Hepatitis

Find the right hepatitis test with Ulta Lab Tests to monitor your liver for infection and its health. Get an accurate reading of your results sent confidentially online in 24 to 48 hours. Order from Ulta Lab Tests today! 


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Actin is the major antigen to which smooth muscle antibodies react in autoimmune hepatitis. F-Actin IgG antibodies are found in 52-85% of patients with autoimmune hepatitis (AIH) or chronic active hepatitis and in 22% of patients with primary biliary cirrhosis (PBC). Anti-actin antibodies have been reported in 3-18% of sera from normal healthy controls.

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Aids in the diagnosis of primary disease of skeletal muscle myocardial infarction and viral hepatitis.


IMPORTANT - The specimen for this test must be collected at a patient service center that can collect, store and transport frozen samples as outlined below.  

IMPORTANT: Before ordering this lab test, check and confirm with the selected patient service center to ensure that they can collect, store and transport frozen samples as outlined below.

Preferred Specimen(s) 

2 mL frozen plasma collected in an EDTA (lavender-top) tube

Collection Instructions 

Collect blood from stasis-free vein of patient (e.g., no tourniquet). Patient should not clench fist during collection, as muscular exertion often increases venous ammonia levels. Patient should avoid smoking prior to phlebotomy since smoking increases plasma ammonia levels. Tubes should be filled completely and kept tightly stoppered at all times. Place immediately on ice. Separate plasma from cells within 20 minutes and freeze plasma immediately.

Transport Temperature 

Frozen

Specimen Stability 

Room temperature: Unstable
Refrigerated: Unstable
Frozen -20° C: 72 hours
Frozen -70° C: 7 days

Reject Criteria 

Hemolysis • Lipemia • Received thawed • PPT Potassium EDTA (white-top) tube

Clinical Significance

Ammonia is one of the by-products of protein metabolism. Elevated blood ammonia levels have been associated with severe liver dysfunction such as hepatic encephalopathy, coma resulting from cirrhosis, severe hepatitis, Reye's syndrome, and drug hepatotoxicity. Also, elevated blood ammonia has been reported in cardiac failure, azotemia, and pulmonary emphysema. Correlation between plasma ammonia and the degree of encephalopathy can be erratic.


Antinuclear antibodies are associated with rheumatic diseases including Systemic Lupus Erythematous (SLE), mixed connective tissue disease, Sjogren's syndrome, scleroderma, polymyositis, CREST syndrome, and neurologic SLE. 

Reflex Information: If ANA Screen, IFA is positive, then ANA Titer and Pattern will be performed at an additional charge.



AST is widely distributed throughout the tissues with significant amounts being in the heart and liver. Lesser amounts are found in skeletal muscles, kidneys, pancreas, spleen, lungs, and brain. Injury to these tissues results in the release of the AST enzyme to general circulation. In myocardial infarction, serum AST may begin to rise within 6-8 hours after onset, peak within two days and return to normal by the fourth or fifth day post infarction. An increase in serum AST is also found with hepatitis, liver necrosis, cirrhosis, and liver metastasis.

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Measurement of the levels of bilirubin is used in the diagnosis and treatment of liver, hemolytic, hematologic, and metabolic disorders, including hepatitis and gall bladder obstruction. The assessment of direct bilirubin is helpful in the differentiation of hepatic disorders. The increase in total bilirubin associated with obstructive jaundice is primarily due to the direct (conjugated) fraction. Both direct and indirect bilirubin are increased in the serum with hepatitis.

Measurement of the levels of bilirubin is used in the diagnosis and treatment of liver, hemolytic, hematologic, and metabolic disorders, including hepatitis and gall bladder obstructive disease

Measurement of the levels of bilirubin is used in the diagnosis and treatment of liver, hemolytic, hematologic, and metabolic disorders, including hepatitis and gallbladder obstructive disease.

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Decreased levels of ceruloplasmin are found in Wilson''s Disease, fulminant liver failure, intestinal malabsorption, renal failure resulting in proteinuria, chronic active hepatitis and malnutrition. Elevated levels are found in primary biliary cirrhosis, pregnancy (first trimester), oral contraceptive use and in acute inflammatory conditions since ceruloplasmin is an acute phase reactant

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Copper is an essential element that is a cofactor of many enzymes. Copper metabolism is disturbed in Wilson's disease, Menkes disease, primary biliary cirrhosis, and Indian childhood cirrhosis. Copper concentrations increase in acute phase reactions and during the third trimester of pregnancy. Copper concentrations are decreased with nephrosis, malabsorption, and malnutrition. Copper concentrations are also useful to monitor patients, especially preterm newborns, on nutritional supplementation. Results of copper are often interpreted together with ceruloplasmin.


A synthetic circular peptide containing citrulline called CCP IgG (cyclic citrullinated peptide) has been found to be better at discriminating Rheumatoid Arthritis patients from other patients than either the perinuclear autoantibody test or the test for rheumatoid factor. Approximately 70% of patients with Rheumatoid Arthritis are positive for Anti-CCP IgG, while only about 2% of random blood donors and disease controls subjects are positive.

