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22730 Hepatitis A Panel

Hepatitis A Panel
Test Code: HEPA
Test Components
Hepatitis A Antibody Total, Hepatitis A Antibody IgM (If needed).
Useful For
As an aid in the diagnosis of acute or recent infections with Hepatitis A virus.
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) 1 mL​ 0.5 mL​ 0.3 mL​
Collection Processing Instructions
Separate serum from the blood within 60 minutes of venipuncture. Recommended guidelines for optimal sample processing should be followed. Specimen must be free of particulate matter including fibrin. Specimens transported to Marshfield must be removed from the primary collection tube and sent in a labeled daughter tube. Store samples at 2 to 8°C if not tested within 8 hours of collection. The frozen specimens should be completely thawed thoroughly mixed and centrifuged before analysis. 4 freeze/thaw cycles has shown to have no qualitative difference in results.
 
High doses of exogenous biotin (also termed Vitamin B7, Vitamin H or Coenzyme R) may interfere with this assay (A-M, A). 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​ 2 days​
Frozen​ at -20 °C 6 months
​Frozen at -70 °C ​Longer period
Rejection Criteria
Gross hemolysis & icterus specimens. No interference with gross lipemia has been recognized. Specimen will be rejected if contaminated with microbes, or containing precipitate. Cadaver specimens, heat-inactivated specimens, body fluids other than serum or plasma, such as saliva, urine, amniotic, or pleural fluids.
Interference
Heterophilic antibodies in human serum can react with the immunoglobulins included in the assay components causing interference with immunoassay. Patients receiving therapy with high doses of biotin (>5 mg/day), should be tested 8 hours after last biotin administration.
 
High doses of exogenous biotin (also termed Vitamin B7, Vitamin H or Coenzyme R) may interfere with this assay (A-M, A).
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Marshfield​ Monday through Friday​ 1 day​ Competitive Chemiluminometric & Microparticle Chemiluminometric Immunoassay/Centaur, Siemens     ​
Test Information

If Hepatitis A Antibody Total is elevated, reflexes to Hepatitis A Antibody IgM.

Hepatitis A virus (HAV) is endemic throughout the world, however, occurring most commonly in areas of poor hygiene and low socioeconomic conditions. The virus is transmitted primarily by the fecal-oral route, and it is spread by close person-to-person contact and by food- and water-borne epidemics. Viral spread by parenteral routes (e.g., exposure to blood) is possible but rare, because infected individuals are viremic for a short period of time (usually <3 weeks). There is little or no evidence of transplacental transmission from mother to fetus or transmission to newborn during delivery.

Limitations
• The results determined by different assays from different manufacturers can vary due to differences in assay specificities and cannot be used interchangeably.
• Assay performance characteristics have not been evaluated for immunocompromised, immunosuppressed, infants, children or adolescent patients.
• A reactive or positive result does not exclude co-infection by another hepatitis virus.

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

Antibodies to HAV (anti-HAV) are detectable by the time symptoms occur, usually 15 to 45 days after exposure. The early antibody response is largely comprised of the IgM antibody subclass. Anti-HAV IgM is detectable for 3 to 6 months after the onset of illness, whereas anti-HAV IgG can persist indefinitely. The specific determination of anti-HAV IgM is the most useful serological marker for diagnosing acute HAV infection. Total anti-HAV is used primarily for determination of previous exposure to Hepatitis A virus. The measurement of anti-HAV total activity is also used to identify HAV susceptible individuals for vaccination. Positive results should be correlated with the patient’s clinical history.

A positive anti-HAV total result with a negative anti-HAV IgM result indicates immunity to hepatitis A from either past/resolved hepatitis A or vaccination against hepatitis A. Hepatitis A is a reportable disease in Wisconsin and other states.

Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
86708​ ​ ​ ​ ​
86709​ ​ ​ Hepatitis A IgM (if needed)​ ​
Test Components
Hepatitis A Antibody Total, Hepatitis A Antibody IgM (If needed).
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) 1 mL​ 0.5 mL​ 0.3 mL​
Collection Processing
Separate serum from the blood within 60 minutes of venipuncture. Recommended guidelines for optimal sample processing should be followed. Specimen must be free of particulate matter including fibrin. Specimens transported to Marshfield must be removed from the primary collection tube and sent in a labeled daughter tube. Store samples at 2 to 8°C if not tested within 8 hours of collection. The frozen specimens should be completely thawed thoroughly mixed and centrifuged before analysis. 4 freeze/thaw cycles has shown to have no qualitative difference in results.
 
High doses of exogenous biotin (also termed Vitamin B7, Vitamin H or Coenzyme R) may interfere with this assay (A-M, A). 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​ 2 days​
Frozen​ at -20 °C 6 months
​Frozen at -70 °C ​Longer period
Rejection Criteria
Gross hemolysis & icterus specimens. No interference with gross lipemia has been recognized. Specimen will be rejected if contaminated with microbes, or containing precipitate. Cadaver specimens, heat-inactivated specimens, body fluids other than serum or plasma, such as saliva, urine, amniotic, or pleural fluids.
Interference
Heterophilic antibodies in human serum can react with the immunoglobulins included in the assay components causing interference with immunoassay. Patients receiving therapy with high doses of biotin (>5 mg/day), should be tested 8 hours after last biotin administration.
 
High doses of exogenous biotin (also termed Vitamin B7, Vitamin H or Coenzyme R) may interfere with this assay (A-M, A).
Useful For
As an aid in the diagnosis of acute or recent infections with Hepatitis A virus.
Test Components
Hepatitis A Antibody Total, Hepatitis A Antibody IgM (If needed).
Reference Range Information
Performing Location Reference Range
Marshfield​ Reported as "Reactive" or "Non-reactive" or "Equivocal"​
Interpretation

Antibodies to HAV (anti-HAV) are detectable by the time symptoms occur, usually 15 to 45 days after exposure. The early antibody response is largely comprised of the IgM antibody subclass. Anti-HAV IgM is detectable for 3 to 6 months after the onset of illness, whereas anti-HAV IgG can persist indefinitely. The specific determination of anti-HAV IgM is the most useful serological marker for diagnosing acute HAV infection. Total anti-HAV is used primarily for determination of previous exposure to Hepatitis A virus. The measurement of anti-HAV total activity is also used to identify HAV susceptible individuals for vaccination. Positive results should be correlated with the patient’s clinical history.

A positive anti-HAV total result with a negative anti-HAV IgM result indicates immunity to hepatitis A from either past/resolved hepatitis A or vaccination against hepatitis A. Hepatitis A is a reportable disease in Wisconsin and other states.

For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Marshfield​ Monday through Friday​ 1 day​ Competitive Chemiluminometric & Microparticle Chemiluminometric Immunoassay/Centaur, Siemens     ​
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
86708​ ​ ​ ​ ​
86709​ ​ ​ Hepatitis A IgM (if needed)​ ​
For most current information refer to the Marshfield Laboratory online reference manual.