Tests for Hepatitis

What is Hepatitis?

Hepatitis is an inflammation of the liver. Hepatitis is usually caused by viruses typically A, B, C, D and E.

Hepatitis B and C are chronic infections caused by exposure to infected blood or needles. These can go undetected for many years until symptoms surface. Hepatitis A and E are acute manifesting in jaundice - like symptoms and caused by contaminated water and food.

How to Diagnose Hepatitis?

A simple blood test is used to detect the presence of hepatitis viruses. The hepatitis virus panel or hepatitis panel is a series of blood tests to diagnose current or past infections caused by hepatitis A virus (HAV), hepatitis B virus (HBV) and hepatitis C virus (HCV). The antibody and antigen tests can detect each of the hepatitis viruses within the blood. Since hepatitis D is only present in those already affected by HBV, it is usually not part of the routine hepatitis virus panel.

Apart from the hepatitis virus panel, patients with suspected infection may also be asked to take liver function tests to gauge the extent of damage to the liver.

Hepatitis Virus Panel Procedure

There is no special preparation required for the test. One can walk in at any time to give a blood sample. Blood is usually drawn from a vein in the crook of the elbow. The area is cleaned with an antiseptic and a venipuncture is done to draw blood. The blood is collected in airtight test tubes under aseptic conditions taking care not to contaminate the sample.

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The test tubes containing the blood are then sent to the laboratory for testing for the presence of antibodies and antigens.

When is Hepatitis Virus Panel Ordered?

Hepatitis virus panel can be carried out when an individual shows abnormal results on liver tests or when someone has symptoms associated with liver damage such as:

• Fever
• Loss of appetite
• Feeling tired
• Nausea, vomiting
• Pale colored stool
• Pain in the joints
• Jaundice
• Dark colored urine

Hepatitis diagnostic test can be used to screen people who are at an increased risk for hepatitis B and C infection when it is known that they have been exposed. In the following cases, screening tests can be carried out:

• People with elevated level of liver enzymes
• People with sexually transmitted diseases
• People with chronic liver disease
• People with suppressed immune system (for example transplant recipients)

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Interpreting Results

The test results should be interpreted and evaluated by a doctor who will provide further suggestions and treatment if necessary.

If the test indicates that the antibodies for the virus types are not present in the blood, then the result is hepatitis negative.

A positive test indicates that the person either has a current viral infection or a chronic viral infection.

Hepatitis A:

The presence of IgM antibodies HAV indicates that the person had a recent infection with hepatitis A and persisted for about 2 to 6. Total antibodies (IgM and IgG) HAV indicate a past infection and immunity to hepatitis A.

Hepatitis B:

Hepatitis B surface antigen (HBsAg) indicates an active infection either recent or chronic.

Antibodies to hepatitis B core antigen (Anti-HBc) indicate a recent or past infection.

The presence of antibodies to HBsAg usually indicate a past HBV infection or vaccination against HBV.

Hepatitis B type e antigen (HBeAg) indicates chronic HBV infection. In this case, the infected person can spread the disease through sexual contact or by sharing needles.

Hepatitis C:

Hepatitis C is detected in the blood if the person tests positive for the HCV antibodies. HCV can be detected 4-10 weeks since infection. The antibody usually peaks 6-12 months after first exposure to the infection. If the person tests positive, another test called PCR (polymerase chain reaction) is conducted. This test detects if the virus is still present in the liver and if it is multiplying. A positive test indicates that person still has the virus in its chronic form.

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Whether you test positive for current or chronic hepatitis infections, it is best to seek medical advice as soon as possible. A general physician will usually refer you to a gastroenterologist if you test positive for chronic HBV and HCV. The gastroenterologist will suggest further tests like RNA qualitative and RNA quantitative for chronic HBV and HCV infections.

RNA qualitative determines the genotype of the virus and RNA quantitative determines the viral load in the blood.

Anyone testing positive for acute viral or chronic hepatitis needs to take proper precautions like fat-free diet, adequate rest and lifestyle changes including quitting smoking and alcohol. Consult your doctor to help you lead a quality life by managing the virus.