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HelpTest ID: PHEPU Previous Viral Hepatitis (Unknown Type), Serum
Necessary Information
Date of collection is required.
Specimen Required
Patient Preparation: For 24 hours before specimen collection, patient should not take multivitamins or dietary supplements (eg, hair, skin, and nail supplements) containing biotin (vitamin B7).
Supplies: Sarstedt 5 mL Aliquot Tube (T914)
Collection Container/Tube: Serum gel (red-top tubes are not acceptable)
Submission Container/Tube: Plastic vial
Specimen Volume: 2.6 mL
Collection Instructions:
1. Centrifuge blood collection tube per manufacturer's instructions (eg, centrifuge and aliquot within 2 hours of collection for BD Vacutainer tubes).
2. Aliquot 1.8 mL serum into a plastic vial and ship frozen (preferred).
Useful For
Determining if an individual has been infected following exposure to an unknown type of viral hepatitis virus
Obtaining baseline serologic markers of an individual exposed to a source with an unknown type of hepatitis
Determining immunity to hepatitis A and B viral infections
Profile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| HAVTA | Hepatitis A Virus Total Ab, S | Yes | Yes |
| HBAG | HBs Antigen, S | Yes | Yes |
| HBAB | HBs Antibody, S | Yes | Yes |
| HBC | HBc Total Ab, S | Yes | Yes |
| HCVDX | HCV Ab w/Reflex to HCV PCR, S | Yes | Yes |
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| HBGNT | HBs Antigen Confirmation, S | No | No |
| HCVQN | HCV RNA Detect/Quant, S | Yes | No |
Testing Algorithm
If hepatitis C virus (HCV) antibody is reactive, then HCV RNA detection and quantification by real-time reverse transcription polymerase chain reaction will be performed at an additional charge.
If hepatitis B virus surface antigen (HBsAg) is reactive, then HBsAg confirmation will be performed at an additional charge.
For more information see:
-Hepatitis B: Testing Algorithm for Screening, Diagnosis, and Management.
Special Instructions
Method Name
HAVTA, HBAG, HBAB, HBC, HCVDX, HBGNT: Electrochemiluminescence Immunoassay (ECLIA)
HCVQN: Real-Time Reverse Transcription-Polymerase Chain Reaction (RT-PCR)
Reporting Name
Previous Hepatitis ProfileSpecimen Type
Serum SSTSpecimen Minimum Volume
1.8 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum SST | Frozen (preferred) | 84 days | |
| Refrigerated | 6 days |
Clinical Information
Hepatitis A:
Hepatitis A virus (HAV) is an RNA virus that accounts for 20% to 25% of viral hepatitis in adults in the United States. HAV infection is spread by the oral/fecal route and produces acute hepatitis that follows a benign, self-limited course. Spread of the disease is usually associated with contaminated food or water caused by poor sanitary conditions. Outbreaks frequently occur in overcrowded situations and institutions or high-density centers such as prisons and healthcare centers. Epidemics may occur following floods or other disaster situations. Chronic carriers of HAV have never been observed.
Hepatitis B:
Hepatitis B virus (HBV) is a DNA virus that is endemic throughout the world. The infection is spread primarily through percutaneous contact with infected blood products (eg, blood transfusion, sharing of needles among injection drug users). The virus is found in various human body fluids and is known to be spread through oral and genital contact. HBV can be transmitted from mother to child during delivery through contact with blood and vaginal secretions; it is not commonly transmitted transplacentally.
After a course of acute illness, HBV persists in approximately 10% of patients. Some chronic carriers are asymptomatic, while others develop chronic liver disease, including cirrhosis and hepatocellular carcinoma.
Hepatitis C:
Hepatitis C virus (HCV) is an RNA virus recognized as the cause of most cases of posttransfusion hepatitis that is a significant cause of morbidity and mortality worldwide. HCV is transmitted through contaminated blood or blood products or close, personal contact. HCV shows a high rate of progression (~75%) to chronic disease. In the United States, HCV infection is quite common, with an estimated 3.5 to 4 million chronic HCV carriers. Cirrhosis and hepatocellular carcinoma are sequelae of chronic HCV.
