Rational hepatitis A diagnostics
- Hepatitis A serology comprises only parameters anti-HAV-IgG and anti-HAV-IgM.
- On suspicion of an acute infection, IgG and IgM should be requested!
- For immunity checks, IgG is sufficient.
Rational hepatitis B diagnostics
- HBs-antigen is the outer surface antigen of HBV. It is a marker for infectivity.
- Anti-HBc is produced at any contact with the virus, but not after vaccination!
- Anti-HBs is the marker for immunity, it is aimed against the HBs-antigen. It is the only positive parameter after vaccination.
- HBe-antigen and anti-HBe are additional markers for the estimation of infectivity.
Rational hepatitis C and hepatitis D diagnostics
- For hepatitis C and D, only combined tests (IgG and IgM) are available.
- The question of possible immunity does not make sense, as hepatitis C gets chronic in 80 % of cases, and a previous infection does not provide protection from re-infection. Hepatitis D only occurs in connection with hepatitis B.
- There are no vaccinations for hepatitis C and D.
- Tests only inform of exposure, infectivity has to be clarified by PCR.
- Guideline serological hepatitis diagnostics for medical assistant staffWhich parameters have to be requested/marked when?
Conclusion: For screening of hepatitis B infection, HBs-antigen, anti-HBs and anti-HBc should be tested, for checks following vaccination only anti-HBs (serum for each test).
