Hepatitis A Diagnostic (anti-HAV IgG, IgM)

Reporting Name


Useful For

Suspected hepatitis A virus infection.

 

Indications for Testing

·         Aid in the differential diagnosis of acute hepatitis in unvaccinated/non-immune patients and returning travelers typically with new onset of jaundice, anorexia or dark urine.

·         Immune status determination

·         Confirmation of seroconversion in acute anti-HAV IgM-positive patients

 

Test Components

Reporting Name Available separately Always performed
Acute Unknown hepatitis    

Anti-HAV IgM

NO YES
Chronic unknown hepatitis    

Anti-HAV IgG

YES YES
Hepatitis A diagnostic    

Anti-HAV IgM

NO YES

Anti-HAV IgG

YES YES

Special Instructions and Forms

HAV in a Provincial Notifiable disease. More information on Provincial vaccination and epidemiology can be found HERE.

 

Method Name

IgG and IgM enzyme-linked immunosorbent assay (ELISA)

 

Reporting Name

Anti-HAV IgM

Anti-HAV IgG

 

Aliases

Anti-HAV

Hepatitis A Virus

HAA

Hepatitis A Antibody

Jaundice

HAV

Hep A

 

Serology: Suitable specimens are individual samples (human sera or EDTA/heparinized/citrated plasma) obtained by standard laboratory techniques.

 

Specimen Minimum Volume

0.6ml

 

Transport Temperature

Specimen Room temperature Refrigerated Frozen
Serum NO YES* YES**

*The samples should be stored for not more than 3 days at 2-8°C.

**For longer delay, freeze at -70°C and transport on dry ice.

 

Reject Due To

Specimens other than Serum
Anticoagulants OK
Hemolysis OK
Lipemia OK
Icteric OK

 

Useful For

Anti-HAV IgM is useful for the serological diagnosis of acute-phase Hepatitis A virus (HAV) infection. Anti-HAV IgG is an indicator of successful HAV vaccination or indicator of prior HAV exposure.

 

Clinical Information

Hepatitis A characteristically is an acute, self-limited illness associated with fever, malaise, jaundice, anorexia, and nausea. Among older children and adults, infection usually is symptomatic and typically lasts several weeks, with jaundice occurring in 70% or more. Symptomatic infection occurs in approximately 30% of infected children younger than 6 years of age; few of these children will have jaundice. Fulminate hepatitis is rare but is more common in people with underlying liver disease. Chronic infection does not occur.

 

Serological diagnosis of acute viral hepatitis A depends on the detection of specific anti-HAV IgM. Its presence in the patient’s serum indicates a recent exposure to HAV. Anti-HAV IgM becomes detectable in the blood within 2 weeks after infection, persisting at elevated levels for about 2 months before declining to undetectable levels by 6 months. However, sensitive immunoassays may occasionally detect anti-HAV IgM for up to 1 year after acute hepatitis A.

 

Hepatitis A virus (HAV) is endemic throughout the world, occurring most commonly in areas of poor hygiene and low socioeconomic conditions. The virus is transmitted by the fecal-oral route, and it is spread by close person-to-person contact and by contaminated food and water. Thorough cooking is necessary to inactivate HAV in contaminated foods. Outbreaks frequently occur in overcrowded situations and in high-density institutions and centers, such as prisons and health care or day care centers. Viral spread by parenteral routes (eg, 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.

 

HAV is a nonenveloped, positive-strand RNA virus of the Picornaviridae family, which includes the enteroviruses, parechoviruses, and rhinoviruses of humans, as well as the apthoviruses or hoofed animals and cardioviruses of mice. Although HAV shares general structure and genomic organization with the other picornaviruses, it has limited nucleotide sequence homology and distinguishing characteristics that have resulted in its being classified in its own genus, Hepatovirus.

 

 

Reference Values

Anti-HAV IgG

NONREACTIVE

 

Anti-HAV IgM

NONREACTIVE

 

Interpretation

Anti-HAV IgM Anti-HAV IgG Interpretation
REACTIVE REACTIVE Previous recent (natural or vaccination) to Hepatitis A virus.
NONREACTIVE REACTIVE Previous remote exposure (natural or vaccination) to HAV.
REACTIVE NONREACTIVE Possible early acute infection, follow up specimen required to document IgG seroconversion
NONREACTIVE NONREACTIVE Absence of prior exposure to HAV and nonimmunity. However, a negative result does not rule out HAV infection. The specimen may have been drawn before the appearance of detectable antibodies. Negative results in suspected early HAV infections should be followed by testing a new serum specimen.

 

Clinical Reference

Abbott. 2004. ARCHITECT System HAVAb-IgG: package insert. Abbott Diagnostics Division, Wiesbaden, Germany.

 

Abbott. 2004. ARCHITECT System HAVAb-IgM: package insert. Abbott Diagnostics Division, Wiesbaden, Germany.

 

Anderson, D. A. 2007. Hepatitis A and E Viruses, p. 1424-1436. In Murray, P. R., Baron, E. J., Jorgensen, J. H., Landry, M. L., and Pfaller, M. A. Manual of Clinical Microbiology, 9th ed., vol. 2. ASM Press, American Society for Microbiology, Washington, DC.

 

Wasley, A., Feinstone, S. M, and Bell, B. P. 2010. Hepatitis A Virus, p. 2367-2387. In Mandell, D., Bennett, J. E., and Dolin, R. Principles and practice of infectious diseases, 7th ed., vol. 2. Churchill Livingstone, Elsevier, Philadelphia, PA.

 

Status Days Analytic Time Maximum Laboratory Time Specimen Retention
Routine Mon, Wed,  Friday 7h 72h 1 month

 

Method Description

Enzyme-linked immunosorbent assay (ELISA)

 

Performing Laboratory Location

Newfoundland & Labrador Public Health Laboratory

St. John’s

 

 

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