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HelpTest Code HEPPAN Hepatitis Panel, Comprehensive
Useful For
To aid in the diagnosis of acute and chronic viral hepatitis caused by the three most common viruses in the USA: Hepatitis A, hepatitis B, & hepatitis C. Useful in determining immune status to hepatitis A and hepatitis B.
Synonyms/Keywords
Panel, Hepatitis Comprehensive
Specimen Requirements
| Fasting Required | Specimen Type | Preferred Container/Tube | Acceptable Container/Tube | Specimen Volume | Specimen Minimum Volume (allows for 1 repeat) |
Pediatric Minimum Volume (no repeat) |
|---|---|---|---|---|---|---|
| No | Serum | Serum Separator Tube (SST) | Red Top Tube (RTT) | 2 mL | 1.5 mL | 1 mL |
Collection/Processing Instructions
Separate serum from the blood within 60 minutes of venipuncture and transport in an aliquot tube. Specimen must be free of particulate matter including fibrin.
Regional/Outreach sites: Please send samples to Marshfield frozen.
High doses of exogenous biotin (also termed Vitamin B7, Vitamin H or Coenzyme R) may interfere with this assay. It is recommended that patients refrain from consuming any multivitamin or supplement containing biotin for at least 72 hours prior to collection of a blood sample.
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
|
Serum |
Ambient | <8 hours |
| Refrigerate | <48 hours | |
| Frozen at -20oC | 6 months | |
| Frozen at -70oC | >6 months |
Rejection Criteria
| Grossly hemolyzed |
|---|
| Grossly icteric |
| Specimens containing precipitate |
| Cadaver specimens |
| Heat-inactivated specimens |
| Body fluids other than serum |
Test Components
Hepatitis A Antibody Total, Hepatitis B Surface Antibody, Hepatitis B Surface Antigen, Hepatitis B Core Antibody Total and Hepatitis C Antibody.
Test Information
Acute hepatitis may be caused by viral infection, non-viral infection, or non-infectious causes. Hepatitis A is transmitted by the oral-fecal route, while hepatitis B & hepatitis C are primarily borne by blood and other body fluids. While all three viruses can cause acute viral hepatitis, only B & C can progress to a chronic infection.
Limitations:
- The results determined by different assays from different manufacturers can vary due to differences in assay specificities and cannot be used interchangeably.
- For other limitations consult individual test reference assay entries.
Interferences
Heterophilic antibodies in human serum can react with the immunoglobulins included in the assay components causing interference with immunoassay.
High doses of exogenous biotin (also termed Vitamin B7, Vitamin H or Coenzyme R) may interfere with this assay (A, HAA).
Interpretations
1. Hepatitis A
a. Reactive hepatitis A IgM antibody AND reactive hepatitis A total antibody is indicative of acute infection.
b. Reactive hepatitis A total antibody AND non-reactive hepatitis A IgM antibody is indicative of past, resolved infection.
c. A non-reactive hepatitis A total antibody result indicates probable susceptibility to hepatitis A infection.
d. A reactive hepatitis A total antibody result indicates probable immunity to infection/reinfection; however, this assay does not have FDA clearance for confirmation of immunity, whether by natural infection or vaccination.
2. Hepatitis B
a. Hepatitis B surface antibody can be measured to determine if vaccination is needed or, following a vaccination regimen, to determine if protective immunity has been achieved.
Diagnostic interpretations are as follows:
| HBsAg | NON-REAC | No serologic evidence of infection with hepatitis B was detected. |
| HBsAb | NON-REAC | |
| HBcAb (Total) | NON-REAC | |
| HBsAg | NON-REAC | This serologic pattern is suggestive of the recovery phase of acute hepatitis B: in such cases, repeat testing once with HEPATITIS B SURFACE ANTIBODY to document seroconversion. This pattern may also rarely represent chronic hepatitis B with undetectable level of hepatitis B surface antigen: consultation with a specialist is suggested if clinical conditions warrant. |
| HBsAb | NON-REAC | |
| HBcAb (Total) | REACTIVE | |
| HBsAg | NON-REAC | This serologic pattern is consistent with vaccine-induced hepatitis B surface antibody. |
| HBsAb | REACTIVE | |
| HBcAb (Total) | NON-REAC | |
| HBsAg | NON-REAC | This serologic pattern is found in resolved acute hepatitis B. |
| HBsAb | REACTIVE | |
| HBcAb (Total) | REACTIVE | |
| HBsAg | REACTIVE | This serologic pattern is found in late incubation period or early acute hepatitis B. |
| HBsAb | NON-REAC | |
| HBcAb (Total) | NON-REAC | |
| HBsAg | REACTIVE | This serologic pattern may be found in either acute or chronic hepatitis B: HEPATITIS B CORE ANTIBODY, IgM has been reflexively ordered to resolve. |
| HBsAb | NON-REAC | |
| HBcAb (Total) | REACTIVE | |
| HBsAg | REACTIVE | This pattern is not consistent with any phase of hepatitis B infection. Suggest repeating the test once in 2-4 weeks and/or consultation with a specialist if clinical conditions warrant. |
| HBsAb | REACTIVE | |
| HBcAb (Total) | NON-REAC | |
| HBsAg | REACTIVE | This pattern is not consistent with any phase of hepatitis B infection. Suggest repeating the test once in 2-4 weeks and/or consultation with a specialist if clinical conditions warrant. |
| HBsAb | REACTIVE | |
| HBcAb (Total) | REACTIVE | |
HBsAg -Hepatitis B surface antigen; HBsAb - Hepatitis B surface antibody; HBcAb (total) - Hepatitis B core total antibody.
3. Hepatitis C a. Reactive hepatitis C antibody indicates either acute or chronic hepatitis C infection. The Hepatitis C Virus RNA, Quantitative test (test code HCVQT) may be used to detect ongoing viral replication. Immune status cannot be determined with this assay.
Reference Range Information
| Performing Location | Reference Range |
|---|---|
| Marshfield | Reported as "Reactive" or "Non-reactive" |
Marshfield Labs Performing Department
Marshfield Labs Chemistry
Performing Information
| Performing Location | Day(s) Test Performed | Analytical Time | Methodology/Instrumentation |
|---|---|---|---|
| Marshfield | Monday through Friday | 1 day | Chemiluminometric Immunoassays/Siemens Centaur |
CPT Codes
| CPT | Modifier (if needed) |
Quantity | Description | Comments |
|---|---|---|---|---|
| 87340 | Hepatitis B Surface Antigen | |||
| 86706 | Hepatitis B Surface Antibody | |||
| 86704 | Hepatitis B Core Antibody Total | |||
| 86708 | Hepatitis A Antibody | |||
| 86803 | Hepatitis C antibody | |||
| 86709 | Hepatitis A Antibody, IgM (if needed) |
Outreach CPT Codes
| CPT | Modifier (if needed) |
Quantity | Description | Comments |
|---|---|---|---|---|
| 87340 | Hepatitis B Surface Antigen | |||
| 86706 | Hepatitis B Surface Antibody | |||
| 86704 | Hepatitis B Core Antibody Total | |||
| 86708 | Hepatitis A Antibody | |||
| 86803 | Hepatitis C antibody | |||
| 86709 | Hepatitis A Antibody, IgM (if needed) |
Ordering Applications
| Ordering Application | Description |
|---|---|
| Cerner | Hepatitis Panel, Comprehensive |