Clinical Indication
HAMILTON REGIONAL MICROBIOLOGY LABORATORY PROTOCOL FOR VIRAL HEPATITIS TESTING
Order
Laboratory Tests Performed
Comments
Suspect acute hepatitis: nausea,
vomiting, jaundice, anorexia and
elevated ALT (at least 1.5 x normal).
“Acute
Hepatitis”
Hepatitis A (Anti-HAV IgM)
Hepatitis B (HBsAg)
(Anti-HBc IgM)
Suspect chronic hepatitis: previous
history of elevated liver enzymes or liver
cirrhosis or cancer. ALT normal or
elevated.
“Chronic
Hepatitis”
Hepatitis B (HBsAg)
Hepatitis C (Anti-HCV)
Does my patient have immunity to
Hepatitis A?
“Immune
status,
Hepatitis A”
Anti-HAV IgG
Does my patient have Immunity to
Hepatitis B?
“Immune
status,
Hepatitis B”
Anti-HBs
Needlestick injury: blood is obtained from
the source to determine infectivity (often
this is a patient).
“Hepatitis
Needlestick
Source”
HBsAg
Anti-HCV
“Hepatitis
Needlestick
Recipient”
The laboratory will test for acute Hepatitis A and Hepatitis B. If both
anti-HAV and HbsAg are negative, the specimen will automatically
be tested for anti-Hepatitis B core IgM antibody (anti-HBc IgM). In
an acute hepatitis B infection, anti-HBc IgM is detectable for a
longer time than HbsAg (“window period”).
Chronic hepatitis may or may not be symptomatic. Long-term
complications include liver cirrhosis and liver cancer. ALT may or
may not be elevated. The laboratory will test for Hepatitis B
surface antigen as well as for Hepatitis C antibodies. If the HBsAg
is positive for > 6 months, this is consistent with chronic Hepatitis B
infection. If Anti-HCV is present, this is consistent with current or
past infection. There is no test available at this time to distinguish
between current and previous hepatitis C infection.
To document immunity to hepatitis due to either natural infection or
vaccination, please order “immune status” followed by either
“Hepatitis A” or “Hepatitis B.”
When a needlestick injury has occurred, please contact Employee
Health Services at your hospital. Draw blood as soon as possible
on both source and recipient. Cross-reference the source and
recipient under “comments” when ordering the test.
Anti-HBs
Anti-HCV
Other tests on request:
HBsAg
Anti HBc
The blood samples are stored. If any of these additional hepatitis tests are required, please contact a Microbiologist.
Hepatitis B core Antibody (Anti HBc)
Hepatitis C RNA (Qualitative PCR) *
Hepatitis E Virus**
Hepatitis Be Antigen (HBeAg)
Hepatitis C RNA (Quantitative PCR) *
Hepatitis G Virus**
Hepatitis Be Antibody (Anti Hbe)
Hepatitis C Genotyping PCR *
** No testing available
Hepatitis Delta Antibody (Anti HBD)
Hepatitis B DNA PCR (HBV DNA) *
* Requires new specimen
Needlestick injury: blood is obtained from
the recipient to determine susceptibility
(often this is a health care worker).
03/09/16