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Acute Viral Hepatitis Panel

Last updated May 13, 2019

Approved by: Krish Tangella MD, MBA, FCAP

Acute Viral Hepatitis Panel is ordered to determine hepatitis virus infection and its type, in cases, where risk factors for infection are present, or where there is a possibility of exposure to the virus.


What are the other Names for this Test? (Equivalent Terms)

  • Acute Viral Hepatitis Serology Panel
  • Hepatitis Screening Panel
  • Viral Hepatitis Panel

What is the Acute Viral Hepatitis Panel Test? (Background Information)

  • The Acute Viral Hepatitis Panel is a series of blood tests performed to determine current or past infection by most the common types of hepatitis viruses - hepatitis A, B, or C
  • The series of blood tests can simultaneously test for more than one type of the hepatitis virus. Once a diagnosis is established, then a specific hepatitis test is ordered. Hepatitis A, B, C, D and E, are the 5 main types of viruses causing hepatitis
  • During hepatitis, the liver is inflamed and enlarged. There can be many causes of hepatitis, such as viruses, drugs, autoimmune diseases, toxins, etc. All cases of acute hepatitis usually presents with the same set of signs and symptoms
  • Acute Viral Hepatitis Panel is ordered to determine hepatitis virus infection and its type, in cases, where risk factors for infection are present, or where there is a possibility of exposure to the virus

The Acute Viral Hepatitis Panel includes the following tests:

  • Hepatitis A Virus IgM Antibody (HAVAB IgM) Test to diagnose acute Hepatitis A: IgM are the first antibodies produced in response to an infection. IgM antibodies are usually positive 2-4 weeks after infection and remain positive for about 3-6 months. Hepatitis A virus IgG antibody test may sometimes be ordered along with IgM. IgG antibodies also become positive at the same time and they remain positive indefinitely. Presence of IgG antibodies denotes a prior infection (from which one has recovered), or effective immunization
  • Hepatitis B Core IgM Antibody (HBC IgM) Test to diagnose acute or chronic hepatitis B
  • Hepatitis B Virus Surface Antigen (HBsAG) Test: This surface antigen usually appears in blood 4-8 weeks after exposure, denoting an acute infection, and it disappears within 6 months of its appearance. If the antigen is detected for more than 6 months, then it indicates chronic hepatitis B
  • Hepatitis B Virus Surface Antibody Test: Sometimes, this test is included in the panel by some laboratories. A positive test result either signifies a previous infection (from which one has recovered), or immunity due to effective immunization
  • Hepatitis C Virus Antibody (HCV AB) Test to detect a current or past hepatitis C infection. These antibodies appear in blood 2-4 months after exposure. Positive results are usually followed up by more specific procedures to diagnose the (current) infection

What are the Clinical Indications for performing the Acute Viral Hepatitis Panel Test?

Following are the clinical indications for performing an Acute Viral Hepatitis Panel:

  • If an individual is exposed to any one of the 3 most common hepatitis viruses - hepatitis A, B, or C, then full Acute Viral Hepatitis Panel is performed
  • To detect current or prior hepatitis infection
  • To monitor an individual, who is currently being treated with hepatitis, to determine the level of infection and response to treatment
  • The test is performed in the wake of an abnormal liver panel test, during routine screening, or if hepatitis is suspected based on the clinical findings. Some of the signs and symptoms of acute hepatitis are:
    • Yellowness of the skin
    • Fever
    • Loss of appetite
    • Fatigue or weakness
    • Pain in the abdomen
    • Nausea and vomiting
    • Dark urine and/or pale-colored stool
    • Itching (pruritus)
    • Joint pain

How is the Specimen Collected for the Acute Viral Hepatitis Panel?

Following is the specimen collection process for Acute Viral Hepatitis Panel:

Sample required: Blood

Process of obtaining blood sample in adults:

  • A band is wrapped around the arm, 3-4 inches above the collection site (superficial vein that lies within the elbow pit)
  • The site is cleaned with 70% alcohol in an outward spiral, away from the zone of needle insertion
  • The needle cap is removed and is held in line with the vein, pulling the skin tight
  • With a small and quick thrust, the vein is penetrated using the needle
  • The required amount of blood sample is collected by pulling the plunger of the syringe out slowly
  • The wrap band is removed, gauze is placed on the collection site, and the needle is removed
  • The blood is immediately transferred into the blood container, which has the appropriate preservative/clot activator/anti-coagulant
  • The syringe and the needle are disposed into the appropriate “sharp container” for safe and hygienic disposal

Preparation required: No special preparation is needed prior to the test.

