Hepatitis A (HAV)

Test

Code (lab)

Reason for ordering and comments

Result interpretation

 Hepatitis A AB IgG

 LAB3779 (MIBH)

Tests for current or previous infection; used to decide whether to vaccinate and if vaccine worked

Positive HAV IgG- Patient is considered to be immune to HAV from vaccination or previous infection. Immunity post infection persist for life.

Hepatitis A AB IgM

LAB798 (MIBH)

Tests for current or acute infection.

Positive HAV IgM is presumptive evidence of HAV infection. Repeat testing in 1wk intervals will distinguish rapidly rising IgM anti-HAV levels associated with early acute hepatitis A infection. IgM anti HAV can persist up to 6 months after infection.

Hepatitis B (HBV)

Test

Code (lab)

Reason for ordering and comments

Result interpretation

Surface antibody anti-HBs - qualitative

 LAB472 (MIBH)

Tests for immunity following vaccination or following resolution of an active infection 
To confirm that an infection has resolved

Positive indicates immunity from a vaccination or after recovery from an infection.

Surface antigen
HBsAg

 LAB471 (MIBH)

Earliest indicator of acute infection - often before symptoms
Can detect chronic infection or carrier status
Is often used to demonstrate recovery from infection (the body has rid itself of the virus)
Donated blood is tested for HBsAg

Positive result indicates presence of virus anywhere in the body – in cells or in blood indicating chronic disease or carrier status
Negative result indicates no virus present. Presumptive Postive results will automatically Refelx to Hepatitis B Virus Surface Antigen, Confirmation to ARUP

e-antibody HBe Total

LAB796
(Mayo)

Recognizes resolution of HB infection with seroconversion of HBeAg to anti-HBe

Seroconversion usually indicates loss of infectivity

e-antigen
HBeAg

LAB908
(Mayo)

Tests for infectivity – the ability to spread the disease to others
Used to determine if a carrier (who has a positive HBsAg) can infect others

Presence of active virus replication & infectivity

HBe Ab & Ag

LAB3780
(Mayo)

Both HBe total antibody and antigen

See above, plus HbsAg carrier state may persist

Total -anti-HBc w/ Reflex to IgM

LAB1242 (MIBH)

Total antiHBc demonstrates current or past infection (Includes both IgM and IgG) and (often ordered with anti-HBs and includes both IgM and IgG). Positive Total anti HBc reflexes to anti HBc IgM.

Positive total antiHBc and positive anti-HBs indicate resolved infection

Viral DNA - quantitative

LAB1337
(Mayo)

Tests for infectivity by measuring the actual virus in blood by RT-PCR. More sensitive than HBeAg for detecting response to therapy
Usually ordered to monitor therapy for HBV

Chronic carriers persist producing detectable HBV DNA. Can be used to monitor progression of disease

Link to more interpretive guidelines for serological Hepatitis B tests

Hepatitis C (HCV)

Test

Code (lab)

Reason for ordering and comments

Result interpretation

HCV Total  antibody

 LAB21130 (MIBH)

Screens for possible type C hepatitis. A confirmatory Hepatitis C Virus RNA by RT- PCR(Reference Lab test#: LAB887  HCQTR) is required. Laboratory will contact patient for redraw.

Positive suggests presence of HCV

HCV RNA Quatification by RT-PCR Viral load – quantitative

LAB887
(Mayo)

Supplemental test to confirm positive screen.

Diagnosis of acute hepatitis C virus (HCV) infection before the appearance of anti-HCV antibodies in serum. Confirmatory testing for chronic HCV infection in anti-HCV antibody-positive patients, Detection of serum HCV RNA to distinguish between chronic HCV infection and resolved HCV infection among anti-HCV antibody-positive patients

Gives a quantitative value for viral particles.  Regular test reports 43 –69,000,000 IU/ml.  Negative result indicates no HCV RNA was not detected. A titer result indicates active viral replication.

Genotype

LAB3140
(Mayo)

Decisions regarding therapy

Determines HCV genotype to guide antiviral therapy. Differentiates between HCV subtypes 1a and b.