At a Glance
Why Get Tested?
To detect and diagnose an infection with a hepatitis virus
When to Get Tested?
A blood sample drawn from a vein in your arm
Test Preparation Needed?
The Test Sample
What is being tested?
An acute viral hepatitis panel is a group of tests often performed together to detect a viral hepatitis infection. Hepatitis is a condition characterized by inflammation and enlargement of the liver. It has many different causes including, for example, drugs and autoimmune diseases, but a common cause is infection with a virus. (For more information on the various causes of acute hepatitis, see the Hepatitis article.) There are five hepatitis viruses identified so far that can cause the disease, including Hepatitis A, B, C, D, and E. Viral hepatitis is most commonly caused by Hepatitis A, B, or C.
Regardless of cause, the signs and symptoms of hepatitis are the same. 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 is usually mild, it can on rare occasions cause a severe, acute disease; however, it 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. 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 health care 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 includes tests that can detect an infection caused by one of these three viruses. It typically includes:
- Hepatitis A antibody, IgM
- Hepatitis B core antibody, IgM
- Hepatitis B surface Ag
- Hepatitis C antibody
Some of the panel tests detect IgM antibodies. These are the first antibodies produced during the initial stages of infection. As the disease progresses or resolves, IgM antibody levels decrease. The panel also typically includes a test for hepatitis B surface antigen (HbsAg). It detects proteins on the surface of the virus. HBsAg is the earliest indicator of an acute Hepatitis B infection and is usually present even before symptoms appear, so this test is useful for screening those who are at high risk of infection or who may have been exposed. A test for Hepatitis C antibody cannot distinguish between an active or previous infection and further testing is necessary to determine whether the infection is current.
How is the sample collected for testing?
A blood sample is obtained by inserting a needle into a vein in the arm.
NOTE: If undergoing medical tests makes you or someone you care for anxious, embarrassed, or even difficult to manage, you might consider reading one or more of the following articles: Coping with Test Pain, Discomfort, and Anxiety, Tips on Blood Testing, Tips to Help Children through Their Medical Tests, and Tips to Help the Elderly through Their Medical Tests.
Another article, Follow That Sample, provides a glimpse at the collection and processing of a blood sample and throat culture.
Is any test preparation needed to ensure the quality of the sample?
No test preparation is needed.
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NOTE: This article is based on research that utilizes the sources cited here as well as the collective experience of the Lab Tests Online Editorial Review Board. This article is periodically reviewed by the Editorial Board and may be updated as a result of the review. Any new sources cited will be added to the list and distinguished from the original sources used.
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 through http://www.cdc.gov. 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 through http://emedicine.medscape.com. 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 through http://emedicine.medscape.com. Accessed August 2010.