Hepatitis Profile

What is the hepatitis profile test?

A hepatitis profile or a hepatitis panel is a blood test that checks for markers of hepatitis infection caused by one of the hepatitis viruses – A, B or C. Hepatitis panel comprises a cluster or battery of blood examinations performed at one time to aid in the diagnosis of viral hepatitis.  The tests seek to spot the presence of antibodies released by the immune system to fight the hepatitis infection. A hepatitis panel test usually consists of the following tests :

– Hepatitis A IgG antibodies(HA Ab-IgG)
– Hepatitis A IgM antibodies (HA Ab-IgM)
– Hepatitis B surface antibody (HBsAb)
– Hepatitis B surface antigen (HBsAg)
– Hepatitis B type e antigen (HBeAg)
– Hepatitis B IgM core antibody (HBcAb-IgM)
– Hepatitis B IgG core antibody (HBcAb-IgG)
– Hepatitis C antibodies (HC Ab)

What are the other titles for this test?

This test is also referred to as Hepatitis Screening Panel and Viral Hepatitis Panel.

What happens during hepatitis A, B, and C infection?

Hepatitis is a type of liver disease condition that leads to irritation, swelling, and enlargement of the liver. Viruses categorized under hepatitis A, hepatitis B, and hepatitis C are the most common causes of hepatitis.

Hepatitis A virus (HAV) is a food and water-borne disease.  Consumption of contaminated food, water, or contact with an infected person can cause hepatitis A.  Transmission of Hepatitis A virus is through the fecal-oral route. Although it is rare, hepatitis A can also be conveyed through unprotected sex.  It is, therefore, a highly contagious disease. Although the infection in most of the cases is not chronic or acute, on rare occasions hepatitis A can lead to a severe infection. Hepatitis A is preventable with the help of vaccines.

No permanent damage to the liver is caused by Hepatitis A. The prognosis and recovery for patients of hepatitis A is good in most cases. Acute viral hepatitis is most of the time caused by the Hepatitis B virus (HBV). Hepatitis B is usually transmitted through contact with bodily fluids such as infected blood or through sexual contact. The recovery for infected people varies; some recover very well while others suffer chronic liver disease. The HBV is transmitted  in one of the following ways :

– Travel to hepatitis B infected areas
– Sharing of needles for IV drug use
– Unprotected sex
– Through pregnancy and childbirth to the fetus

Hepatitis C is also transmitted after contact with infected blood, usually through the sharing of hypodermic needles. Though uncommon, it can also spread through sexual contact with an infected person. Many people with hepatitis C develop chronic liver disease and cirrhosis.

Do I need a Hepatitis Panel?

Few reasons that have prompted your healthcare provider to order the hepatitis panel for you are:

You have exhibited some acute symptoms of hepatitis and the type of virus – A, B, or C is not known. You carry an elevated risk of hepatitis infection due to recent exposure and a hepatitis panel may be recommended to determine the type of virus behind the hepatitis infection. Your doctor may ask you to undergo the test even in the absence of symptoms.  If you show signs of liver damage, then the hepatitis panel test is a must for you. Some of the overriding symptoms that prompt a hepatitis panel test are:
– Loss of appetite
– Extreme tiredness
– Fever
– Light colour stool
– Nausea
– Vomiting
– Jaundice,
– Dark-coloured urine

Your healthcare provider may ask you to undergo a hepatitis panel if you carry certain risk factors for the infection. Some of the risk factors are as listed below:

– Have been undergoing dialysis for a long time
– Close proximity to an infected person
– Victim of sexually transmitted disease
– Injection drugs
– Illegal drugs

How is the hepatitis panel test performed?

The hepatitis panel test requires a blood sample.  Your healthcare professional will use a small needle to draw a sample of blood from a vein in your arm.  The blood sample is collected in a test tube and is sent to the laboratory for testing.

Is there any special preparation required for this test?

There is no special preparation needed for the hepatitis panel test. It is a simple test done in a few minutes. It is important to inform your healthcare provider about your medical history including information about all the medicines, vitamins and supplements you take.   

Should every patient of hepatitis be screened for all types of hepatitis as included in the panel tests?

It is not necessary to conduct a hepatitis panel test on all patients. If the specific hepatitis virus that has caused the infection is known, then the specific hepatitis test may only be conducted. In some cases, doctors may want to know how the treatment is going on or to evaluate the progression of a disease. In such cases, only specific hepatitis tests are conducted.

Will I need any other tests along with the hepatitis panel?

Apart from the tests for hepatitis viruses, your doctor may want to know the impact of disease or medical conditions on your liver. Your healthcare provider may recommend liver enzyme tests such as alkaline phosphatase (ALP) aminotransferase (AST), and aspartate alanine aminotransferase (ALT). Further, you may also be asked to undergo a test for prothrombin time (PT) and bilirubin to ascertain the extent of liver damage.

When will I get the results and what do they mean?

