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To detect and diagnose an infection with a hepatitis virus
When you have symptoms of acute hepatitis and a viral infection is suspected to be the cause; when you have been exposed to one or more of the three most common hepatitis viruses: hepatitis A, hepatitis B, or hepatitis C
A blood sample drawn from a vein in your arm
Hepatitis is an inflammation and enlargement of the liver. One of the most common causes of acute hepatitis is infection with a hepatitis virus, usually hepatitis A, hepatitis B or hepatitis C. An acute viral hepatitis panel is a group of blood tests often performed together to help diagnose viral hepatitis. Some of the tests detect antibodies produced by the immune system in response to the infection and one detects proteins (antigens) that indicate the presence of the virus.
A hepatitis panel typically includes:
See "How is the test used?" under Common Questions below for more details.
If acute symptoms are suspected to be caused by one of the hepatitis viruses or if someone is at an increased risk of being infected or has been exposed, then a hepatitis panel can help determine if the person has been infected and which virus is present.
Hepatitis A virus (HAV) is highly contagious and is usually contracted by ingesting food or water contaminated with the virus or by coming in contact with an infected person. While hepatitis A infections are usually mild, the virus can on rare occasions cause a severe, acute disease. Hepatitis A does not cause a chronic infection, as do hepatitis B and C. A vaccine is available to prevent hepatitis A.
Hepatitis B virus (HBV) is the most common cause of acute viral hepatitis. It is spread through contact with blood or other body fluids from an infected person. Exposure can occur, for example, through sharing of needles for intravenous drug use or through unprotected sex. People who live in or travel to areas of the world where hepatitis B is prevalent are at a greater risk. Rarely, mothers can pass the infection to their babies, usually during birth. The virus, however, is not spread through food or water, casual contact such as holding hands, or coughing or sneezing. A vaccine can be given to protect against hepatitis B.
Hepatitis C virus (HCV) is also spread by exposure to contaminated blood, primarily though the sharing of needles by intravenous drug users, but also by sharing personal items contaminated by blood such as razors, through sex with an infected person, via healthcare occupational exposure, and from mother to baby during childbirth. Before tests for HCV became available in the 1990s, HCV was often transmitted by blood transfusions. Currently, there is no vaccine to prevent infection with HCV.
An acute viral hepatitis panel is used to help detect and/or diagnose acute liver infection and inflammation that is due to one of the three most common hepatitis viruses: hepatitis A virus (HAV), hepatitis B virus (HBV), or hepatitis C virus (HCV).
There are several causes of hepatitis and the accompanying symptoms, so these tests are used to determine if symptoms are due to a current infection with a virus and to identify which virus in particular is causing the disease. These tests may also help determine if someone has been exposed to one of the viruses even before symptoms develop.
An acute viral hepatitis panel typically consists of the following tests:
There are some other tests that may be offered as part of a hepatitis panel, depending on the laboratory performing the tests. These may include:
An acute viral hepatitis panel may be ordered when a person has had blood tests done as part of a health checkup that show abnormal results on liver tests or when someone has acute symptoms associated with liver damage, such as:
The acute viral hepatitis panel may sometimes be used to screen people when they are at an increased risk for hepatitis B or hepatitis C infection or when it is known that they have been exposed. Below are listed some examples of who may be screened using the panel:
The table below summarizes results that may be seen with a hepatitis panel that is performed to detect an infection:
|Anti-hepatitis A, IgM||Hepatitis B surface antigen||Anti-hepatitis B core, IgM||Anti-hepatitis C||Interpretation|
|Positive||Negative||Negative||Negative||Acute hepatitis A|
|Negative||Positive||Positive||Negative||Acute hepatitis B|
|Negative||Positive||Negative||Negative||Chronic hepatitis B infection|
|Negative||Negative||Positive||Negative||Acute hepatitis B; quantity of hepatitis B surface antigen is too low to detect|
|Negative||Negative||Negative||Positive||Acute or chronic hepatitis C; additional tests are required to make the determination|
If other hepatitis tests are performed to help determine prior exposure or previous infection, they may indicate the following:
It is possible to be infected with more than one hepatitis virus, and an acute infection with one hepatitis virus can be superimposed on a chronic infection with a different hepatitis virus. In such cases, there may be a positive result for more than one type of virus and care must be taken when interpreting the results.