Elevated GGT is found in all forms of liver disease. Measurement of GGT is used in the diagnosis and treatment of alcoholic cirrhosis, as well as primary and secondary liver tumors. It is more sensitive than alkaline phosphatase, the transaminases, and leucine aminopeptidase in detecting obstructive jaundice, cholangitis, and cholecystitis. Normal levels of GGT are seen in skeletal diseases; thus, GGT in serum can be used to ascertain whether a disease, suggested by elevated alkaline phosphatase, is skeletal or hepatobiliary.

Heparin can induce thrombocytopenia, a decreased platelet count, due to antibody stimulation. False positive results may be due to immune complexes. False negative results may be due to low titer, low avidity antibodies.

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Hepatitis A Antibody, Total (IgM - IgG)

Hepatitis A Total (IgM - IgG) Blood Test is used to help diagnose a liver infection due to the hepatitis A virus. There are several causes of hepatitis and the accompanying symptoms, so this test may be used to determine if the symptoms are due to hepatitis A.

The total Hepatitis A antibody test detects both IgM and IgG antibodies and thus may be used to identify both current and past infections. This test will also be positive after receiving the vaccine, so sometimes it may be used to determine whether a person has developed immunity after vaccination.

  • A positive result Hepatitis A Antibody, Total that is not accompanied with Hepatitis A IgM test indicates  exposure to hepatitis A vairus but does not rule out acute infection. 
  • A Negative result Hepatitis A Antibody, Total that is not accompanied with Hepatitis A IgM test indicates no current or previous HAV infection; vaccine may be recommended if at risk.

Results of this hepatitis testing may indicate the following.

A total antibody test detects both IgM and IgG antibodies but does not distinguish between them.

If the total antibody test or hepatitis A IgG result is positive and someone has never been vaccinated against HAV, then the person has had past exposure to the virus. About 30% of adults over age 40 have antibodies to hepatitis A.


Hepatitis A IgM Antibody

This test is used to screen for recent exposure to the Hepatitis A virus.and to help diagnose a liver infection due to the Hepatitis A virus. There are several causes of hepatitis and the accompanying symptoms, so this test may be used to determine if the symptoms are due to Hepatitis A.

Hepatitis A IgM Antibody

The Hepatitis A IgM antibody test detects the first antibody produced by the body when it is exposed to Hepatitis A. This test is used to detect early or recent infections and to diagnose the disease in people with symptoms of acute hepatitis. IgM antibodies to Hepatitis A suggest a current, acute or recent Hepatitis A infection.

Results of this hepatitis testing may indicate the following:

  • If Hepatitis A IgM Antibody is positive the results indicate Acute or recent Hepatitis A virus infection.
  • If Hepatitis A IgM Antibody is negative and the Hepatitis A Antibody, Total is positive then the results indicate no active infection but previous Hepatitis A virus exposure; has developed immunity to Hepatitis A virus or recently vaccinated for Hepatitis A virus.
  • Dietary supplements containing biotin may interfere in assays and may skew analyte results to be either falsely high or falsely low. For patients receiving the recommended daily doses of biotin, draw samples at least 8 hours following the last biotin supplementation. For patients on mega-doses of biotin supplements, draw samples at least 72 hours following the last biotin supplementation.

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Hepatitis A Antibody Test to diagnose the Hepatitis A Virus (HAV) in the blood. The hepatitis A test looks for antibodies to the HAV virus in the blood. These antibodies are proteins made by the body in response to the presence of the hepatitis A virus. Our type- specific hepatitis A antibody test is used to determine whether a person is or has been infected with the hepatitis A virus.

Hepatitis A Antibody, Total

This test is used to help diagnose a liver infection due to the hepatitis A virus. There are several causes of hepatitis and the accompanying symptoms, so this test may be used to determine if the symptoms are due to hepatitis A.

The total Hepatitis A antibody test detects both IgM and IgG antibodies and thus may be used to identify both current and past infections. This test will also be positive after receiving the vaccine, so sometimes it may be used to determine whether a person has developed immunity after vaccination.

A positive result Hepatitis A Antibody, Total that is not accompanied with Hepatitis A IgM test indicates  exposure to hepatitis A vairus but does not rule out acute infection. 

A Negative result Hepatitis A Antibody, Total that is not accompanied with Hepatitis A IgM test indicates no current or previous HAV infection; vaccine may be recommended if at risk.


Hepatitis B Core Antibody (IgM) also known as (Anti-HBc, IgM)

Clinical Significance

Hepatitis B core-specific IgM class antibody has been detected in most acute infections and is a reliable marker for acute disease. In some cases, hepatitis B core IgM antibody may be the only specific marker for the diagnosis of acute infection with hepatitis B virus.

Alternative Name(s)

Anti-HBc, IgM

A Positive Result may indicate an Acute infection, usually with symptoms; contagious; could also be flare of chronic infection or Acute infection is resolving (convalescent). 


This assay does not distinguish between Total B core antibody IgG and IgM detected before or at the onset of symptoms; however, such reactivity can persist for years after illness, and may even outlast anti-HBs. Occasionally Hepatitis B core antibody may be the only marker of either current or past Hepatitis B infection.


Hepatitis B Surface Antibody, Qualitative  (anti-HBs)

Detects only the IgM antibody to the hepatitis B core antigen. Used to detect acute infections; sometimes present in chronic infections as well as used to detect previous exposure to HBV; it can also develop from successful vaccination so it is used to determine the need for vaccination (if anti-HBs is absent) or to determine if a person has recovered from an infection and is immune (cannot get the infection again).