Your test results will be ready in a few days to a week following the test. The results of the hepatitis panel can best be explained by your healthcare provider. If your overall test results are negative, this shows you do not suffer from hepatitis infection. If the result is positive, it either means you are suffering from a  current infection or have experienced an infection of hepatitis A, hepatitis B, or hepatitis C in the past.

There are cases where patients get a positive result for more than one type of hepatitis virus. It is possible for a patient to suffer from acute hepatitis infection from more than one type of hepatitis virus. In such cases, doctors interpret the results very carefully.

In case all the hepatitis viral tests turn negative, it could also mean the level of antibodies in the blood is insufficient for detection.  The hepatitis panel test result may point to the following:

Interpretation of test results
Case 1
Anti-hepatitis A, IgM :                   Positive
Hepatitis B surface antigen:        Negative
Anti-hepatitis B core, IgM:           Negative             
Anti-hepatitis C:                             Negative
Interpretation:                            Acute hepatitis A
 
Case 2
Anti-hepatitis A, IgM :                   Negative
Hepatitis B surface antigen :       Positive
Anti-hepatitis B core, IgM:           Positive               
Anti-hepatitis C :                            Negative
Interpretation:                              Acute hepatitis B
 
Case 3
Anti-hepatitis A, IgM :                   Negative
Hepatitis B surface antigen:        Positive
Anti-hepatitis B core, IgM:           Negative             
Anti-hepatitis C :                            Negative
Interpretation:                             Chronic hepatitis B infection
 
Case 4
Anti-hepatitis A, IgM :                   Negative
Hepatitis B surface antigen :       Negative
Anti-hepatitis B core, IgM:           Positive               
Anti-hepatitis C :                            Negative
Interpretation:                             Acute hepatitis B
 
Case 5
Anti-hepatitis A, IgM:                    Negative
Hepatitis B surface antigen:        Negative
Anti-hepatitis B core, IgM:           Negative             
Anti-hepatitis C :                            Positive
Interpretation:                             Chronic hepatitis C
 
Hepatitis A antibody, total (IgM and IgG) — if this is positive it means there has been an exposure to HAV. It also indicates the use of the HAV vaccine in the past. In case of an acute infection, doctors may recommend an IgM test.

Hepatitis B core antibody, total (IgM and IgG) — If the test result is positive, it means there has been an exposure to the hepatitis virus.

Hepatitis B surface antibody — if this test result is positive it means recovery from an HBV infection. A negative test result means the contrary. If the hepatitis B core antibody is negative, the hepatitis B surface antibody will be positive, if the person has taken the hepatitis B vaccine.

Can hepatitis patients spread the infection to others?

Patients can spread hepatitis infection and the spread depends on the type and stage of the hepatitis infection. Those suffering from viral hepatitis can easily spread the infection even while being asymptomatic. Those with hepatitis A can spread the infection from the time they are infected. Those with hepatitis B are contagious as long as the virus is present in the blood. Those with hepatitis C infection are contagious and can transmit the infection.

Is it possible to prevent hepatitis?

Hepatitis prevention is very much a possibility with the right strategies. A vaccine is available for hepatitis A. Healthcare providers recommend this vaccine for all people who are at high risk of exposure to the virus. Children- one year and above, should take this vaccine. Prevention of hepatitis A is possible with good hygiene and sanitation. Washing hands especially after using the toilet and before consumption of food can help with cutting hepatitis A transmission.

Hepatitis B vaccine has become the norm in developed nations and most new-borns are given these shots. The hepatitis B shots are recommended for children and adolescents as well as adults in high-risk groups.

Hepatitis C vaccine is not developed yet, and efforts are in the process to have a vaccine for this infection. Prevention of hepatitis C is possible by avoiding contact or exposure to blood and bodily fluids. Further, avoiding the sharing of needles or other instruments to inject drugs can cut the rate of transmission of this disease.

Can other medical conditions have similar symptoms like hepatitis?

Few viral infections also trigger similar symptoms like hepatitis. There are autoimmune conditions that may portray similar symptoms like hepatitis. In that case, the hepatitis panel test result may turn negative, which will prompt your doctor to order additional tests for you. Inherited disorders and drugs such as acetaminophen can cause hepatitis. Alcohol abuse can also result in this condition. Few viral infections such as Epstein-Barr virus (EBV) and cytomegalovirus (CMV) can cause hepatitis.

Is the hepatitis panel conducted on children?

The hepatitis panel test is ordered for children who carry the risk factors for the infection or have exhibited few symptoms of the disease or have been exposed to the virus.

Can the hepatitis panel test be conducted on pregnant women?

Pregnant women can easily pass on the hepatitis B or C virus to their fetus. Doctors’ advice routine hepatitis B tests for pregnant women. In case, there are risk factors for hepatitis C, then expectant women are advised to undergo the hepatitis C test.

How much does the hepatitis panel test cost in India?

The price of the hepatitis panel varies according to the facility and location. The price may range from INR 4500 to 5500.