office of to Vitro Diagnostic Device Evaluation and Safe

510(k) KD33105/51

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