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HelpTest ID AHEP Acute Hepatitis Profile, Serum
Necessary Information
Date of collection is required.
Specimen Required
Two aliquots of serum are required for testing: 0.5 mL of refrigerated serum and 2.5 mL of frozen serum
Patient Preparation: For 24 hours before specimen collection do not take multivitamins or dietary supplements containing biotin (vitamin B7), which is commonly found in hair, skin, and nail supplements and multivitamins.
Collection Container/Tube: Serum gel
Submission Container/Tube: Plastic vial
Specimen Volume: 3 mL
Collection Instructions:
1. Centrifuge blood collection tube per collection tube manufacturer's instructions (eg, centrifuge and aliquot within 2 hours of collection for BD Vacutainer tubes).
2. Aliquot 0.5 mL serum into a plastic vial labeled as HAIGM, and ship refrigerate (required).
3. Aliquot remaining 2.5 mL serum into a second plastic vial labeled as SST Serum, and ship frozen (preferred).
Forms
If not ordering electronically, complete, print, and send 1 of the following:
Secondary ID
56105Useful For
Differential diagnosis of recent acute viral hepatitis
Profile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| HAIGM | Hepatitis A IgM Ab, S | Yes | Yes |
| HBAG | HBs Antigen, S | Yes | Yes |
| HBIM | HBc IgM 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 surface antigen is reactive, then confirmation will be performed at an additional charge.
The following algorithms are available:
-Hepatitis B: Testing Algorithm for Screening, Diagnosis, and Management
Special Instructions
Method Name
HAIGM: Chemiluminescent Microparticle Immunoassay (CMIA)
HBAG, HBIM, HCVDX, HBGNT: Chemiluminescence Immunoassay (CIA)
HCVQN: Real-Time Reverse Transcription-Polymerase Chain Reaction (RT-PCR)
Reporting Name
Acute Hepatitis ProfileSpecimen Type
SerumSerum SST
Specimen Minimum Volume
2 mL (send 0.5 mL refrigerate and the remaining 1.5 mL frozen)
Specimen Stability Information
| Specimen Type | Temperature | Time | |
|---|---|---|---|
| Serum | Refrigerated | 5 days | |
| Serum SST | Frozen (preferred) | 28 days | |
| Refrigerated | 5 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, which 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 an endemic DNA virus throughout the world. The infection is spread primarily through percutaneous contact with infected blood products (eg, blood transfusion, sharing of needles by drug addicts). The virus is also found in virtually every human body fluid 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; others develop chronic liver disease, including cirrhosis and hepatocellular carcinoma.
Hepatitis C:
Hepatitis C virus (HCV) is an RNA virus that is a significant cause of morbidity and mortality worldwide. HCV is transmitted through contaminated blood or blood products or other close, personal contacts. It is recognized as the cause of most cases of posttransfusion hepatitis. HCV shows a high rate of progression (>50%) 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 SURFACE ANTIGEN
Negative
HEPATITIS B SURFACE ANTIGEN CONFIRMATION
Negative
HEPATITIS B CORE IgM ANTIBODY
Negative
HEPATITIS A IgM ANTIBODY
Negative
HEPATITIS C ANTIBODY
Negative
HEPATITIS C VIRUS RNA DETECTION AND QUANTIFICATION BY REAL-TIME RT-PCR
Undetected
Interpretation depends on clinical setting. See Viral Hepatitis Serologic Profiles
Cautions
Consider administration of immune globulin to individuals exposed to patients with hepatitis A.
Consider administration of hepatitis B immune globulin and/or hepatitis B vaccine to individuals exposed to hepatitis B patient's blood or body fluids.
Positive hepatitis B surface antigen or positive antibody to hepatitis A virus IgM test results should be reported by the attending physician to the State Department of Health, as required by law in some states.
Performance characteristics have not been established for the following specimen characteristics:
-Grossly icteric (total bilirubin level of >20 mg/dL)
-Grossly lipemic (triolein level of >3000 mg/dL)
-Grossly hemolyzed (hemoglobin level of >500 mg/dL)
-Containing particulate matter
-Cadaveric specimens
Day(s) Performed
Monday through Saturday
Report Available
Same day/1 to 2 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Test 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
80074 (if all 4 initial tests are performed)
86709 (if all 4 are not performed)
86705 (if all 4 are not performed)
87340 (if all 4 are not performed)
86803 (if all 4 are not performed)
87522 (if appropriate)
87341 (if appropriate)