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22737 Hepatitis Panel, Comprehensive

Hepatitis Panel, Comprehensive
Test Code: HEPPAN
Synonyms/Keywords
Panel, Hepatitis Comprehensive​
Test Components
Hepatitis A Antibody Total, Hepatitis B Surface Antibody, Hepatitis B Surface Antigen, Hepatitis B Core Antibody Total and Hepatitis C Antibody.
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.
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 mL1.5 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 -20 °C 6 months
​Frozen at -70 °C ​>6 months
Rejection Criteria
​Grossly hemolyzed
​Grossly icteric
​Specimens containing precipitate
​Cadaver specimens
​Heat-inactivated specimens
​Body fluids other than serum
Interference
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).
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Marshfield​ Monday through Friday​ 1 day​ Chemiluminometric Immunoassays/Siemens Centaur
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.

Reference Range Information
Performing Location Reference Range
Marshfield​ Reported as "Reactive" or "Non-reactive"​
Interpretation

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.

Outreach CPTs
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)​ ​
Synonyms/Keywords
Panel, Hepatitis Comprehensive​
Test Components
Hepatitis A Antibody Total, Hepatitis B Surface Antibody, Hepatitis B Surface Antigen, Hepatitis B Core Antibody Total and Hepatitis C Antibody.
Ordering Applications
Ordering Application Description
​Centricity ​Hep. Panel, Comp
​Cerner ​Hepatitis Panel, Comprehensive
​Clinical Order Manager ​Hep Panel, Comprehensive
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
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 mL1.5 mL​1 mL​
Collection Processing
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 -20 °C 6 months
​Frozen at -70 °C ​>6 months
Rejection Criteria
​Grossly hemolyzed
​Grossly icteric
​Specimens containing precipitate
​Cadaver specimens
​Heat-inactivated specimens
​Body fluids other than serum
Interference
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).
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.
Test Components
Hepatitis A Antibody Total, Hepatitis B Surface Antibody, Hepatitis B Surface Antigen, Hepatitis B Core Antibody Total and Hepatitis C Antibody.
Reference Range Information
Performing Location Reference Range
Marshfield​ Reported as "Reactive" or "Non-reactive"​
Interpretation

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.

For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Marshfield​ Monday through Friday​ 1 day​ Chemiluminometric Immunoassays/Siemens Centaur
For billing questions, see Contacts
Outreach CPTs
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)​ ​
For most current information refer to the Marshfield Laboratory online reference manual.