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Test Code PHEPU Previous Viral Hepatitis (Unknown Type), Serum


Necessary Information


Date of collection is required.



Specimen Required


Patient Preparation: For 24 hours before specimen collection, patient should not take multivitamins or dietary supplements (eg, hair, skin, and nail supplements) containing biotin (vitamin B7).

Supplies: Sarstedt Aliquot Tube, 5 mL (T914)

Collection Container/Tube: Serum gel (red-top tubes are not acceptable)

Submission Container/Tube: Plastic vial

Specimen Volume: 2.6 mL

Collection Instructions:

1. Centrifuge blood collection tube per manufacturer's instructions (eg, centrifuge and aliquot within 2 hours of collection for BD Vacutainer tubes).

2. Aliquot 1.8 mL serum into a plastic vial and ship frozen (preferred).


Useful For

Determining if an individual has been infected following exposure to an unknown type of viral hepatitis virus

 

Obtaining baseline serologic markers of an individual exposed to a source with an unknown type of hepatitis

 

Determining immunity to hepatitis A and B viral infections

Profile Information

Test ID Reporting Name Available Separately Always Performed
HAVTA Hepatitis A Virus Total Ab, S Yes Yes
HBAG HBs Antigen, S Yes Yes
HBAB HBs Antibody, S Yes Yes
HBC HBc Total 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 virus surface antigen (HBsAg) is reactive, then HBsAg confirmation will be performed at an additional charge.

 

For more information see:

-Hepatitis B: Testing Algorithm for Screening, Diagnosis, and Management.

-Hepatitis C: Testing Algorithm for Screening and Diagnosis

Method Name

HAVTA, HBAG, HBAB, HBC, HCVDX, HBGNT: Electrochemiluminescence Immunoassay (ECLIA)

HCVQN: Real-Time Reverse Transcription-Polymerase Chain Reaction (RT-PCR)

Reporting Name

Previous Hepatitis Profile

Specimen Type

Serum SST

Specimen Minimum Volume

1.8 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum SST Frozen (preferred) 84 days
  Refrigerated  6 days

Reject Due To

Gross hemolysis Reject
Gross lipemia Reject
Gross icterus Reject
Heat-inactivated specimen Reject

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 that 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 a DNA virus that is endemic throughout the world. The infection is spread primarily through percutaneous contact with infected blood products (eg, blood transfusion, sharing of needles among injection drug users). The virus is found in various human body fluids 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, while others develop chronic liver disease, including cirrhosis and hepatocellular carcinoma.

 

Hepatitis C:

Hepatitis C virus (HCV) is an RNA virus recognized as the cause of most cases of posttransfusion hepatitis that is a significant cause of morbidity and mortality worldwide. HCV is transmitted through contaminated blood or blood products or close, personal contact. HCV shows a high rate of progression (~75%) 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 VIRUS SURFACE ANTIGEN

Negative

 

HEPATITIS B VIRUS SURFACE ANTIGEN CONFIRMATION

Negative

 

HEPATITIS B VIRUS SURFACE ANTIBODY, QUALITATIVE/QUANTITATIVE

Hepatitis B Surface Antibody

Unvaccinated: Negative

Vaccinated: Positive

 

HEPATITIS B VIRUS SURFACE ANTIBODY, QUANTITATIVE

Unvaccinated: <8.5 mIU/mL

Vaccinated: ≥11.5 mIU/mL

 

HEPATITIS B VIRUS CORE TOTAL ANTIBODIES

Negative

 

HEPATITIS A VIRUS TOTAL ANTIBODY

Unvaccinated: Negative

Vaccinated: Positive

 

HEPATITIS C VIRUS ANTIBODY

Negative

 

HEPATITIS C VIRUS RNA DETECTION and QUANTIFICATION by REAL-TIME RT-PCR

Undetected

 

Interpretation depends on clinical setting. For more information see Viral Hepatitis Serologic Profiles.

Interpretation

Interpretation depends on clinical setting. For more information see Viral Hepatitis Serologic Profiles.

 

Hepatitis A:

Hepatitis A virus (HAV)-specific total antibodies are almost always detectable by the onset of symptoms of acute hepatitis A (usually 15 to 45 days after exposure). The initial antibody consists almost entirely of the IgM subclass of antibody. Anti-HAV IgM usually falls to undetectable levels 3 to 6 months after infection. Anti-HAV IgG levels rise quickly once the virus is cleared and persist for many years.

 

Hepatitis B:

Hepatitis B virus surface antigen (HBsAg) is the first serologic marker appearing in the serum 6 to 8 weeks following hepatitis B virus (HBV) infection. A confirmed positive result for HBsAg is indicative of acute or chronic hepatitis B. In acute cases, HBsAg usually disappears 1 to 2 months after the onset of symptoms. Anti-HBs appears with the resolution of HBV infection after the disappearance of HBsAg. Anti-HBs also appears as the immune response following a course of inoculation with the hepatitis B vaccine.

 

Hepatitis B virus core antibody (anti-HBc) appears shortly after the onset of symptoms of HBV infection and may be the only serologic marker remaining years after exposure to hepatitis B.

 

Hepatitis C:

Hepatitis C virus-specific antibodies are usually not detectable during the first 2 months after exposure, but they are almost always detectable by the late convalescent stage of infection. HCV antibodies are not neutralizing and do not provide immunity.

Cautions

Positive hepatitis B surface antigen (HBsAg) results may need to be reported by the healthcare providers to their communicable disease surveillance units of state departments of health, as required by law in various states.

 

Type-specific tests should be used to evaluate individuals who have been exposed to a source with a known type of hepatitis (eg, hepatitis A, hepatitis B, hepatitis C).

 

Serum specimens from individuals taking biotin supplements at 20 mg or more per day may have false-positive results for HAV total antibody and HBc total antibody, as well as false-negative results for HBsAg and HCV total antibody, due to interference of biotin with the assay. Such individuals should stop taking these biotin-containing dietary supplements for minimum 12 hours before blood collection for this test.

 

Performance characteristics have not been established for the following specimen characteristics:

-Grossly icteric (total bilirubin level of >25 mg/dL)

-Grossly lipemic (intralipid level of >1000 mg/dL)

-Grossly hemolyzed (hemoglobin level of >500 mg/dL)

-Containing particulate matter

-Cadaveric specimens

-Immunocompromised or immunosuppressed specimens

Day(s) Performed

Profile tests: Monday through Friday; Reflex tests: Varies

Report Available

Same day/1 to 2 days

Performing 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

86704

86706

86708

86803

87340

87341 (if appropriate)

87522 (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
PHEPU Previous Hepatitis Profile 92890-3

 

Result ID Test Result Name Result LOINC Value
HCVA4 HCV Ab, S 40726-2
HAVT Hepatitis A Virus Total Ab, S 13951-9
HBC HBc Total Ab, S 13952-7
HB_AB HBs Antibody, S 10900-9
H_BAG HBs Antigen, S 5196-1
HBSQN HBs Antibody, Quantitative, S 5193-8

Forms

If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:

Gastroenterology and Hepatology Test Request (T728)

Infectious Disease Serology Test Request (T916)