Hepatitis Markers

 

Hepatitis means inflammation of the liver. It is commonly the result of a viral infection (hepatitis viruses A, B, C, D, and E), but there are other possible causes of hepatitis like autoimmune hepatitis and hepatitis that occurs as a secondary to medications, drugs, toxins, and alcohol. Hepatitis markers (Antigens, Antibodies & PCR) are useful for determining diagnosis, appropriate treatment, and vaccination status and for monitoring treatment.

 Viral Hepatitis Markers:

Hepatitis A virus-IgM Antibodies (anti-HAV IgM): Serum IgM antibody to the hepatitis A virus (antiHAV) appears at about four weeks after initial infection and usually persists for 2-6 months as the initial phase of the immune response. (Test code H018)

Hepatitis A virus-IgG Antibodies (anti-HAV IgG): Serum IgG antibody to HAV generally persists for lifetime, conferring immunity to further HAV infection. (Test code H017)

Hepatitis A virus-Total Antibodies (Anti-HAV-Total Ab): The total HAV antibody test detects both IgM and IgG antibodies, and used to identify both current and past infections. Detection of total anti-HAV is used to determine the immune status of an individual after vaccination or infection. (Test code H019)

HAV-RNA PCR: The PCR detection of HAV RNA has an important role in the early diagnosis of infection, especially in the window period during outbreaks. (Test code H016)

Hepatitis B surface antigen (HBsAg): Hepatitis B surface antigen is the earliest indicator of acute infection and is also indicative of chronic infection if its presence persists for more than 6 months. Test code H026 (by ELISA), H028 (by CLIA), H029 (by Rapid)

Hepatitis B surface antibody (Anti-HBs Ab):  A positive result indicates recovery from acute or chronic hepatitis B virus (HBV) infection, or acquired immunity from HBV vaccination. (Test code H026 by ELISA, H028 by CLIA)

Hepatitis B core Total antibody (anti-HBc Total Ab): Anti-HB core antibodies appear as a patient develops symptoms of hepatitis, and they remain detectable for life. Anti-HBc total antibodies may be the only serologic marker remaining years after exposure to hepatitis B. (Test code H020)

Hepatitis B core IgM antibody (anti-HBc IgM):  IgM Hepatitis B core antibody is detected only in acute hepatitis B infections within six months of infection. (Test code H021)

Hepatitis B e antigen (HBeAg): HBe antigen becomes detectable shortly after HBsAg is detectable and is an indicator of active infection and replicating virus. (Test code H023)

Hepatitis B e antibody (anti-HBe):  The appearance of anti-HBe in patients who have previously been HBeAg positive indicates a reduced risk of infectivity. The seroconversion from HBeAg positivity to Anti-HBe Ab positivity indicate a reduce level of infectious virus because virus replication has decreased. (Test code H022)

Hepatitis B viral DNA PCR: A hepatitis B viral DNA test detects the virus’s genetic material and determines the viral load in the blood. A positive test indicates that the virus is multiplying in a person’s body, making that person contagious. The test is often used to monitor the effectiveness of antiviral therapy in people with chronic HBV infections. (Test code H033 for Qualitative, H034 for Quantitative)

Hepatitis B Virus (HBV) Genotyping: Determining the genotype could be helpful for predicting the outcome of antiviral therapy in patients with chronic hepatitis. (Test code H031)

Hepatitis C antibody (anti-HCV) test:  Testing for hepatitis C antibodies determines whether or not a patient has been exposed to the hepatitis C virus at some point in their life. If this test is positive, the next step is to test for hepatitis C RNA which can tell you if you have a current infection. (Test code H035 by CLIA, H036 by Rapid card)

Hepatitis C Virus RNA PCR:  Qualitative HCV RNA tests can detect the presence of HCV RNA, while quantitative HCV RNA tests measure the amount of HCV RNA (Viral Load). Understanding the amount of HCV in the blood helps to monitor response to treatment. (Test code H039 for Qualitative, H040 for Quantitative)

HCV Genotype test: There are at least six types of hepatitis C, which are also called strains or genotypes. Treatment for hepatitis C depends on the strain, so genotype testing to guide treatment is performed in patients who are diagnosed with an HCV infection. (Test code H038)

Hepatitis Delta Virus (HDV) Total Antibodies: Hepatitis D can be acquired either as co-infection or uper-infection in people with HBV infection. The hepatitis D total antibody may indicate either acute or chronic HDV infection and may disappear with resolution of the infection. (Test code H042)

Hepatitis E virus-IgM Antibodies (HEV IgM): The anti-HEV IgM titre peaks during the symptomatic phase and declines thereafter to baseline values within 3-6 months of symptomatic disease. (Test code H044)

Hepatitis E virus-IgG Antibodies (HEV IgG): The anti-HEV IgG usually persists for many years after infection. Anti-HEV IgG is the serologic test of choice to determine past exposure to HEV. (Test code H043)

Auto-immune hepatitis Markers:

• Anti-liver/kidney microsomal antibodies (anti LKM1)
• Anti-mitochondrial antibodies (AMA)
• Anti-nuclear antibodies (ANA)
• Anti-smooth muscle antibodies (ASMA)
• Serum IgG

 

- Dr Prashant Goyal