Clinical Significance

The detection of anti-HBs is indicative of a prior immunologic exposure to the antigen or vaccine. To determine immune status as ≥10 mIU/mL as per CDC guidelines, please order Hepatitis B Surface Antibody, Quantitative.



Whether you’ve traveled outside the country for mission work or signed a consent form to get a tattoo, chances are you’ve heard about hepatitis before. Most of us have the general idea that there are different varieties and that some are worse than others. But which ones are the bad ones, and how do we tell if we have any of them?

The truth is that most adults will get exposed to some strain of hepatitis at some point in their lives. Knowing which strains are dangerous and when you should have hepatitis testing performed could save your life. Read on to learn more about hepatitis and the tests you can have run to screen for it.

What Is Hepatitis?

Hepatitis is a disease that causes your liver to get inflamed. It is caused by viruses and comes in three primary forms: hepatitis A, hepatitis B, and hepatitis C. The three strains vary in how dangerous and long-lasting they are.

Your liver is the largest organ in your body and helps digest food and store energy. It also forms the center of your body’s detox system, meaning you never have to do another juice cleanse again. As long as it’s healthy, your liver can take care of removing any dangerous toxins from your body.

When you develop hepatitis, you may see several symptoms depending on the strain you have. Common symptoms include loss of appetite, nausea, vomiting, diarrhea, stomach pain, and jaundice. There are vaccines you can get against certain strains of hepatitis, so be sure you’re up to date on those.

Hepatitis A 

Hepatitis A is a highly infectious viral infection and is the easiest of the strains to get. You can pick up Hepatitis A from food or water contaminated with the virus or from close contact with an infected person. There is a vaccine available to prevent this disease, and washing your hands is a great way to keep it from spreading.

Hepatitis A is the most minor of the strains, and some people who get it never develop symptoms. If you do get symptoms, you may notice you’re more fatigued, you may have sudden nausea or vomiting, or you may have pain in the upper right side of your abdomen. You may also have a low-grade fever, clay-colored bowel movements, or dark-colored urine.

In many cases, hepatitis A will resolve on its own with no treatment needed. It’s a good idea to see your doctor if you develop symptoms or if you’ve been recently out of the country to an area with poor sanitation. Most people who get hepatitis A will recover with no lasting liver damage.

Hepatitis B

Hepatitis B is a more serious form of the disease that usually lasts about six months. This disease passes through bodily fluid contact, especially during sexual interactions. You can also get hepatitis B from sharing infected needles (including tattooing needles), or through medical syringes contaminated with infected blood.

Hepatitis B symptoms can show up anywhere, from a month to four months after exposure. You may notice abdominal pain, fever, dark urine, or joint pain. You may also lose your appetite, experience nausea and vomiting, feel weak and fatigued, and have abdominal pain.

In most cases, hepatitis B will resolve within six months with treatment. Sometimes, however, complications can arise that lead to a chronic infection. This chronic form of the disease can lead to scarring of the liver (cirrhosis) and even liver cancer, so it’s important to make sure you get a hepatitis B vaccine.

Hepatitis C

Hepatitis C is the most dangerous form of the disease, and it is also the hardest to get. The virus spreads through infected blood, which puts health care workers and drug users at the biggest risk. The most common way that the disease passes is through infected needles, so make sure you always use clean needles.

The dangerous thing about hepatitis C is it can be a silent killer. In many cases, people won’t show symptoms of hepatitis C until they start seeing signs of the liver damage it’s inflicted. Symptoms include jaundice (a yellowing of the skin and eyes), bruising or bleeding easily, poor appetite, itchy skin, swelling in your legs, fatigue, and spider-like veins on your skin.

Treatments for chronic hepatitis C have improved greatly over the past several years, and these days, the condition is almost always curable. Treatments involve oral medications taken for a few months. The key is catching it before it does serious damage to your liver.

Who’s at Risk?

In most cases, hepatitis transmits through contact with infected blood. This means some of the highest risk populations are people who use injectable drugs. If you fall into this category, reach out to someone to help you get clean, or at least always use clean needles.

Health care workers are also at risk since they handle blood from people who are potentially infected. Nurses who perform blood draws may be at a higher risk, as are healthcare workers who travel to or work in areas with poor sanitation. 

People with tattoos and piercings could also encounter infected needles. If you’re getting a tattoo or piercing, always do so at a reputable and clean location. Ask the tattooist or piercer to let you watch them open a new needle to be certain they aren’t reusing old needles. 

When to Get Tested

The most important time to get tested for hepatitis is as soon as possible after exposure. This includes after you’ve used a dirty needle, gotten a piercing or tattoo, visited an unsanitary location, or had sex with someone who has done any of the above.

If you are pregnant or planning on becoming pregnant, testing for hepatitis B is very important. Hepatitis B can pass from mother to child during childbirth, and in infants, it’s more likely to develop into a chronic condition. However, newborns can receive a vaccine against hepatitis B that will prevent infection in almost all cases. Without the vaccine, 90 percent of newborns develop chronic hepatitis.  