Reference Values
HEPATITIS B VIRUS SURFACE ANTIGEN
Negative
HEPATITIS B VIRUS SURFACE ANTIGEN CONFIRMATION
Negative
HEPATITIS B VIRUS SURFACE ANTIBODY, QUALITATIVE/QUANTITATIVE
Hepatitis B Surface Antibody
Unvaccinated: Negative
Vaccinated: Positive
HEPATITIS B VIRUS SURFACE ANTIBODY, QUANTITATIVE
Unvaccinated: <8.5 mIU/mL
Vaccinated: ≥11.5 mIU/mL
HEPATITIS B VIRUS CORE TOTAL ANTIBODIES
Negative
HEPATITIS A VIRUS TOTAL ANTIBODY
Unvaccinated: Negative
Vaccinated: Positive
HEPATITIS C VIRUS ANTIBODY
Negative
HEPATITIS C VIRUS RNA DETECTION and QUANTIFICATION by REAL-TIME RT-PCR
Undetected
Interpretation depends on clinical setting. For more information see Viral Hepatitis Serologic Profiles.
Interpretation
Interpretation depends on clinical setting. For more information see Viral Hepatitis Serologic Profiles.
Hepatitis A:
Hepatitis A virus (HAV)-specific total antibodies are almost always detectable by the onset of symptoms of acute hepatitis A (usually 15 to 45 days after exposure). The initial antibody consists almost entirely of the IgM subclass of antibody. Anti-HAV IgM usually falls to undetectable levels 3 to 6 months after infection. Anti-HAV IgG levels rise quickly once the virus is cleared and persist for many years.
Hepatitis B:
Hepatitis B virus surface antigen (HBsAg) is the first serologic marker appearing in the serum 6 to 8 weeks following hepatitis B virus (HBV) infection. A confirmed positive result for HBsAg is indicative of acute or chronic hepatitis B. In acute cases, HBsAg usually disappears 1 to 2 months after the onset of symptoms. Anti-HBs appears with the resolution of HBV infection after the disappearance of HBsAg. Anti-HBs also appears as the immune response following a course of inoculation with the hepatitis B vaccine.
Hepatitis B virus core antibody (anti-HBc) appears shortly after the onset of symptoms of HBV infection and may be the only serologic marker remaining years after exposure to hepatitis B.
Hepatitis C:
Hepatitis C virus-specific antibodies are usually not detectable during the first 2 months after exposure, but they are almost always detectable by the late convalescent stage of infection. HCV antibodies are not neutralizing and do not provide immunity.
Clinical Reference
1. De Paula VS. Laboratory diagnosis of hepatitis A. Future Virology. 2012;7(5):461-472
2. American Association for the Study of Liver Diseases and Infectious Diseases Society of America: HCV guidance: Recommendations for testing, managing, and treating hepatitis C. Accessed December 20, 2023. Available at www.hcvguidelines.org/contents
3. WHO guidelines on hepatitis B and C testing. World Health Organization, 2017. Accessed December 20, 2023. Available at www.who.int/publications/i/item/9789241549981
4. Conners EE, Panagiotakopoulos L, Hofmeister MG, et al. Screening and testing for hepatitis B virus infection: CDC Recommendations – United States, 2023. MMWR Recomm Rep. 2023;72(1):1-25
Day(s) Performed
Profile tests: Monday through Friday; Reflex tests: Varies
Report Available
Same day/1 to 2 daysTest Classification
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.CPT Code Information
86704
86706
86708
86803
87340
87341 (if appropriate)
87522 (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| PHEPU | Previous Hepatitis Profile | 92890-3 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| HCVA4 | HCV Ab, S | 40726-2 |
| HAVT | Hepatitis A Virus Total Ab, S | 13951-9 |
| HBC | HBc Total Ab, S | 13952-7 |
| HB_AB | HBs Antibody, S | 10900-9 |
| H_BAG | HBs Antigen, S | 5196-1 |
| HBSQN | HBs Antibody, Quantitative, S | 5193-8 |
Forms
If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:
mml-gi-liver-hepatitis