hepatitis-testing

Why this test may be ordered

• You have symptoms of hepatitis, such as jaundice (yellow skin or eyes), fever, fatigue, loss of appetite, dark urine, pale or clay-colored stool, abdominal pain, nausea, vomiting, joint pain, or diarrhea (hepatitis A only).
• You have had liver function tests with abnormal results.
• You have been exposed to a specific hepatitis virus or are at high risk (e.g., health care work, IV drug use, certain medical conditions, men who have sex with men, or already have another hepatitis infection).
• As part of routine screening: all adults aged 18 and older should be tested for hepatitis B and/or C at least once in their lifetime, and during each pregnancy.

Preparation and collection

You don't need any special preparations for 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. This usually takes less than five minutes. At-home testing kits are available for hepatitis B and C; they typically use a lancet to prick your finger so you can collect a drop of blood and send it to a lab.

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.

Understanding results

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

• Negative or normal: 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. Limitation: A negative result does not rule out very early infection or past exposure that has cleared. Next step: If you have ongoing symptoms or known exposure, your provider may recommend repeat testing.
• Positive or abnormal: Signs of hepatitis were found in your blood. This may mean you have an active hepatitis infection now (acute or chronic) or you had a hepatitis infection in the past that cleared up. Limitation: For hepatitis C, a test cannot tell the difference between an active infection and a past infection that has cleared up. For hepatitis A, B, D, and E, a test can tell the difference between a present and a past infection. Next step: You will likely need other tests to find out if you have an active infection and whether it is acute or chronic. For example, if your test results suggest a hepatitis B infection, your provider may use a triple panel that checks for Hepatitis B Surface Antigen (HBsAg), Hepatitis B Surface-Antibody (Anti-HBs), and Anti-HBc. Talk with your provider about what your results mean.

• A positive result does not always mean you have a current infection; it may indicate a past infection that has resolved.
• For hepatitis C, the test cannot distinguish between an active infection and a past infection that has cleared.
• If you have hepatitis antigens in your blood, it may mean you have an active infection (acute or chronic). If you have hepatitis antibodies, it may mean you have an acute or chronic infection or had an infection in the past.
• If left untreated, a chronic hepatitis infection can lead to serious liver problems such as cirrhosis or liver cancer.

What to do next

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. Talk with your provider about what your results mean and any follow-up testing that may be needed.

• What type of hepatitis was found in my blood?
• Do I have an active infection or a past infection?
• Do I need any additional tests to confirm the diagnosis?
• What are the next steps for my care?

Evidence source

U.S. National Library of Medicine: hepatitis-testing