HEPATITIS TESTING GUIDE Alegent Health Reference Laboratory Test Name NextGen Alegent Test Directory Test Description (Cerner) Orderable Name Number Order when patient has had clinical acute hepatitis of unknown origin for less than 6 months. Hepatitis Panel, Hepatitis Panel Panel includes; Hep A virus, IgM, Hepatitis Panel ARUP Acute with reflex to Hepatitis Panel, Acute with reflex Hep B virus Core antibody, IgM, Acute (0020457) HBsAg to HBsAg Confirmation Hep B virus Surface antigen with reflex to confirmation, Hep C virus antibody by CIA ARUP Order this assay when acute Hepatitis A infection is suspected. Hepatitis A Ab IgM Hep A Ab IgM Hepatitis A, IgM (0020093) Positive HAV IgM shows current or recent infection. Order only when assessing immunity for HAV from either Hepatitis A Hepatitis A Hepatitis A Virus Antibodies ARUP vaccination or previous infection. Do not use to diagnose acute antibody, total (IgG Antibody IgG & (Total) (0020591) infection. Total assay detects both IgG and IgM antibodies but and IgM IgM does not differentiate between them. Order when patient has had clinical acute hepatitis of unknown origin for less than 6 months. Positivity indicates recent Hepatitis B core Ab Hep B Core Ab Hepatitis B Virus Core Antibody, ARUP infection with hepatitis B virus, with onset < 6 months. It's IgM IgM IgM (0020092) presence indicates acute infection. In some cases, hepatitis B core IgM antibody may be the only specific marker for the diagnosis of acute infection with hepatitis B virus. This assay does not distinguish between Total B core antibody IgG and IgM detected before or at the onset of symptoms; Hepatitis B Core Hepatitis B core Hepatitis B Virus Core Antibodies ARUP however, such reactivity can persist for years after illness, and Antibody IgG & antibody (Total) (0020091) may even outlast anti-HBs. Occasionally Hepatitis B core IgM antibody may be the only marker of either current or past Hepatitis B infection. Used to detect immunity to Hepatitis B virus. The presence of anti-HBs is generally interpreted as indicating recovery and immunity from hepatitis B virus infection. Anti-HBs also Hepatitis B surface Hepatitis B Surface Hepatitis B surface antibody Alegent develops in a person who has been successfully vaccinated antibody Antibody against hepatitis B. To determine immune status as ≥10 mIU/mL as per CDC guidelines, please order Hepatitis B Surface Antibody, Quantitative. A protein on the surface of hepatitis B virus; it can be detected in high levels in serum during acute or chronic hepatitis B virus Hepatitis B surface Hepatitis B Surface Hepatitis B surface antigen Alegent infection. The presence of HBsAg indicates that the person is antigen Antigen infectious. The body normally produces antibodies to HBsAg as part of the normal immune response to infection. Surface antigen usually appears in the serum after an incubation period of 1 to 6 months following exposure to HBV and peaks shortly after onset of symptoms. It typically disappears within 1 to 3 months. Persistence of HBsAg for greater than 6 months is a prognostic indicator of chronic Hepatitis B infection. Chronic carriers will persist in producing detectable HBV. Hepatitis B Virus DNA Patients with chronic liver disease of unknown origin most Hepatitis B viral Hepatitis B viral ARUP Ultrasensitive Quatitative Real- commonly have HBV that is detected by viral DNA testing. DNA, Quantitative DNA, Quantitative (0056025) Time PCR Quantitative measurement of HBV viral DNA may be used to monitor progression of disease. Anti-HBe in the blood following exposure to the Hepatitis B Hepatitis Be Hepatitis Be ARUP Hepatitis Be Virus Antibody virus suggests a good prognosis for patients with Hepatitis B antibody Antibody (0020095) infection. Hepatitis Be ARUP Persistence of HBeAg for greater than 6 months is a prognostic Hepatitis Be antigen Hepatitis Be Virus Antigen Antigen (0020094) indicator of a chronic hepatitis B virus carrier state. Hepatitis C Virus (HCV) is the major cause of hepatitis. Approximately 1% of blood donors are seropositive for anti- HCV. The clinical symptoms of a HCV infection are variable. Hepatitis C antibody Hep C Ab Hepatitis C Virus Antibody Alegent Exposure to HCV results in a chronic infection in 50 to 80% of cases. The "window" between infection and seroreactivity is highly variable, up to 12 months. Hepatitis C Hepatitis C Hepatitis C Virus Genotyping by ARUP Assess length of treatment required and likelihood of response genotyping Genotyping PCR & Sequencing (0055593) (used as baseline) Confirm active hepatitis C virus (HCV) infection. Document Hepatitis C RNA Hepatitis C RNA Hepatitis C Virus RNA Qualitative ARUP rapid (RVR) and early (EVR) virologic response. Guide PCR Qualitative PCR Qualitative PCR (0098264) duration of antiviral therapy. Confirm resolution of infection and sustained virologic response (SVR) Confirm active hepatitis C virus (HCV) infection. Document rapid (RVR) and early (EVR) virologic response. Guide duration of antiviral therapy. Confirm resolution of infection Hepatitis C RNA Hepatitis C RNA Hepatitis C Virus RNA ARUP and sustained virologic response (SVR) PCR Quantitative PCR Quantitative Quantitative, Real-Time PCR (0098268) Establish viral load at baseline; monitor viral load during therapy; determine duration of treatment; assess likelihood of non-response during treatment Hepatitis C RNA Miscellaneous Hepatitis C Virus RNA PCR ARUP Establish viral load and genotype at baseline; determine duration Serology Quantitative by Real-Time PCR Quantitative/Reflex (2002685) of treatment and likelihood of response with Reflex to Genotype genotyping November 2012 .