If all the viral tests are negative, then the antibody or antigen level is too low to detect or the hepatitis is due to some other cause. For more on this and other tests that may be done to determine the cause, see the article on Hepatitis.
The tests that are typically included in an acute viral hepatitis panel may not always be able to tell whether someone has had a previous hepatitis infection or has developed antibodies in response to a vaccine. Usually other types of tests are performed to provide this type of information. See the individual articles on Hepatitis A Testing, Hepatitis B Testing or Hepatitis C Testing for more on this.
The presence of hepatitis A IgM antibodies in the blood are considered diagnostic for acute infection with hepatitis A when the test information is combined with a person's signs and symptoms. When the hepatitis screening test is performed for people who do not have symptoms of acute hepatitis, the presence of hepatitis A IgM antibodies may represent a false-positive result. Therefore, the Centers for Disease Control and Prevention has recommended against using the test for screening in people without acute hepatitis symptoms to decrease the possibility of false-positive results.
No. Sometimes, if the particular hepatitis virus a person was exposed to is known, tests specific for that virus may be performed. Also, some of these tests are used for other purposes, such as monitoring the progression of disease or determining if treatment is working, and they may be run singly or in different combinations in those cases. For more about other tests used in viral hepatitis infections, see the individual articles on Hepatitis A Testing, Hepatitis B Testing, and Hepatitis C Testing.
In addition to tests for hepatitis viruses, your healthcare practitioner may choose to run tests to see how your liver has been affected. These may include a liver panel or individual liver enzyme tests such as aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase (ALP). Your healthcare practitioner may also run a test for bilirubin and a prothrombin time (PT), which can help determine if there is liver damage.
You may be contagious; it depends on which hepatitis virus you were infected with and the stage of your infection. Often, people with viral hepatitis can spread the infection even though they don't have symptoms. With hepatitis A, you may be contagious from the time you are infected and continue to be contagious, but less so, for several weeks after symptoms, such as jaundice, develop. A person with hepatitis B is contagious as long as the virus is present in their blood. Anyone who tests positive for the presence of hepatitis C virus (HCV RNA test) should be considered contagious. The HCV RNA test may be performed as follow up to a positive result for anti-HCV.
Yes. There is a vaccine available for hepatitis A. It is recommended for all children at age one year and for people who are at an increased risk of exposure to the virus. Hepatitis A can also be prevented with good hygiene. This includes washing hands well after using the bathroom, after changing diapers, and before eating or starting any food preparation.
Effective hepatitis B vaccines have been available in the U.S. since 1981, and beginning in 1991, healthcare practitioners in the U.S. began vaccinating all newborns. Children and adolescents who were not vaccinated at birth are routinely given the series of shots. The Centers for Disease Control and Prevention also recommends that adults in high risk groups get vaccinated. Unless there is something in your medical history to the contrary, it is prudent to get the series of vaccinations.
Currently, there is no vaccine available for hepatitis C, although efforts are ongoing to develop one. Spread of hepatitis C can be prevented by avoiding exposure to blood and body fluids and the sharing of needles or other equipment to inject drugs.
Hepatitis can be caused by several different factors and conditions such as alcohol, drugs like acetaminophen, or inherited disorders. (For more on these, see the article on Hepatitis.) There are a few other viral infections that may cause similar symptoms, such as cytomegalovirus (CMV) and Epstein-Barr virus (EBV). An autoimmune disease is another possibility your healthcare provider may need to consider if your hepatitis panel is negative. Typically, additional tests will be performed to help determine the cause of your condition.
Sources Used in Current Review
2018 April 19, Updated). Viral Hepatitis. Centers for Disease Control and Prevention. Available online at https://www.cdc.gov/hepatitis/abc/index.htm. Accessed on 07/07/18.
(2017 May, Updated). Hepatitis B. National Institute of Diabetes and Digestive and Kidney Diseases. Available online at https://www.niddk.nih.gov/health-information/liver-disease/viral-hepatitis/hepatitis-b Accessed on 07/07/18.
(2017 May, Updated). Hepatitis A. National Institute of Diabetes and Digestive and Kidney Diseases. Available online at https://www.niddk.nih.gov/health-information/liver-disease/viral-hepatitis/hepatitis-a. Accessed on 07/07/18.
