What Other Laboratory Tests Might My Healthcare Practitioner Perform
In addition to tests for hepatitis viruses, your healthcare practitioner may choose to run tests to see how your liver has been affected. These may include a liver panel or individual liver enzyme tests such as aspartate aminotransferase , alanine aminotransferase , and alkaline phosphatase . Your healthcare practitioner may also run a test for bilirubin and a prothrombin time , which can help determine if there is liver damage.
If I Have Viral Hepatitis Am I Contagious
You may be contagious it depends on which hepatitis virus you were infected with and the stage of your infection. Often, people with viral hepatitis can spread the infection even though they don’t have symptoms. With hepatitis A, you may be contagious from the time you are infected and continue to be contagious, but less so, for several weeks after symptoms, such as jaundice, develop. A person with hepatitis B is contagious as long as the virus is present in their blood. Anyone who tests positive for the presence of hepatitis C virus should be considered contagious. The HCV RNA test may be performed as follow up to a positive result for anti-HCV.
Discussing Screening Results With Clients
The medical personnel who ordered or arranged the screening test, not counselors, usually explain the results. Hepatitis screening should be part of the intake physical examination in an opioid treatment program, and medical personnel may report the results. However, the client may want to discuss the results with the counselor or ask the counselor questions.
Anxiety might interfere with some clients ability to comprehend or retain information, which might need to be repeated.
Suggestions for conversations with clients when the test results are negative include the following:
- Explain results clearly and simply: So the HCV screening result was negative? This means that, as of 6 months ago, you did not have .
- Emphasize that a negative result to an HCV test does not indicate to and that the client should take precautions to avoid . If a relapse to drug use occurs, advise clients to avoid sharing any drug paraphernalia or equipment. Specify that this includes cookers, cotton, water, needles, syringes, pipes, and straws.
- Emphasize the importance of getting HAV and HBV vaccinations. Provide information about the availability of low- or no-cost vaccinations.
Clients whose screening test results are positive for will need additional tests and examinationsusually with doctors who specialize in diseases of the liver to get accurate diagnoses and to determine their health status and the extent of liver damage. These tests are described in .
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Is There A Way To Prevent Viral Hepatitis
Yes. There is a vaccine available for hepatitis A. It is recommended for all children at age one year and for people who are at an increased risk of exposure to the virus. Hepatitis A can also be prevented with good hygiene. This includes washing hands well after using the bathroom, after changing diapers, and before eating or starting any food preparation.
Effective hepatitis B vaccines have been available in the U.S. since 1981, and beginning in 1991, healthcare practitioners in the U.S. began vaccinating all newborns. Children and adolescents who were not vaccinated at birth are routinely given the series of shots. The Centers for Disease Control and Prevention also recommends that adults in high risk groups get vaccinated. Unless there is something in your medical history to the contrary, it is prudent to get the series of vaccinations.
Currently, there is no vaccine available for hepatitis C, although efforts are ongoing to develop one. Spread of hepatitis C can be prevented by avoiding exposure to blood and body fluids and the sharing of needles or other equipment to inject drugs.
What Does The Test Measure
An acute viral hepatitis panel includes several tests that measure antigens and antibodies. Antigens are foreign substances such as proteins of the virus itself, while antibodies are substances produced by the immune system in response to the viral infection.
An acute viral hepatitis panel tests for antigens and/or antibodies of hepatitis A, B, and C:
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The Treatment Programs Role In The Screening Process
Medical staff members at substance abuse treatment programs might assume the primary role for screening individuals for and explaining the screening process and test results. Opioid treatment programs with medical staff members should screen for and C at intake and periodically as indicated. In programs without onsite medical staff, clients may be referred elsewhere for screening with minimal involvement of the substance abuse treatment program.
Regardless of the type of program, counselors should have a basic understanding of the importance of screening, the screening process, and the meaning of the results. Counselors can encourage clients referred for screening to follow through and complete the screening and evaluation process . Clients might feel anxious about being diagnosed with hepatitis, and they might delay or avoid getting screened.
How To Get Tested
An acute viral hepatitis panel is performed after being prescribed by a doctor. This panel of tests requires one sample of blood, on which multiple tests can be conducted.
A blood sample can be taken in a hospital, lab, or other medical setting. Blood can be drawn from a vein or, in children, blood can be obtained by pricking the skin. After collection, the blood sample is sent to a laboratory for analysis.
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Hepatitis Panel Acute With Reflex To Confirmation
CPT Code: 80074
Hepatitis B Surface Antigen with Reflex to Confirmation
Hepatitis B Core Antibody
Hepatitis C Antibody with Reflex to HCV, RNA, Quantitative, Real-Time PCR
Hepatitis B Surface Antigen: Positive samples will be confirmed based on the manufacturers FDA approved recommendations at an additional charge : 87341).