What is the Significance of the Acute Viral Hepatitis Panel Result?

The significance and interpretation of Acute Viral Hepatitis Panel is explained:

  • A negative (or normal) result indicates that there are no hepatitis antibodies present, or the levels are too low to be detected by the test. The test may be repeated after 2-8 weeks, to clear any suspicion since the antibodies may develop over a period of time
  • A positive (or abnormal) result is interpreted as an acute infection, a chronic active infection, recovery from a past infection, or effective immunity from immunization, depending on the result of the test. However, clinical correlation by the healthcare provider is necessary
  • A positive test result is usually followed-up by more specific procedures, to diagnose the infection present
  • It is to be noted that there is a possibility of infection with more than one virus. A superimposed infection may occur in chronic cases of hepatitis, with other hepatitis viruses too. In such cases, the results may be positive for more than one virus type(s)

For hepatitis A infection:

  • A positive result for IgM hepatitis A (HAV) antibodies indicates a recent infection with hepatitis A virus (HAV)
  • A positive result for total (IgM and IgG) HAV antibodies indicates a previous or past infection, or effective immunization against HAV

For hepatitis B infection:

  • A positive result for hepatitis B core IgM antibody (HBC IgM) indicates acute or chronic hepatitis B infection
  • A positive result for hepatitis B surface antigen (HBsAG) indicates acute hepatitis B. If it is detected for more than 6 months, then it indicates chronic hepatitis B
  • A positive result for hepatitis B virus surface antibody denotes a previous infection (from which the individual recovered), or immunity due to effective immunization
  • A positive result for hepatitis B type e antigen (HBeAg) indicates chronic hepatitis B. The infected individual can also easily spread the infection to others, through sexual contact or by sharing needles, etc.

For hepatitis C infection:

  • A positive result for hepatitis C virus antibody (HCV AB) denotes a current or past hepatitis C infection

The laboratory test results are NOT to be interpreted as results of a "stand-alone" test. The test results have to be interpreted after correlating with suitable clinical findings and additional supplemental tests/information. Your healthcare providers will explain the meaning of your tests results, based on the overall clinical scenario.

Additional and Relevant Useful information:

  • Acute Viral Hepatitis Panel Tests may not necessarily reveal, whether or not one has had a prior hepatitis infection. A liver panel test is also ordered along with the hepatitis screening panel in suspected cases, to help make a diagnosis
  • Hepatitis A virus (HAV) is transmitted via fecal-oral route through person-to-person contact or ingestion of contaminated food and water. It causes only acute infection. Hepatitis A can be prevented through vaccination
  • Hepatitis B virus (HBV) is transmitted through blood or other body fluids from an infected person. Individuals at risk include those having sexual contact with infected persons, IV drug users, infants born to infected mothers, medical personals coming into an occupational contact with infected blood/products, recipients of infected blood or blood products, hemodialysis patients, travel to endemic areas, etc. The HBV is not transmitted through casual contact, such as by kissing, hugging, holding hands, sneezing, or coughing. Vaccinations are available to prevent hepatitis B infections
  • Hepatitis C virus (HCV) is also transmitted via blood and blood products, like hepatitis B. Currently, no vaccine is available to prevent hepatitis C
  • The US CDC (Center for Disease Control and Prevention) do not recommend screening for hepatitis A in individuals, who do not have any acute hepatitis symptoms. However, screening may sometimes be performed for hepatitis B and C; for individuals at high risk for an infection

Certain medications that you may be currently taking may influence the outcome of the test. Hence, it is important to inform your healthcare provider of the complete list of medications (including any herbal supplements) you are currently taking. This will help the healthcare provider interpret your test results more accurately and avoid unnecessary chances of a misdiagnosis.

Please visit our Laboratory Procedures Center for more physician-approved health information:

http://www.dovemed.com/common-procedures/procedures-laboratory/

References and Information Sources used for the Article:


Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: Dec. 1, 2015
Last updated: May 13, 2019