You should also get tested for hepatitis if you start showing any of the symptoms we’ve mentioned above. In particular, jaundice is usually a sign of liver damage, so pay attention to that. Hepatitis C may only show symptoms for a couple of weeks before fading into the background, so don’t ignore an illness because it goes away.

How Often to Get Tested

In general, it’s a good rule of thumb to get tested for hepatitis if you think you’ve been exposed to the virus any time in the last six months. If you face exposure regularly for any reason, you may need to get routine testing.

The CDC recommends routine testing every six months for people who have transplanted tissue. People who use drugs, including snorting cocaine, and using other non-injectable drugs, should get tested routinely. A routine screen should also be a habit for anyone who has multiple sexual partners or a long-term sexual relationship with someone who has tested positive for hepatitis, especially hepatitis C.

If you are pregnant, a healthcare worker, or have nonsexual contact with someone with hepatitis C; you need to have routine screenings. If you are pregnant, one screening at the beginning of your pregnancy will be fine. And, of course, if you are potentially exposed or start showing symptoms, get tested immediately.

Hepatitis A Testing

If you believe you have been exposed to hepatitis A, you can get a screening done for this strain. There are two main antibodies this test checks for: IgM and IgG. The body first produces IgM antibodies about two or three weeks after infection, often before symptoms even start to show up.

If any IgM antibodies show up on your screen, it means you have or have had recent acute hepatitis A. If your IgM test comes back negative, you may want to run an IgG test, as IgG antibodies show up later in the disease process and stay in your bloodstream for life. If your IgG test comes back positive, it means you have had hepatitis A at some point in the past.

It’s important to note that if you’ve ever received a hepatitis A immunization, you will have the IgG antibodies in your bloodstream since that’s how your body fights off the infection. Even if you haven’t had the immunization, you may still see those antibodies show up; about 30 percent of American adults carry IgG antibodies. In the case of IgM tests, IgG tests, and total antibody tests, which check for both antibodies, the screen will involve getting blood drawn.

Hepatitis B Testing

Hepatitis B panels look for proteins that the hepatitis virus produces in your body. They may also look for the antibodies your body produces to fight the virus or even the DNA of the virus itself. Depending on how your results come out, you can see if you currently have the virus, if you have had it in the past, or if you’ve had the immunization.

If your hepatitis B surface antibody scan (Anti-HBs) comes back positive, but your core antibody total (Anti-HBc IgG IgM) comes back negative, it means you’ve had the vaccination but not the disease. If both tests come back positive, it means you’ve had the disease before and may be at risk of developing it again if your immune system is ever compromised.

If your surface antigen test (HBsAg) comes back positive, it means you currently have an active form of hepatitis B. A positive core antibody scan (Anti-HBc IgM) in combination with this result means you have an acute infection. A negative core antibody scan means your infection is chronic.

If you find out you have a chronic infection, you may choose to run a test for hepatitis B e antigens and antibodies, as well as DNA from the hepatitis B virus. If your test comes back negative for the antigens and positive for the antibodies, you are a disease carrier. You have the virus, but it’s not likely to do any liver damage. If the scan picks up on the hepatitis B virus DNA, chances are your chronic condition is causing damage to your liver. 

Hepatitis C Testing 

Hepatitis C tests look for one of two things: the antibodies your body produces to fight the virus or the RNA of the virus itself. Most of these scans look for the antibodies, with the RNA used as a backup measure. If your antibody scan is positive or inconclusive, the RNA scan can give you more information.

If your antibody test comes back negative, it can mean one of two things. Either you do not have the infection, or not enough time has passed for your body to produce detectable levels of antibodies. If you or your doctor suspects you may still have hepatitis C, you should wait a little longer and run the test again.

If your antibody test comes back positive or indeterminate, you may run an RNA scan. If this test comes back negative, you may have had the infection in the past, but you do not have it now. If the RNA scan comes back positive, you have a current infection.

Additional Liver Testing

If any of your hepatitis screens come back positive, you’ll need to run some additional tests to determine if you have liver damage and to what extent, if so.

Your doctor may also want to look at your levels of bilirubin, albumin, and total protein. These are all connected with liver function and can fluctuate with severe liver damage.

Learn More About Hepatitis Testing

If you suspect you may have any of the hepatitis viruses, it’s a good idea to get a hepatitis test. Sure, hepatitis A is harmless enough, but it’s hard to tell the difference between a simple hepatitis A infection and a hepatitis C infection that can lead to serious liver damage. Hepatitis testing is the only way to know, and your life is worth the investment.

If you’d like to get your hepatitis tests run, here are links to three Hepatitis tests that you can get select to get started:


Check out the rest of our site at ultalabtests.com, where we have over 2,000 lab tests, including the full spectrum of hepatitis screens available today.

We are here to help you know your health, one test at a time.

Hepatitis refers to the condition where the liver becomes inflamed. In most cases, the disease is caused when the liver gets infected by certain viruses. However, it can also be as a result of exposure to chemicals, prescription or over-the-counter drugs, inherited diseases, heavy alcohol use, fatty buildup in the liver, or autoimmune disease.  

The condition can be acute – at first, flaring up before receding within a couple of weeks or a few months-, or chronic, lasting for years. The chronic version of hepatitis can persist for more than 20-years before it starts producing significant symptoms connected to progressive liver damage like liver cancer, cirrhosis, or even death.  