(2017 May, Updated). Hepatitis C. National Institute of Diabetes and Digestive and Kidney Diseases. Available online at https://www.niddk.nih.gov/health-information/liver-disease/viral-hepatitis/hepatitis-c. Accessed on 07/07/18.
Samji, N. et. al. (2017 June 12, Updated). Viral Hepatitis. Medscape Gastroenterology. Available online at https://emedicine.medscape.com/article/775507-overview. Accessed on 07/07/18.
Hillyard, D. and Slev, P. (2018 June, Updated). Acute Viral Hepatitis. ARUP Consult. Available online at https://arupconsult.com/content/hepatitis-acute. Accessed on 07/07/18.
(© 1995–2018). Acute Hepatitis Profile. Mayo Clinic Mayo Medical Laboratories. Available online at https://www.mayomedicallaboratories.com/test-catalog/Clinical+and+Interpretive/56105. Accessed on 07/07/18.
(2018 May 9, Updated). Hepatitis E Questions and Answers for Health Professionals. Centers for Disease Control and Prevention. Available online at https://www.cdc.gov/hepatitis/hev/hevfaq.htm. Accessed on 07/07/18.
Sources Used in Previous Reviews
Kasper DL, Braunwald E, Fauci AS, Hauser SL, Longo DL, Jameson JL eds (2005). Harrison's Principles of Internal Medicine, 16th Edition, McGraw Hill, Pp 1822-1833.
Centers for Disease Control and Prevention. Surveillance for Acute Viral Hepatitis—United States 2006, MMWR, March 21,2008/ 57(SS02);1-24. Available online at http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5702a1.htm. Accessed August 2010.
Henry's Clinical Diagnosis and Management by Laboratory Methods. 21st ed. McPherson R, Pincus M, eds. Philadelphia, PA: Saunders Elsevier: 2007, Pp 271-274; 992-993.
(Updated June 25, 2010) Buggs A. Viral Hepatitis. Medscape Clinical Reference. Available online at http://emedicine.medscape.com/article/775507-overview. Accessed August 2010.
Clarke, W. and Dufour, D. R., Editors (2006). Contemporary Practice in Clinical Chemistry, AACC Press, Washington, DC. Pp 272-275.
(June 25, 2010) Wolf D. Hepatitis, Viral. Medscape Clinical Reference. Available online at http://emedicine.medscape.com/article/185463-overview. Accessed August 2010.
George F. Longstreth, G. (Updated 2012 October 8). Hepatitis virus panel. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003558.htm. Accessed April 2014
Hillyard, D. and Slev, P. (Reviewed 2012 August). Hepatitis, Acute. ARUP Consult [On-line information]. Available online at http://www.arupconsult.com/Topics/AcuteHepatitis.html. Accessed April 2014
(© 1995–2014). Acute Hepatitis Profile. Mayo Clinic Mayo Medical Laboratory [On-line information]. Available online at http://www.mayomedicallaboratories.com/test-catalog/Overview/9022. Accessed April 2014.
Buggs, A. (Updated 2012 August 23). Viral Hepatitis. Medscape Reference [On-line information]. Available online at http://emedicine.medscape.com/article/775507-overview. Accessed April 2014.
Rutherford, A. (Reviewed 2014 February). Acute Viral Hepatitis. Merck Manual for Healthcare Professionals [On-line information]. Available online through http://www.merckmanuals.com. Accessed April 2014.
(Updated 2014 March 21). Hepatitis B FAQs for Health Professionals. Centers for Disease Control and Prevention [On-line information]. Available online at http://www.cdc.gov/hepatitis/HBV/HBVfaq.htm#general. Accessed April 2014.
(Updated 2014 February 10). Hepatitis C FAQs for Health Professionals. Centers for Disease Control and Prevention [On-line information]. Available online at http://www.cdc.gov/hepatitis/HCV/HCVfaq.htm#section3. Accessed April 2014.
(Updated 2013 June 6). Hepatitis A FAQs for Health Professionals. Centers for Disease Control and Prevention [On-line information]. Available online at http://www.cdc.gov/hepatitis/HAV/HAVfaq.htm. Accessed April 2014.