If Hepatitis C Antibody is reactive, then Hepatitis C Viral RNA, Quantitative, Real-Time PCR will be performed at an additional charge : 87522).
Alternative Name: Acute Hepatitis Panel with ReflexABN Requirement: No
Collection Instructions: Dietary supplements containing biotin may interfere in assays and may skew analyte results to be either falsely high or falsely low. For patients receiving the recommended daily doses of biotin, draw samples at least 8 hours following the last biotin supplementation. For patients on mega-doses of biotin supplements, draw samples at least 72 hours following the last biotin supplementation.
Transport: Store serum at 2°C to 8°C after collection and ship the same day per packaging instructions included with the provided shipping box.
Stability:
Ambient : 72 hoursRefrigerated : 14 daysFrozen : 21 days
Methodology: Immunoassay
Turn Around Time: 1 to 3 days
Reference Range: See individual tests
Are Test Results Accurate
Although an acute viral hepatitis panel is a standard panel used to detect evidence of viral hepatitis, in many cases it provides only preliminary results. For patients who have abnormal results on the hepatitis B or C portions of this panel, additional testing is necessary to confirm the diagnosis.
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Understanding Of Lab Tests Results
Please visit the page about Acute Viral Hepatitis Panel on the site associated with The American Association for Clinical Chemistry for better understanding of tests. There you will find the most detailed and full information regarding lab tests. In “common questions” tab you will find answers on the most common questions.
In addition, you can use a special form to ask the question. It is useful, if there is no answer on your question on the web site. A laboratory scientist will answer your question. It is a part of voluntary service provided by the American Society for Clinical Laboratory Science.
What Happens During A Hepatitis Panel
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
At-home testing kits are available for hepatitis B and C. Usually the test kit will include a sharp device, to prick your finger so you can collect a drop of blood to send to a lab for testing. For more information on at-home testing for hepatitis, talk to your provider.
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Questions For Your Doctor About Test Results
The following questions about the results of an acute viral antibody panel may be helpful to review with a doctor:
- What tests were included in this panel?
- What was my test result?
- Do I have a hepatitis infection, and if so, which type?
- Would I benefit from hepatitis vaccination?
- Do I need any follow-up tests based on my test result?
When Is It Ordered
An acute viral hepatitis panel may be ordered when a person has had blood tests done as part of a health checkup that show abnormal results on liver tests or when someone has acute symptoms associated with liver damage, such as:
- Fever, fatigue
- Jaundice
- Itching
The acute viral hepatitis panel may sometimes be used to screen people when they are at an increased risk for hepatitis B or hepatitis C infection or when it is known that they have been exposed. Below are listed some examples of who may be screened using the panel:
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Hepatitis Panel/acute Hepatitis Panel
Please Note: This may not be an exhaustive list of all applicable Medicare benefit categories for this item or service.
This panel consists of the following tests:
- Hepatitis A antibody , IgM Antibody
- Hepatitis B core antibody , IgM Antibody
- Hepatitis B surface antigen and
- Hepatitis C antibody.
Hepatitis is an inflammation of the liver resulting from viruses, drugs, toxins, and other etiologies. Viral hepatitis can be due to one of at least five different viruses, designated Hepatitis A, B, C, D, and E. Most cases are caused by Hepatitis A virus , Hepatitis B virus , or Hepatitis C virus .
HAV is the most common cause of hepatitis in children and adolescents in the United States. Prior exposure is indicated by a positive IgG anti-HAV. Acute HAV is diagnosed by IgM anti-HAV, which typically appears within four weeks of exposure, and which disappears within three months of its appearance. IgG anti-HAV is similar in the timing of its appearance, but it persists indefinitely. Its detection indicates prior effective immunization or recovery from infection. Although HAV is spread most commonly by fecal-oral exposure, parenteral infection is possible during the acute viremia stage of the disease. After exposure, standard immune globulin may be effective as a prophylaxis.
Indications
Limitations
Educating Clients About Viral Hepatitis
Clients may believe they know about viral , but their understanding of the disease may not be accurate. It is easy to confuse the three main types of viral , B, and C. Clients may have formed impressions based on limited or incorrect information. Counselors should briefly describe hepatitis A, B, and C, including their prevalence, , and relationship to drug use, as well as to other infections, such as HIV and sexually transmitted diseases. Specific strategies for speaking with clients include:
- Speak clearly and keep the message simple, focused, and brief.
- Use language, examples, and concepts that the client understands.
- Use appropriate visual aids.
- Frame numerical statements in terms that are easy to visualize. Say 5 out of 100 people rather than 5 percent of the population say more than half instead of the majority.
- Repeat the information at different times in different ways. The average client retains only approximately one-third of what he or she is told. Summarize essential points.
