Liver Test Examination: Components, Preparation, and Outcomes
A hepatitis panel is a crucial tool in diagnosing hepatitis, a group of viral liver diseases that includes hepatitis A, B, and C. This simple blood test does not require any preparation and carries a low risk of side effects.
Symptoms of liver damage that may indicate the need for a hepatitis panel include jaundice, fatigue, fever, pale-colored stool, dark urine, loss of appetite, nausea or vomiting. However, it's important to note that a hepatitis panel may not always provide a conclusive result.
If a hepatitis panel does not identify any antigens or antibodies, it is unlikely that the person has hepatitis, but there is a window of time after potential exposure where the test may not be reliable. The window of time for HAV is around 3-4 weeks, for HBV it is about 2-6 weeks, and for HCV it is anywhere from 6-12 weeks to 6 months.
A positive antibody test for HAV does not necessarily mean the person currently has hepatitis A. On the other hand, if a person tests positive for HBV or HCV antibodies, a doctor may schedule follow-up tests to determine if they have an active infection.
The three most common types of hepatitis detected by the panel are hepatitis A virus (HAV), hepatitis B virus (HBV), and hepatitis C virus (HCV). Hepatitis A causes an acute infection and most people recover without any lasting damage to the liver. There is no medication for the disease, but doctors can provide treatment to relieve any symptoms. Hepatitis C requires an RNA test for confirmation and direct-acting antiviral drugs can clear HCV in a certain period.
Hepatitis B does not have a cure, but antiviral drugs can prevent the progression of the disease and prevent complications such as liver failure or liver cancer. Chronic hepatitis B affects 6-10% of older children and adults, but for unvaccinated infants, this figure is around 90%.
In addition to a hepatitis panel, a doctor may run other tests such as liver function tests, total blood count, blood clotting tests, and urinalysis to measure the virus's impact on the body.
For those at risk for hepatitis, it's important to be aware of potential exposure factors. These may include people who inject drugs or share needles, have a sexually transmitted infection, have HIV, are in close contact with someone who has hepatitis, were born to a parent with HCV, are receiving long-term dialysis, are men who have sex with men, have received tattoos or piercings from unlicensed or unsanitary practitioners, were born between 1945-1965, were born in a country where more than of the population have hepatitis B and have not had a vaccination, spent time in a facility that had a hepatitis outbreak, received a blood transfusion that did not undergo hepatitis screening, or received a blood transfusion before 1992 in the United States.
As for treatment options, for chronic hepatitis C, the standard treatment is direct-acting antiviral (DAA) regimens, such as sofosbuvir/velpatasvir, which are highly effective at achieving viral clearance, often curing hepatitis C infection in the majority of patients.
For chronic hepatitis B, the current treatment options include oral antiviral medications such as tenofovir and entecavir, which help suppress viral replication, slow progression to cirrhosis, reduce liver cancer risk, and improve survival, but usually must be taken lifelong and rarely achieve a complete cure. Emerging novel treatments aim for a functional cure by eliminating or inactivating the viral DNA reservoirs; these include gene-editing therapies like PBGENE-HBV, currently in clinical trials, designed to eliminate covalently closed circular DNA (cccDNA) and integrated HBV DNA, and therapeutic vaccines such as TherVacB, which are being evaluated as immunotherapies to cure chronic HBV.
Questions people may want to ask a doctor about their hepatitis panel include the reliability of the test, what the results prove, how soon they will get the results, if they will need follow-up tests, what treatments are available if they test positive, how effective the treatments are, and how to monitor for signs of complications or progression.
In summary, hepatitis C treatment is highly effective and curative with DAAs, while hepatitis B treatment currently focuses on viral suppression with antivirals but investigational gene-editing and therapeutic vaccine approaches are under development and hold promise for a functional cure. It is crucial to be aware of the risks, symptoms, and available treatments for hepatitis to ensure early detection and effective management of the disease.
- A hepatitis panel may identify chronic medical conditions such as hepatitis A, B, or C, which are considered chronic diseases and can lead to serious health-and-wellness consequences, including liver damage and potential liver failure.
- For people who test positive for HBV or HCV antibodies, a doctor may schedule follow-up tests to determine if they have an active hepatitis infection, as a positive antibody test does not necessarily mean the person currently has the disease.
- In addition to the hepatitis panel, liver function tests and blood clotting tests are essential to measure the impact of the disease on the body, and to evaluate the effectiveness of treatments for chronic hepatitis B and C, which currently include oral antiviral medications and emerging novel treatments like gene-editing therapies.