The liver, one of the vital organs in our bodies, is in the upper, right-hand side of our abdomen. The organ is responsible for a barrage of bodily functions, including producing bile juice to help digest fats, processing the body’s nutrients, regulating blood clotting, breaking down toxic substances into harmless ones that our bodies can either eliminate or use, and synthesizing proteins. In severe cases, hepatitis interferes with these processes, allowing potentially toxic substances to build up. 

Types of Hepatitis: 

Viral: Infection with a hepatitis virus causing inflammation; may be chronic or acute, depending on the type of virus. In the United States, hepatitis A, B, & C are the most common causes of infection. 

Drug-induced or Toxic: Our livers process many substances, making them easier for the body to eliminate or use. This process’ byproducts can be toxic to the liver, causing it to get inflamed. In other instances, inflammation occurs when someone takes a drug that isn’t exactly toxic to the organ, but the body identifies it as foreign and attacks it, hence, causing hepatitis. Examples include prescription drugs, over-the-counter pain relievers, industrial chemicals, herbal and vitamin supplements, alcohol.   

Inherited: Gene mutations that are passed on from generation to generation can result in diseases that damage the liver, hence causing hepatitis. Examples include hemochromatosis, a deficiency of alpha-1 antitrypsin, Wilson disease. 

Nonalcoholic fatty liver: When fat deposits in liver cells increase, they increase the liver’s likelihood of injury and inflammation, causing hepatitis. This condition is linked with metabolic syndrome. 

Autoimmune: This is when the immune system incorrectly produces antibodies that attack liver tissues, causing it to become inflamed. The condition is sometimes associated with other types of autoimmune diseases like Sjogren syndrome, pernicious anemia, Hashimoto thyroiditis, type-1 diabetes. 

Signs and Symptoms 

Hepatitis signs and symptoms are all the same, irrespective of the cause; however, they may vary from one person to the other and over time. It is worth noting that most of the people who have chronic hepatitis generally exhibit no symptoms. At the same time, some with acute hepatitis will show no symptoms too, but many have vague or mild symptoms that can easily be mistaken for the flu. Common signs and symptoms of hepatitis include:  

  • –Nausea  
  • –Fatigue  
  • –Joint aches  
  • –Abdominal pain 
  • –Itching 
  • –Yellowing of the skin and eyes (this condition is known as jaundice and is one of the symptoms which strongly suggest that liver damage is the cause of other symptoms) 

Some individuals may experience additional symptoms and signs like dark-colored urine, loss of appetite, or a lighter-colored stool. More severe cases may include complications that involve mental confusion and ascites (accumulation of fluids in the abdomen.) 

Physical examinations tend to reveal that the liver is enlarged and tender. In some people, chronic forms of hepatitis can slowly damage the liver over time, causing liver failure at some point. Chronic forms of hepatitis rarely go away without treatment and typically last for many years. 

Tests  

There are a couple of laboratory tests that can be performed in cases of suspected or known hepatitis. It is worth noting that the available tests fall into either one or more of these categories.  

General Chemistry Tests for Detecting Liver Inflammation and Damage 

  • –Screening tests for detecting viral hepatitis. For instance, screening for exposure to types of hepatitis like hepatitis B and hepatitis C can be performed due to increased risks of the disease after donating blood or due to multiple sex partners, use of illegal drugs. 
  • –Tests to help identify other underlying causes of the condition 
  • –Tests to help guide treatment and monitor the progression of damage to the liver 

 Acute forms of hepatitis are often suspected and tested because of the appearance of symptoms and signs such as loss of appetite, nausea, and fever, often accompanied by pale stools, dark urine, and jaundice (yellow discoloration of the whites of the eyes and the skin.) 

Chronic hepatitis generally has no visible signs and symptoms and is often detected through routine abnormal laboratory tests. These, for example, may include a CMP or comprehensive metabolic panel, which is a group of tests that are generally ordered as part of a liver panel or annual health exam. 

Liver panels and CMPs include a couple of general blood tests that can, in some instances, be used to help assess the liver and detect the condition. They include: 

–ALT or Alanine aminotransferase – This is an enzyme that’s primarily found in the liver. When the organ is damaged, the enzyme is released into the bloodstream, often before more obvious signs of damage like jaundice occur. This makes alanine aminotransferase a very useful test for the early detection of damage to the liver. Results are generally compared to those of aspartate aminotransferase or AST tests to help determine liver injury causes.  

–AST or Aspartate aminotransferase – AST is another enzyme present in the liver and a couple of other organs, especially the heart and various muscles. The AST test is mostly used to detect liver damage caused by hepatitis and is often more elevated than ALT with exposure to alcoholism, cirrhosis, or drugs that are toxic to the liver. However, AST isn’t specific to the liver and can be increased in conditions that affect other parts of a patient’s body. AST test results are often compared to those of ALT tests. 

–ALP or Alkaline phosphatase – ALP is an enzyme that’s related to the bile ducts but is also found in various other tissues in the body. ALP tests are often increased when a patient’s bile ducts are blocked. At the same time, it can be increased if bone disorders are being suspected. 

