The hepatitis panel is a standard blood test used by healthcare providers to screen for, diagnose, and determine immunity status against viral liver infections. This panel is a collection of specific tests run simultaneously on a single blood sample. The results provide detailed information about whether a person has an active infection, a past infection, or is protected from the disease.
Which Viruses Are Included
A standard hepatitis panel screens for the three most common causes of viral hepatitis: Hepatitis A (HAV), Hepatitis B (HBV), and Hepatitis C (HCV). These viruses all cause liver inflammation but differ in their transmission and clinical courses.
Hepatitis A is primarily spread through the fecal-oral route, usually by consuming contaminated food or water. This infection is almost always acute, meaning it is a short-term illness that the body clears on its own. In contrast, Hepatitis B and Hepatitis C are transmitted through exposure to infected blood or other body fluids, such as during birth, sexual contact, or sharing needles. Both HBV and HCV can establish a chronic infection that persists for years and can lead to severe liver damage, including cirrhosis or liver cancer.
How Antigens and Antibodies Are Measured
The panel detects specific biological markers in the blood, categorized as either antigens or antibodies. Antigens are components of the virus itself, such as surface proteins, and their presence indicates an active infection. Antibodies are proteins produced by the body’s immune system in response to the virus.
Detecting an antibody signifies the immune system has encountered the virus, meaning a current infection, a past resolved infection, or immunity from a vaccine. For example, the Hepatitis B surface Antigen (HBsAg) shows the virus is present and replicating. Conversely, the Hepatitis B surface Antibody (Anti-HBs) indicates immunity. Analyzing the combination of these markers allows healthcare providers to determine the stage of infection or immunity.
Deciphering Your Test Results
Interpreting the panel results requires analyzing the pattern of positive and negative markers for each virus, with Hepatitis B involving the most complex set of markers.
Hepatitis B (HBV)
The HBV portion includes the Surface Antigen (HBsAg), the Surface Antibody (Anti-HBs), and the Core Antibody (Anti-HBc), often split into Total and IgM types. A person susceptible to HBV will have all three main markers come back negative, indicating no prior exposure or immunity. Immunity due to vaccination is indicated by a positive Anti-HBs result alone, as the vaccine only stimulates the surface antibody without exposure to the full virus. The presence of HBsAg is the hallmark of an active infection, whether acute or chronic.
To distinguish between acute (recent) and chronic (long-term) infection, the Core Antibody (Anti-HBc) is analyzed further. If HBsAg is positive and the IgM Anti-HBc is also positive, it points to an acute infection that occurred within the last six months. If HBsAg is positive but the IgM Anti-HBc is negative, the infection is considered chronic, meaning the virus has persisted for more than six months.
A negative HBsAg but positive results for both Anti-HBs and Total Anti-HBc signifies a past, resolved natural infection. The positive Anti-HBc is a lifelong marker of past exposure, while the positive Anti-HBs indicates the person has cleared the virus and is immune. An “isolated Anti-HBc” pattern (only Total Anti-HBc is positive) can be ambiguous, suggesting a resolved infection where Anti-HBs levels have dropped, a false-positive result, or, rarely, a low-level chronic infection.
Hepatitis A (HAV)
For Hepatitis A, two primary markers are usually tested: the Total Hepatitis A Antibody (Total Anti-HAV) and the IgM Anti-HAV. A positive IgM Anti-HAV confirms a recent or acute infection, as this antibody is produced early in the immune response and typically fades after a few months. A positive Total Anti-HAV without the IgM marker indicates previous exposure or successful vaccination, which provides lifelong immunity.
Hepatitis C (HCV)
The Hepatitis C portion of the panel primarily screens for the Hepatitis C Antibody (Anti-HCV). A positive Anti-HCV result means the person has been infected with the virus at some point, but it does not differentiate between a current active infection and a past infection that has been cleared. If the antibody test is reactive, a follow-up test for Hepatitis C RNA is necessary to determine if the virus is currently active in the blood.
Preparing for the Panel
The hepatitis panel is a simple blood test that requires minimal specific preparation. Generally, a person does not need to fast before having their blood drawn. The blood sample is collected by a healthcare professional inserting a needle into a vein, typically in the arm.
Patients should inform their healthcare provider about any medications, supplements, or herbal remedies they are taking, as some substances may influence test results. Providing a complete medical history, including recent travel, vaccination records for Hepatitis A and B, and any known exposure risks, is helpful for accurate result interpretation.