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DRVVT Confirm

Immunology & Autoimmune

Dilute Russell Viper Venom Time, ConfirmdRVVT-CDRVVT-CLupus anticoagulant confirm (DRVVT)

Review status

Currently under review

Pending specialist review and validation.

What it shows

The DRVVT Confirm is a follow-up blood test used to help identify a lupus anticoagulant, an antibody that interferes with phospholipid-dependent clotting reactions. It is performed after a DRVVT screen suggests interference, and it uses additional phospholipid in the test system to check whether the interference can be neutralized.

In practical terms, your plasma is mixed with a reagent derived from Russell viper venom that triggers clotting, then the confirm step repeats the measurement in the presence of extra phospholipid. If the added phospholipid corrects the interference, this supports the presence of a lupus anticoagulant rather than a clotting factor deficiency.

This test is usually interpreted together with the DRVVT screen and other tests such as mixing studies and antiphospholipid antibody assays to provide a complete picture.

Why it matters

Clinicians order the DRVVT Confirm when they are evaluating a possible lupus anticoagulant, often as part of testing for antiphospholipid syndrome. This can be considered if you have had unexplained blood clots, certain pregnancy complications, or a persistently prolonged clotting test like the aPTT.

The confirm step helps distinguish an inhibitor that targets phospholipids from other causes of abnormal clotting tests. Correct classification matters because lupus anticoagulant is linked to a higher risk of clotting events and may influence decisions about monitoring, prevention, and treatment. Results can also guide timing and selection of other tests in the antiphospholipid antibody panel.

Understanding your results

Your DRVVT Confirm result is interpreted alongside the DRVVT screen and, when needed, other clotting studies. If the confirm step shows that adding phospholipid corrects the abnormality seen on screening, it supports the presence of a lupus anticoagulant. If there is no correction, other explanations such as clotting factor deficiencies, anticoagulant medications, or nonspecific inhibitors may be considered.

A single result is not usually enough to diagnose antiphospholipid syndrome. If your clinician suspects this condition, they may repeat testing after a period of time and pair it with antibody tests for cardiolipin and beta-2 glycoprotein I. If you are taking blood thinners, your care team may adjust timing or use specialized pathways to avoid medication effects. Discuss your medications and medical history so the team can plan any follow-up safely.

Reference ranges

01.13 Ratio
All sexes
0 days – 150 years

Reference intervals vary by laboratory, analyzer, methodology, population, and units. The ranges shown here are for education only. Always interpret your results against the reference interval printed on your own lab report.

Factors that could impact DRVVT Confirm

  • Blood thinner medications

    Direct oral anticoagulants, unfractionated heparin, low molecular weight heparin, and warfarin can alter clot-based assays and lead to misleading results. Tell your clinician exactly what you take and when you took your last dose so they can plan testing or use neutralization strategies.

  • Specimen collection and tube fill

    Underfilled or overfilled citrate tubes and very high or very low hematocrit can distort clotting times. Proper tube fill and prompt processing are important to avoid false results that suggest an inhibitor or a deficiency.

  • Recent clot, surgery, or inflammation

    Acute thrombosis, surgery, infection, or systemic inflammation can temporarily change clotting behavior and interfere with interpretation. Your clinician may wait until you are clinically stable or repeat testing to confirm persistence.

  • Pregnancy and estrogen exposure

    Pregnancy and estrogen-containing therapies can influence coagulation and some antiphospholipid-related tests. If you are pregnant or using hormonal therapy, your clinician will interpret results with this in mind and may coordinate timing.

  • Clotting factor deficiencies

    Low levels of certain clotting factors can prolong screening assays. The confirm step helps separate factor deficiency from phospholipid-dependent inhibition, and additional tests or mixing studies may be needed.

  • Timing of testing

    Testing during or immediately after anticoagulant dosing, or too soon after an acute event, can blur results. Scheduling tests at the right time helps reduce the chance of an inconclusive or misleading result.

2026

References

  1. McGill University Health Centre. (2015, May 09). DRVVT Confirm (Task CD 5892239). Laboratory reference ranges.
  2. McGill University Health Centre. (2017, March 27). DRVVT Confirm (Task CD 18477698). Laboratory reference ranges.
  3. Devreese, K. M. J., de Groot, P. G., de Laat, B., Erkan, D., Favaloro, E. J., Mackie, I., & Tripodi, A. (2020). Guidance from the Scientific and Standardization Committee for lupus anticoagulant detection and interpretation. Journal of Thrombosis and Haemostasis, 18(11), 2828–2839.
  4. Miyakis, S., Lockshin, M. D., Atsumi, T., Branch, D. W., Brey, R. L., Cervera, R., Derksen, R. H. W. M., De Groot, P. G., Koike, T., Meroni, P. L., Reber, G., Shoenfeld, Y., Tincani, A., Vlachoyiannopoulos, P. G., & Krilis, S. A. (2006). International consensus statement on an update of the classification criteria for antiphospholipid syndrome. Journal of Thrombosis and Haemostasis, 4(2), 295–306.