Hepatitis virus panel

Definition

The hepatitis virus panel is a series of blood tests used to detect current or past infection by hepatitis A, hepatitis B, or hepatitis C. It can screen blood samples for more than one kind of hepatitis virus at the same time.

Antibody and antigen tests can detect each of the different hepatitis viruses.

Note: Hepatitis D only causes disease in people who also have hepatitis B. It is not routinely checked on a hepatitis antibody panel.

Alternative Names

Hepatitis A antibody test; Hepatitis B antibody test; Hepatitis C antibody test; Hepatitis D antibody test

How the test is performed

Blood is typically drawn from a vein, usually from the inside of the elbow or the back of the hand. The site is cleaned with germ-killing medicine (antiseptic). The health care provider wraps an elastic band around the upper arm to apply pressure to the area and make the vein swell with blood.

Next, the health care provider gently inserts a needle into the vein. The blood collects into an airtight vial or tube attached to the needle. The elastic band is removed from your arm. Once the blood has been collected, the needle is removed, and the puncture site is covered to stop any bleeding.

In infants or young children, a sharp tool called a lancet may be used to puncture the skin and make it bleed. The blood collects into a small glass tube called a pipette, or onto a slide or test strip. A bandage may be placed over the area if there is any bleeding.

The blood sample is sent to a laboratory for examination. Blood (serology) tests are used to check for antibodies to each of the hepatitis viruses.

How to prepare for the test

No special preparation is needed.

How the test will feel

When the needle is inserted to draw blood, some people feel moderate pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing.

Why the test is performed

Your doctor may order this test if you have signs of hepatitis. It is used to:

• Detect current or previous hepatitis infection
• Determine how contagious a person with hepatitis is
• Monitor a person who is being treated for hepatitis

Other conditions under which the test may be performed:

• Chronic persistent hepatitis
• Delta agent (hepatitis D)
• Nephrotic syndrome

Normal Values

A normal result means no hepatitis antibodies are found in the blood sample. This is called a negative result.

Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.

What abnormal results mean

There are different tests for hepatitis A and B. A positive test is considered abnormal.

A positive test may mean:

• You currently have a hepatitis infection. This may be a new infection (acute hepatitis), or it may be an infection that you have had for a long time ( chronic hepatitis).
• You had a hepatitis infection in the past, but you no longer have the infection and cannot spread it to others.

Hepatitis A test results:

• IgM anti-hepatitis A virus (HAV) antibodies -- you have had a recent infection with hepatitis A
• Total (IgM and IgG) antibodies to hepatitis A -- you have a previous or past infection, or immunity to hepatitis A

Hepatitis B tests:

• Hepatitis B surface antigen (HBsAg) -- you have an active hepatitis B infection, either recent or chronic
• Antibody to hepatitis B core antigen (Anti-HBc) -- you have a recent or past hepatitis B infection
• Antibody to HBsAg (Anti-HBs)
  • You have a past hepatitis B infection
  • You have received the hepatitis B vaccine and are unlikely to become infected
• Hepatitis B type e antigen (HBeAg)
  • You have a chronic hepatitis B infection
  • You are more likely to spread the infection to others through sexual contact or by sharing needles

Antibodies to hepatitis C can usually be detected 4 - 10 weeks after the infection occurs. Other types of tests may be done to decide on treatment and monitor the hepatitis C infection.

What the risks are

Veins and arteries vary in size from one patient to another and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others.

Other risks associated with having blood drawn are slight but may include:

• Excessive bleeding
• Fainting or feeling light-headed
• Hematoma (blood accumulating under the skin)
• Infection (a slight risk any time the skin is broken)

Special considerations

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References

Hoofnagle JH. Acute viral hepatitis. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 151.

Wilkins T, Malcolm JK, Raina D, Schade RR. Hepatitis C: diagnosis and treatment. Am Fam Physician. 2010;81:1351-1357.

Dienstag JL. Hepatitis B virus infection. N Engl J Med. 2008;359:1486-1500.