- Pay attention to a clients response to the information. For example, if a client stiffens his or her posture, consider saying, I notice that this topic seems to make you uncomfortable. It does for a lot of people. Please tell me what youre feeling right now. Id really like to help you with this.
- Use the opportunity to describe the potential detrimental effects of alcohol and other substance use on the liver of a person who is infected with HCV.
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What Does The Test Result Mean
The table below summarizes results that may be seen with a hepatitis panel that is performed to detect an infection:
| Anti-hepatitis A, IgM | |
| Positive | Acute or chronic hepatitis C additional tests are required to make the determination |
If other hepatitis tests are performed to help determine prior exposure or previous infection, they may indicate the following:
- Hepatitis A antibody, total if negative, no current or previous HAV infection if positive, indicates exposure to HAV or the HAV vaccine. An IgM test must be done if an acute infection is suspected.
- Hepatitis B core antibody, total a positive test can indicate exposure to the virus. An IgM test must be performed if an acute infection is suspected.
- Hepatitis B surface antibody if positive, it indicates that a HBV infection has resolved depending on results of other HBV tests, a negative result may indicate that an infection has not resolved. Hepatitis B surface antibody will also be positive with a negative hepatitis B core antibody after a person has received a hepatitis B vaccine.
It is possible to be infected with more than one hepatitis virus, and an acute infection with one hepatitis virus can be superimposed on a chronic infection with a different hepatitis virus. In such cases, there may be a positive result for more than one type of virus and care must be taken when interpreting the results.
What Does A Hepatitis Panel Involve
Hepatitis panels are simple blood tests. They do not involve any preparation and have a very low risk of side effects.
To perform the test, a healthcare professional will insert a needle into a vein in the arm. They will collect a small blood sample in a test tube and seal it. The needle may sting a little, but the process takes only a few minutes. A person may feel a small amount of pain or bruising around the vein, but this should subside quickly.
People can also get at-home testing kits for hepatitis. These come with a sterile lancet that a person uses to prick their finger to collect the blood sample.
When using at-home kits, be sure to take safety precautions to prevent others from coming into contact with blood. Even dry blood or tiny amounts of blood can potentially transmit HBV or HCV to others.
Dispose of items that come into contact with blood in a sealed bag and wash the blood from the skin using soap. Completely cover the finger prick wound with a sterile dressing until it heals.
- of the population have hepatitis B and have not had a vaccination
- spent time in a facility that had a hepatitis outbreak, such as a hospital or prison
- received a blood transfusion that did not undergo hepatitis screening
In the United States, screening eliminated HCV from donated blood in 1992. People who received blood transfusions before 1992 should ask their doctor for a hepatitis C test.
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Hepatitis Blood Test Panel Acute
A Hepatitis Blood Test Panel includes: Hepatitis A antibody, IgM, hepatitis B core antibody, IgM, hepatitis B surface antigen, and hepatitis C antibody with reflex.
Also Known As: Acute Hepatitis Profile
Methodology:
No fasting required. Stop biotin consumption at least 72 hours prior to the collection.
Test Results:
2-3 days. May take longer based on weather, holiday or lab delays.
Also Known As: Acute Hepatitis Profile
Methodology:
No fasting required. Stop biotin consumption at least 72 hours prior to the collection.
Test Results:
2-3 days. May take longer based on weather, holiday or lab delays.
Identifying Patterns Of Risky Behavior
Screening is an opportunity to draw attention to the clients behaviors that put him or her at risk for contracting :
- Ask for the clients perception of his or her risk for having contracted : How likely do you think it is that the test will be positive?
- Listen for and identify behaviors that put the client at risk for contracting , B, and C and HIV, especially unprotected sex and sharing injection drug paraphernalia.
- Assess the clients alcohol consumption.
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Preparing Clients For Screening
Once clients are comfortable talking about viral , they might be more willing to undergo screening. However, clients might be anxious about the test itself a reassurance that testing is a simple procedure can help allay these concerns. Many substance use treatment facilities do not offer screening, and clients might need to be referred elsewhere. The following strategies can enhance the discussion of the hepatitis screening process and hepatitis prevention:
Hepatitis C Reflex Testing
To ensure complete and timely diagnosis of HCV, HCV reflex testing is recommended following a reactive hepatitis C antibody screening test. Reflex testing means the laboratory will perform the hepatitis C antibody test, and if the result is positive, the laboratory will immediately perform an HCV RNA test on the same specimen. If the subsequent HCV RNA test is negative, HCV infection is effectively ruled out for most patients. If the reflex HCV RNA test is positive, a diagnosis of active HCV infection has been confirmed, and the individual should be referred directly for HCV care and treatment.
Reflex testing obviates the need for the patient to return for follow-up testing should the initially HCV antibody test be reactive. If the RNA test is negative, the work-up is done, and the patient may be reassured.
- Rationale for reflex testing:
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