–Bilirubin – This is the waste product produced after old blood cells have been broken down and are processed by the liver in preparation for it to be eliminated. The yellowish compound can start accumulating in the liver when it damaged, causing dark urine and jaundice. 

–Albumin – This is the main protein produced by the liver. Since it is a product of the liver, its levels can considerably decrease with a loss of proper liver function. However, this generally only happens when the organ’s function has been seriously affected. It is worth noting that several other conditions could affect the levels of this protein. 

–Total protein – albumin and other proteins found in the blood can decrease with debilitating liver disease. 

Depending on the laboratory and the healthcare practitioner, other tests that may be performed as part of a liver panel or individually include:  

PT or Prothrombin time – The PT test might be ordered for persons suspected to have hepatitis or who have hepatitis. The liver mostly makes the proteins that are used to form blood clots, and prolonged prothrombin times tell how severe the damage is! 

GGT or Gamma-glutamyl transpeptidase – This enzyme, found in the organ, is very sensitive to liver function changes. GGT tests help differentiate the causes of elevated ALPs: if gamma-glutamyl transpeptidase is increased, then elevated levels of ALP (Alkaline phosphatase) are due to liver issues rather than bone disease.  

LD or Lactase Dehydrogenase – This enzyme, found in cells all over the body, is released when cells get damaged. 

AFP or Alpha-fetoprotein – This protein is associated with the proliferation or regeneration of liver cells.  

While these general tests may help detect the condition, they don’t determine the root cause. Additional tests may be required to pinpoint the cause and determine the best way to treat it. Examples of these tests include:  

  • –An Acute hepatitis panel – can be used to detect hepatitis virus-related infections  
  • –Autoimmune antibodies (e.g., ASMA, ANA, anti-LKM-1) – related to autoimmune hepatitis 

For more information about lab tests performed to monitor and diagnose specific types of the condition, click on the links found in the table in the navigation above or on the Overview page.  

Viral Hepatitis  

Infection caused by a virus is one of the most common causes of hepatitis. Five viruses are primarily associated with the condition and are all named in the order they were discovered, i.e., A, B, C, D, and E. Acute viral hepatitis in the United States is generally caused by HAV/hepatitis A virus, HBV/hepatitis B virus, and HCV/hepatitis C virus. It is worth noting that only HCV and HBV infections generally cause chronic hepatitis. 

HAV or hepatitis A virus is highly contagious and is easily spread through food and water that’s been contaminated with the virus. Luckily, since 1995, HAV infections have considerably declined thanks to a vaccine. In 2014, around 1,200 acute HAV cases were reported to the CDC (Centers for Disease Control and Prevention.) The actual numbers might have been slightly higher, but that is because people with mild symptoms or no symptoms at all might not have realized that they were infected. According to the CDC, the number of infections was probably about 2,500, once corrected for asymptomatic infections and underreporting. 

The hepatitis A virus (HAV) only causes acute infections of the disease. In most cases, treatment only involves supportive therapy, and most patients recover fully within six months. During the onset of an HAV infection, our bodies develop antibodies to the virus; so, once the infection has receded, victims will have a developed a lifelong immunity from the infection. 

The hepatitis B virus (HBV) is generally spread by coming into contact with the semen, blood, or other bodily fluids of an infected person. In Europe and North America, HBV is generally spread by sharing syringes, needles, and other drug injecting equipment, from mother to child during pregnancy (though rare in the U.S., it is quite common in other countries around the world); and through sexual contact. 

Not long ago, HBV infections were the most common cause of acute viral hepatitis in America. Luckily, vaccines have led to the infection rate gradually decreasing. According to the Centers for Disease Control and Prevention, there were slightly above 19,000 new cases of hepatitis B virus infections in the U.S. in 2014. While the official reported numbers were much smaller, the number could have been a bit higher, considering that many people do not know that they’re infected and never see a doctor. Hepatitis B virus infections are highest amongst adults, especially men aged between 25 and 44 years.  

The chances of an acute hepatitis B virus infection becoming chronic largely depends on what age the victim becomes infected. The younger someone is infected, the higher the chances the infection will become chronic. Roughly 90 percent of infants who get infected by the disease end up developing chronic infections. On the other hand, less than 5 percent of adults who become infected with the hepatitis B virus develop chronic hepatitis B. 

Acute HBV infection treatments usually only involves supportive therapy. The good thing is that most patients recover fully within six months. During the onset of the infection, our bodies develop antibodies against the virus, which means that after the infection has receded, an infected person will have developed lifelong immunity against the disease. 

People who contract chronic hepatitis B tend to remain free of the symptoms and signs of the condition for decades. However, once diagnosed, drug treatments could help slow the progression or development of liver damage. In the case of liver failure, liver transplantation can be performed. At the same time, there is a list of approved drugs that can be used to treat chronic HBV infections on the Food and Drug Administration’s official website.  

The Hepatitis C virus is generally spread through exposure to contaminated blood, with the most common form of exposure being the sharing of needles and syringes used for injecting drugs of abuse like heroin or cocaine. Another common means of exposure includes the occupational exposure of health workers to used and infected needles; sharing of personal items that might be contaminated with blood like toothbrushes and razors; sexual activities that result in tissue tears; and from a mother to a baby during childbirth. 

