What is hepatitis testing?

Hepatitis testing uses a sample of your blood to see if you have a current viral hepatitis infection or had one in the past. Hepatitis is a type of liver disease that causes liver inflammation (swelling) and damage. There are several types of hepatitis. Each affects the body and is spread in different ways.

• Hepatitis A (HAV) is usually spread by eating or drinking food or beverages that an infected person has handled without washing their hands. This can result in swallowing tiny amounts of the virus that can be found in an infected person's stool (poop). You can also get HAV from close physical contact with an infected person. Though no specific medicine can cure HAV, most people recover from it on their own. The best way to prevent it is to get vaccinated.
• Hepatitis B (HBV) is mainly spread through blood, semen, or other body fluids.  For example, you can get an HBV infection if you have sex or share needles with an infected person. It can also be passed to your fetus during pregnancy or birth. As with HAV, no medicine can cure HBV, though most adults recover from it on their own. In some cases, it can develop into a chronic (long-term) infection. The best way to prevent HBV is also to get vaccinated.
• Hepatitis C (HCV) is spread through blood. Most people get infected with HCV from sharing needles or other items used for injecting drugs, or through sexual contact. The virus can be passed to the fetus during pregnancy, but this is less common. There is no vaccine for this type of hepatitis, however, unlike with hepatitis A and B, medicine can cure it. HCV is more likely than the other types to develop into a chronic infection.
• Hepatitis D (HDV) is spread the same way HBV is spread, through blood, semen, or other body fluids. However, HDV is unusual among hepatitis variants because you can only develop an HDV infection if you already have HBV. This means that those with HDV have a coinfection (getting HBV and HDV at the same time) or superinfection (having HBV and then getting HDV), which can lead to health complications. The best way to prevent HDV is to get vaccinated for HBV.
• Hepatitis E (HEV) is spread by drinking contaminated water or eating undercooked foods. In most people, HEV causes an acute (sudden) infection that goes away. However, some people, especially those with weakened immune systems, may develop chronic infections. These can be treated with medicines. No vaccine is available for HEV.

Most cases of hepatitis are caused by types A, B, or C. Because of this, the most common type of hepatitis test is a hepatitis panel, which checks for signs of HAV, HBV, and HCV using one blood sample.

Other names: acute viral hepatitis panel, viral hepatitis screening panel, hepatitis D virus (HDV) antibody test, hepatitis B triple panel, HBsAg, anti-HBs, anti-HBc, HBV, HAV, HCV, HDV, HEV

What is it used for?

Generally, hepatitis testing is used to find out if there is any sign of hepatitis in your blood. For hepatitis A, B, D, and E, a test can tell the difference between a present and a past infection. For hepatitis C, however, a test can't tell the difference between an active infection and a past infection that has cleared up.

If testing shows that you may have hepatitis, you'll usually need other tests to confirm the diagnosis and to find out whether your infection is acute (sudden) or chronic (long-term).

Why do I need hepatitis testing?

You may need hepatitis testing if you have symptoms of hepatitis. Hepatitis doesn't always cause symptoms, but when it does, they may include:

• Jaundice, a condition that causes your skin and eyes to turn yellow.
• Fever.
• Fatigue.
• Loss of appetite.
• Dark-colored urine.
• Pale or clay-colored stool (poop).
• Abdominal (belly) pain.
• Nausea and vomiting.
• Joint pain.
• Diarrhea (hepatitis A only).

If left untreated, a hepatitis infection can become chronic (long-term). These kinds of infections can lead to serious liver problems such as cirrhosis or liver cancer. Because of this, your provider may order hepatitis testing if you've had liver function tests with abnormal results.

Even if you don't have symptoms, your provider may order a hepatitis test if you've been exposed to a specific hepatitis virus, or if you're at high risk of getting an infection. You may be at high risk if you:

• Work in certain industries, such as health care.
• Use illegal intravenous (IV) drugs and/or share needles with others.
• Have certain medical conditions that weaken your immune system, such as HIV.
• Have other kinds of liver disease.
• Are a man who has sex with other men.
• Already have another hepatitis infection. For example, your provider may test for hepatitis D if you already have hepatitis B.

Lastly, your provider may test you for hepatitis as part of a more general health screening. Medical experts recommend that all adults aged 18 and older be tested for hepatitis B and/or C at least once in their lifetime. They also recommend HBV and HCV tests during each pregnancy as part of routine prenatal testing.

What happens during hepatitis testing?

A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

At-home testing kits are available for hepatitis B and C. Usually the test kit will include a sharp device (a lancet) to prick your finger so you can collect a drop of blood and send it to a lab for testing. For more information on at-home testing for hepatitis, talk to your provider.

Will I need to do anything to prepare for the test?

You don't need any special preparations for hepatitis testing.

Are there any risks to the test?

There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

What do the results mean?

Different labs report hepatitis test results in various ways, so it's best to ask your provider what your test results mean.

In general:

• A negative or normal result means you probably don't have a hepatitis infection. But if you know you were exposed to hepatitis, you may need to be tested again later on.
• A positive or abnormal result may mean:
  • You have an active hepatitis infection now. It may be an acute infection or one you've had for a long time.
  • You had a hepatitis infection in the past that cleared up.

An abnormal test result means that signs of hepatitis were found in your blood. These signs include:

• Hepatitis antigens, which are substances in the hepatitis virus that trigger your immune system to fight the virus. If you have hepatitis antigens in your blood, it means that you may have an active hepatitis infection. It could be an acute or chronic infection.
• Hepatitis antibodies, which are proteins that your immune system makes to help fight a hepatitis infection. If you have hepatitis antibodies in your blood, it may mean that you have an acute or chronic infection or that you had an infection in the past.

If your test results are abnormal, you will likely need other tests to find out if you have an active infection and whether it is an acute or chronic infection. For example, if your test results suggest a hepatitis B infection, your provider may use a type of test called a triple panel that checks your blood for:

• Hepatitis B Surface Antigen (HBsAg), an antigen on the surface of the hepatitis B virus.
• Hepatitis B Surface-Antibody (Anti-HBs), an antibody that your immune system makes to fight HBV after a hepatitis B infection or vaccination.
• Anti-HBc, another antibody that your immune system makes to fight HBV, but only after a hepatitis B infection.

If you have questions about your results, talk with your provider.

Learn more about laboratory tests, reference ranges, and understanding results.