Test ID: HEPP
Hepatitis Profile, Serum
Secondary ID 
A test code used for billing and in test definitions created prior to November 2011
NY State Approved Indicates the status of NY State approval and if the test is orderable for NY State clients.
Useful For Suggests clinical disorders or settings where the test may be helpful
Screening to determine a patient's previous exposure and/or immunity to hepatitis A and B
Profile Information A profile is a group of laboratory tests that are ordered and performed together under a single Mayo Test ID. Profile information lists the test performed, inclusive of the test fee, when a profile is ordered and includes reporting names and individual availability.
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| HBAG | HBs Antigen, S | Yes | Yes |
| CORAB | HBc Total Ab, w/Reflex, S | Yes | Yes |
| HBAB | HBs Antibody, S | Yes | Yes |
| HAVAB | Hepatitis A Total Ab, w/Reflex, S | Yes | Yes |
Reflex Tests Lists test(s) that may or may not be performed, at an additional charge, depending on the result and interpretation of the initial test(s)
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| HBGNT | HBs Antigen Confirmation, S | No | No |
| HAVM | Hepatitis A IgM Ab, S | Yes | No |
| HBIM | HBc IgM Ab, S | Yes | No |
Testing Algorithm Delineates situation(s) when tests are added to the initial order. This includes reflex and additional tests.
Confirmatory testing will be performed at an extra charge on all reactive Hepatitis B Surface Antigen prenatal specimens as well as all other reactive specimens that have a signal-to-cutoff ratio ( S/CO) of < or =50.0. Specimens with an S/CO of >50.0 that are not prenatal specimens do not require confirmation.
If hepatitis Bc antibody total is positive, then hepatitis Bc antibody IgM is performed at an additional charge. If hepatitis A antibody total is positive, then hepatitis A antibody IgM is performed at an additional charge.
Special Instructions and Forms Describes specimen collection and preparation information, test algorithms, and other information pertinent to test. Also includes pertinent information and consent forms to be used when requesting a particular test
Method Name A short description of the method used to perform the test
Chemiluminescence Immunoassay (CIA)
Reporting Name A shorter/abbreviated version of the Published Name for a test; an abbreviated test name
Aliases Lists additional common names for a test, as an aid in searching
Specimen Type Describes the specimen type needed for testing
Specimen Required Defines the optimal specimen. This field describes the type of specimen required to perform the test and the preferred volume to complete testing. The volume allows automated processing, fastest throughput and, when indicated, repeat or reflex testing.
Collection Container/Tube: Red top or serum gel
Submission Container/Tube: Plastic vial
Specimen Volume: 3 mL
Collection Instructions: Spin down and remove serum from clot within 24 hours.
Additional Information: Date of draw is required.
Specimen Minimum Volume Defines the amount of specimen required to perform an assay once, including instrument and container dead space. Submitting the minimum specimen volume makes it impossible to repeat the test or perform confirmatory or perform reflex testing. In some situations, a minimum specimen volume may result in a QNS (quantity not sufficient) result, requiring a second specimen to be collected.
Reject Due To Identifies specimen types and conditions that may cause the specimen to be rejected
| Hemolysis | Mild reject; Gross reject |
| Lipemia | Mild OK; Gross reject |
| Icterus | Mild OK; Gross reject |
| Other | NA |
Specimen Stability Information Provides a description of the temperatures required to transport a specimen to the laboratory. Alternate acceptable temperature(s) are also included.
| Specimen Type | Temperature | Time |
|---|---|---|
| Serum SST | Frozen (preferred) | |
| Refrigerated | 7 days | |
| Ambient | 24 hours | |
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Hepatitis A
Hepatitis A virus (HAV) is endemic throughout the world, occurring most commonly, however, in areas of poor hygiene and low socioeconomic conditions. The virus, which is transmitted primarily by the fecal-oral route, is spread by close person-to-person contact and by food- and water-borne epidemics. Outbreaks frequently occur in overcrowded situations and in high-density institutions and centers, such as prisons and health care or day care centers. Viral spread by parenteral contact (with blood or oropharyngeal secretions) is possible but rare, because infected individuals are viremic for a short period of time (usually less than 3 weeks). There is little or no evidence of transplacental transmission from mother to fetus, or of newborns contracting HAV infection during delivery.
Hepatitis B
Hepatitis B virus (HBV) is a DNA virus that is endemic throughout the world. The infection is spread primarily through percutaneous contact with infected blood products, eg, blood transfusion, sharing of needles by drug addicts. The virus is also found in virtually every type of human body fluid and is known to be spread through oral and genital contact. HBV can be transmitted from mother to child during delivery through contact with blood and vaginal secretions; it is not commonly transmitted transplacentally. After a course of acute illness, HBV persists in approximately 10% of patients; some of these chronic carriers are asymptomatic.
Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
HEPATITIS B SURFACE ANTIGEN
Negative
HEPATITIS B CORE TOTAL ANTIBODY
Negative
HEPATITIS A ANTIBODY, IgG & IgM
Negative
HEPATITIS B SURFACE ANTIBODY
Unvaccinated: negative
Vaccinated: positive
HEPATITIS B SURFACE ANTIBODY, QUANTITATIVE
Unvaccinated: <5.0
Vaccinated: > or =12.0
See Viral Hepatitis Serologic Profiles in Special Instructions.
Interpretation Provides information to assist in interpretation of the test results
Hepatitis A virus (HAV) infection
Anti-HAV is usually almost detectable by the onset of symptoms (15-45 days after exposure). Serological diagnosis of acute viral hepatitis A depends on the detection of IgM antibody and its presence indicates recent exposure and the possibility to be potentially infectious. Anti-HAV IgG rises quickly once the virus is cleared and persists for years. A positive anti-HAV (IgG and IgM) indicates that the patient has had either a recent or past HAV infection.
Hepatitis B virus (HBV) infection
Hepatitis B surface antigen (HBsAg) is the first serological marker present following HBV infection. A positive result is diagnostic of acute or chronic hepatitis B infection and is associated with infectivity. Hepatitis B surface antibody (anti-HBs) appears with the resolution of HBV infection after the disappearance of HBsAg. In acute cases, HBsAg usually disappears 1 to 2 months following the onset of symptoms. Persistence of HBsAg for more than 6 months indicates development of either a chronic carrier state or chronic liver disease.
Hepatitis B core antibody (anti-HBc) IgM can be detected in serum shortly after the onset of symptoms and is usually present up to 6 months (ie, core window period). Anti-HBc IgM may be the only serologic marker of a recent hepatitis B infection detectable following the disappearance of HBsAg and prior to the appearance of anti-HBs.
See Viral Hepatitis Serologic Profiles in Special Instructions.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
Positive hepatitis B surface antigen (HBsAg) test results should be reported by the attending physician to the State Department of Health, as required by law in some states.
A weakly positive anti-HBc test result unaccompanied by other hepatitis B serologic markers, elevated liver enzymes, or a history of risk factors may be a false-positive result.
Passively acquired anti-HBs (ie, transfusion, recent immune globulin treatment, etc) does not signify immunity.
Anti-HBs may fall below detectable levels with time.
Performance characteristics have not been established for heat inactivated specimens or specimen containing particulate matter.
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
1. Sherlock S: Hepatitis B: the disease. Vaccine 1990;8 Suppl:S6-S9
2. Lemon SM: Type A viral hepatitis: epidemiology, diagnosis, and prevention. Clin Chem 1997 August;43(8 pt 2):1494-1499
3. Ciocca M: Clinical course and consequences of hepatitis A infection. Vaccine 2000;18 Suppl 1: S71-74
Method Description Describes how the test is performed and provides a method-specific reference
See individual unit codes.
Day(s) and Time(s) Test Performed Outlines the days and times the test is performed. This field reflects the day and time the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time required before the test is performed. Some tests are listed as continuously performed, which means assays are performed several times during the day.
Monday through Friday, Sunday
Analytic Time Defines the amount of time it takes the laboratory to setup and perform the test. This is defined in number of days. The shortest interval of time expressed is "same day/1 day," which means the results may be available the same day that the sample is received in the testing laboratory. One day means results are available 1 day after the sample is received in the laboratory.
Maximum Laboratory Time Defines the maximum time from specimen receipt at Mayo Medical Laboratories until the release of the test result
Specimen Retention Time Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location The location of the laboratory that performs the test
Test Classification Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer's instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR), Investigation Use Only (IUO) product, or a Research Use Only (RUO) product.
CPT Code Information Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Medical Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
86704-Hepatitis Bc Ab, IgG & IgM
86706-Hepatitis Bs Ab
86708-Hepatitis A Ab, IgG & IgM
87340-HBsAg
86705-Hepatitis Bc Ab IgM (if appropriate)
86709-Hepatitis A, IgM (if appropriate)
87341-HBsAg, neutralization (if appropriate)
LOINC® Code Information Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the result codes returned for this test or profile.
| Result ID | Reporting Name | LOINC Code |
|---|---|---|
| CORAB | HBc Total Ab, w/Reflex, S | 16933-4 |
| HAVAB | Hepatitis A Total Ab, w/Reflex, S | 20575-7 |
| HB_AB | HBs Antibody, S | 22322-2 |
| H_BAG | HBs Antigen, S | 5195-3 |
| HBSQN | HBs Antibody, Quantitative, S | 16935-9 |
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