There were roughly 30,500 reported cases of acute hepatitis C in America in 2014. But since most cases aren’t reported considering that many people don’t know they are infected due to no visible symptoms, this number could have been higher. Of those infected, about 75 to 85 percent developed chronic hepatitis C. According to data from the CDC, about 3.5 million Americans have chronic hepatitis C. About 60 to 70 percent of people that have untreated chronic hepatitis C end up developing chronic liver disease. If left untreated, about 5 to 20 percent of this number will develop cirrhosis as time goes by, and 1 to 5 percent might die from conditions that result from chronic infections like liver cancer or cirrhosis. 

While there’s currently no vaccine to prevent hepatitis C, research to develop one is still ongoing. Now, the best way to prevent infection is limiting exposure to things that might expose you to HCV, especially the sharing of needles used to inject drugs. Both chronic and acute HCV can be treated using a combination of drugs. For Treatments, see below.  

Hepatitis D and E viruses are quite rare in the United States. It is worth noting that the Hepatitis D virus only causes infections when hepatitis B is present and tends to make the infection worse. The virus is usually spread through exposure to infected needles or blood. The hepatitis E virus is spread in a similar manner as hepatitis A. It is primarily found in Asia, Africa, South and Central America, and the Middle East. However, an increasing number of cases is being reported in American citizens who haven’t traveled to countries in these regions. Hepatitis E can, in rare cases, lead to chronic hepatitis in people whose immune systems aren’t working properly. 

Drug-Induced or Toxic Hepatitis  

The liver’s primary responsibility is to metabolize drugs, alcohol, and other chemicals the body is exposed to, breaking them down to substances that can be used or eliminated by the body. The process rarely creates byproducts that can potentially harm the liver, causing hepatitis. However, symptoms of toxic hepatitis can appear quickly, often within hours or days of being exposed to a harmful substance, while drug-induced hepatitis develops slowly after continued exposure to a chemical or repeated use of a drug or alcohol. 

Toxic Hepatitis 

Good examples of substances or things that cause the liver to create byproducts that are harmful to it or that are directly toxic include pollutants, cleaning solvents, industrial solvents, and a variety of drugs. Acetaminophen, present in most prescription and over-the-counter medications, is a good example of a drug that causes toxic hepatitis. In therapeutic doses, the drug serves as an effective pain reliever. However, in combination with alcohol or in very high doses, it can lead to life-threatening liver failure. 

Drug-Induced Hepatitis  

Some of the most used products capable of instigating drug-induced hepatitis include:  

  • –Large doses of vitamin supplements 
  • –Herbal supplements, including ephedra, cascara, chaparral, kava, and comfrey 
  • –Naproxen sodium, Aspirin, and ibuprofen (especially if combined with alcohol) 

Another common cause of drug-induced hepatitis is excessive consumption of alcohol. Liver inflammation caused by alcohol usage might be chronic but mild, lasting years with no exact symptoms. However, as time goes by, the liver continues to get damaged. The mortality rate in severe alcohol-induced hepatitis (known as alcoholic steatohepatitis) cases is about 50 percent. The good thing is that damage can be reversed if the victim stops consuming alcohol. 

Lots of prescription drugs have the qualities to cause a drug-induced cause of hepatitis. The effects of most drugs on the liver are unforeseen and appear to be related to immune reactions to the drugs. The list of drugs capable of causing damage to the liver is quite long and is still growing. Amongst them are specific types of antifungal and antibiotic medications, anesthetics, seizure medications, chemotherapy drugs, anabolic steroids, and drugs used to lower cholesterol. 

The signs and symptoms of drug-induced and toxic hepatitis tend to vary depending on the root cause. They may develop gradually with continued exposure to specific drugs and toxins or appear suddenly. When present, symptoms, and signs often resemble those of hepatitis. 

Laboratory Tests 

The diagnosis of drug-induced and toxic hepatitis in patients with hepatitis is often reached by obtaining their full medical history with a focus on the use of prescription and over-the-counter medications, vitamin supplements, herbal products, and alcohol use. At the same time, the hazards the patient might have been exposed to at their workplace like industrial solvents are evaluated. Tests that might be performed to examine toxic hepatitis include:  

  • Ethanol level – used if alcohol is thought to be the cause  
  • Liver panel – used to assess liver function and determine liver damage extent  
  • –Liver biopsy – used to determine the type of liver damage and its extent 
  • –Overdose and emergency drug testing – including tests for acetaminophen, therapeutic drugs, and drugs of abuse to help determine the root cause of hepatitis and the best treatment option  

Inherited Forms of Hepatitis  

There are several inherited diseases that affect the liver, and which become apparent, causing symptoms of chronic or acute hepatitis. Examples include: 

  • –Alpha-1-antitrypsin deficiency – This is the number one genetic cause of liver disease in kids. In adults, the deficiency is more likely to affect their lungs, but liver cancer and cirrhosis are also common in people with this disorder. 
  • –Hemochromatosis – This is the most common type of inherited hepatitis. It is also associated with the accumulation and absorption of excessive iron by the body. When that happens, the liver is one of the organs in the body that gets damaged. The resulting chronic hepatitis could be because of iron overload. 
  • –Wilson disease – This rare inherited disorder leads to a buildup of excess copper in the kidneys, eyes, brain, and liver and may cause both chronic and acute hepatitis. If left untreated, the disease becomes worse and could prove fatal. 

The signs and symptoms of inherited types of hepatitis are quite varied and tend to be specific to the person with the disease. Click on the above links to learn more about them. 

The symptoms and signs of the liver’s involvement in these conditions generally correspond to those of general hepatitis. For more details on those, check out the section on Signs and Symptoms. 

Laboratory Tests  

Inherited hepatitis is suspected if there’s a history of liver disease in the victim’s family. Some of the common tests used to confirm the presence of inherited forms of liver disease include: 

–An Alpha-1-antitrypsin level test to determine if there’s a deficiency of alpha-1-antitrypsin. 

–Iron tests like ferritinserum iron, and TIBC or Total Iron Binding Capacity to help identify hemochromatosis  

Copper and ceruloplasmin tests – these can help to diagnose Wilson’s disease. Our bodies normally eliminate excess copper by binding them to an enzyme known as ceruloplasmin before sending them to the bile. With Wilson’s disease, the excretion and binding processed don’t work properly, something that leads to decreased levels of eruloplasmin in the blood and increased levels of free copper in the liver, blood, and urine. 

–Liver biopsy – This test involves the microscopic examination of liver tissue samples 

–Genetic testing – This test is generally used to detect if there are mutations to specific genes that could lead to inherited forms of hepatitis. Mutation tests in the HFE gene, for instance, can help identify hemochromatosis.  

Nonalcoholic Steatohepatitis (NASH) and Nonalcoholic Fatty Liver Disease (NAFLD) 

One common cause of chronic hepatitis is the buildup of excess fat in the liver. This condition is one that develops gradually over time with the excess intake of calories. In most cases, the first sign is usually abnormal results during routine blood tests. Liver biopsies can be ordered in situations where the liver is enlarged after a viral case of hepatitis and other causes have been ruled out. If tests reveal that the victim’s liver tissues are inflamed, excessively fatty, and are damaged, the condition is referred to as nonalcoholic steatohepatitis. If a liver is fatty but healthy and shows no signs of scarring or inflammation, the condition is referred to as nonalcoholic fatty liver disease. Nonalcoholic steatohepatitis can be severe and may cause cirrhosis. Nonalcoholic fatty liver disease, on the other hand, generally does not have any long-term effects on most effects. However, in a small percentage of the population, it might progressively develop into liver damage. 

Both conditions are commonly seen in individuals with hypertension, metabolic syndrome, high triglyceride levels, a combination of health problems like obesity (especially if they have excessive fat in the belly), insulin resistance, type-2 diabetes, and low HDL cholesterol. Now, there are no specific treatments for these conditions. Nevertheless, those affected are encouraged to lose weight by eating healthy and working out. 

Signs and symptoms aren’t always apparent in individuals with hepatitis that’s been caused by NAFLD. When the signs and symptoms are present, they are generally mild and tend to correspond to those of general hepatitis. Check out the Signs and Symptoms section for more detailed information. 

Tests  

Fatty livers are generally detected when routine tests like a liver panel or a CMP (comprehensive metabolic panel) are done for other reasons. In most cases, abnormal results are the first indication that there’s a problem. Imaging tests like MRI, ultrasound, or CT scan may detect some fat around the liver. In most cases, several lab tests will have to be performed to rule out unrelated causes such as hepatitis C or alcohol. Apart from a liver biopsy, there aren’t any other lab tests that can diagnose NASH or NAFLD. 

Autoimmune Hepatitis  

Autoimmune hepatitis is basically a form of chronic hepatitis that often leads to advanced liver damage. However, in 10 to 20 percent of all cases, it sometimes presents itself as acute hepatitis. When it comes to autoimmune hepatitis, the immune system, for reasons unknown, targets, and attacks the patient’s liver, it is worth noting that this condition mostly affects women. According to the American Liver Foundation (ALF), about 70 percent of those affected by the condition are female aged between 15 and 40. 

There are two known forms of the condition, with the more common one being type I. Type I most commonly affects young females and is sometimes found with other autoimmune disorders like Sjogren syndrome, type-1 diabetes, and ulcerative colitis. Type II isn’t that common and mostly affects girls between 2 and 14 years; it’s more common in European countries than in America. 

Signs and symptoms of the condition resemble those of hepatitis. Check out the Signs and Symptoms section for more detailed information. 

Laboratory Tests  

A couple of tests for various autoantibodies may have to be ordered to help identify autoimmune hepatitis and diagnose other related autoimmune disorders. Common tests include:  

Typically, individuals with type I autoimmune hepatitis tend to have ASMA, ANA, or both, and people with type II have antibodies to liver and kidney microsomes. 

Liver biopsies may have to be performed to identify autoimmune hepatitis and check the presence of cirrhosis. 

Tests: Hepatitis A, B, C testing; Liver Panel; Acute Viral Hepatitis Panel; AST; ALT; ALP; Total Protein; Albumin; Autoantibodies; Bilirubin; SMA; ANA; Anti-LKM-1; Alpha-1 Antitrypsin; Iron Tests; Acetaminophen; Copper; Drug Abuse Testing; Ethanol; Comprehensive Metabolic Panel; Emergency and Overdose Drug Testing.