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Test ID: AHEP Acute Hepatitis Profile, Serum

Necessary Information

Date of collection is required.

Specimen Required

Two aliquots of serum are required for testing: 0.5-mL of refrigerated serum and 2.5-mL of frozen serum


Patient Preparation: For 24 hours before specimen collection do not take multivitamins or dietary supplements containing biotin (vitamin B7), which is commonly found in hair, skin, and nail supplements and multivitamins.

Collection Container/Tube: Serum gel

Submission Container/Tube: Plastic vial

Specimen Volume: 3 mL

Collection Instructions:

1. Centrifuge blood collection tube per collection tube manufacturer's instructions (eg, centrifuge and aliquot within 2 hours of collection for BD Vacutainer tubes).

2. Aliquot 0.5 mL serum into a plastic vial labeled as HAIGM, and ship refrigerate (required).

3. Aliquot remaining 2.5 mL serum into a second plastic vial labeled as SST Serum, and ship frozen (preferred).

Useful For

Differential diagnosis of recent acute viral hepatitis

Profile Information

Test ID Reporting Name Available Separately Always Performed
HAIGM Hepatitis A IgM Ab, S Yes Yes
HBAG HBs Antigen, S Yes Yes
HBIM HBc IgM Ab, S Yes Yes
HCVDX HCV Ab w/Reflex to HCV PCR, S Yes Yes

Testing Algorithm

If hepatitis C virus (HCV) antibody is reactive, then HCV RNA detection and quantification by real-time reverse transcription-polymerase chain reaction will be performed at an additional charge.


If hepatitis B surface antigen is reactive, then confirmation will be performed at an additional charge.


The following algorithms are available:

-Hepatitis B: Testing Algorithm for Screening, Diagnosis, and Management

-Hepatitis C: Testing Algorithm for Screening and Diagnosis

-Viral Hepatitis Serologic Profiles

Method Name

HAIGM: Chemiluminescent Microparticle Immunoassay (CMIA)

HBAG, HBIM, HCVDX, HBGNT: Chemiluminescence Immunoassay (CIA)

HCVQN: Real-Time Reverse Transcription-Polymerase Chain Reaction (RT-PCR)

Reporting Name

Acute Hepatitis Profile

Specimen Type

Serum SST

Specimen Minimum Volume

2 mL (send 0.5 mL refrigerate and the remaining 1.5 mL frozen)

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Refrigerated 5 days
Serum SST Frozen (preferred) 28 days
  Refrigerated  5 days

Reference Values



















Interpretation depends on clinical setting. See Viral Hepatitis Serologic Profiles


Hepatitis A:

Antibody against hepatitis A antigen is usually detectable by the onset of symptoms (usually 15-45 days after exposure). The initial antibody consists almost entirely of IgM subclass antibody. Antibody to hepatitis A virus (anti-HAV) IgM usually falls to undetectable levels 3 to 6 months after infection.


Hepatitis B:

Hepatitis B surface antigen (HBsAg) is the first serologic marker appearing in the serum 6 to 16 weeks following hepatitis B virus (HBV) infection. In acute cases, HBsAg usually disappears 1 to 2 months after the onset of symptoms. Anti-HBs appears with the resolution of HBV infection after the disappearance of HBsAg. Anti-HBs also appear as the immune response following a course of inoculation with the hepatitis B vaccine.


Initially, hepatitis B core antibody (anti-HBc) consists almost entirely of the IgM subclass. Anti-HBc, IgM can be detected shortly after the onset of symptoms and is usually present for 6 months. Anti-HBc may be the only marker of a recent HBV infection detectable following the disappearance of HBsAg and prior to the appearance of anti-HBs, ie, window period.


Hepatitis C:

Hepatitis C antibody is usually not detectable during the early months following infection and is almost always detectable by the late convalescent stage of infection. Hepatitis C antibody is not neutralizing and does not provide immunity.


If HBsAg, anti-HAV IgM, and anti-HCV are negative and patient's condition warrants, consider testing for Epstein-Barr virus or cytomegalovirus.


The following algorithms are available:

-Hepatitis B: Testing Algorithm for Screening, Diagnosis, and Management

-Hepatitis C: Testing Algorithm for Screening and Diagnosis

Clinical Reference

1. Roque-Afonso AM, Desbois D, Dussaix E: Hepatitis A virus: serology and molecular diagnostics. Future Virology. 2010 Mar;5(2):233-242

2. de Paula VS: Laboratory diagnosis of hepatitis A. Future Virology. 2012 May;7(5):461-472

3. Bonino F, Piratvisuth T, Brunetto MR, Liaw YF Diagnostic markers of chronic hepatitis B infection and disease. Antivir Ther. 2010;15(Suppl 3):35-44

4. Wasley A, Fiore A, Bell BP: Hepatitis A in the era of vaccination. Epidemiol Rev. 2006;28:101-111

5. American Association for the Study of Liver Diseases and Infectious Diseases Society of America: HCV guidance: Recommendations for testing, managing, and treating hepatitis C. Accessed October 7, 2022. Available at

6. LeFebre ML, U.S. Preventive Services Task Force: Screening for hepatitis B virus infection in nonpregnant adolescents and adults: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2014 Jul;161(1):58-66. doi:10.7326/M14-1018

7. Jackson K, Locarnini S, Gish R: Diagnostics of hepatitis B virus: Standard of care and investigational. Clin Liver Dis (Hoboken). 2018 Aug;12(1):5-11. doi: 10.1002/cld.729

8. Coffin CS, Zhou K, Terrault NA: New and old biomarkers for diagnosis and management of chronic hepatitis B virus infection. Gastroenterology. 2019 Jan;156(2):355-368.e3. doi: 10.1053/j.gastro.2018.11.037

9. World Health Organization: WHO guidelines on hepatitis B and C testing. 2017. Accessed October 7, 2022. Available at

10. Division of Viral Hepatitis, National Center for HIV, Viral Hepatitis, STD, and TB Prevention: Testing and public health management of persons with chronic hepatitis B virus infection. Centers for Disease Control and Prevention. Updated March 28, 2022. Accessed October 7, 2022. Available at

Day(s) Performed

Monday through Saturday

Report Available

Same day/1 to 2 days

Test Classification

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information

80074 (if all 4 initial tests are performed)

86709 (if all 4 are not performed)

86705 (if all 4 are not performed)

87340 (if all 4 are not performed)

86803 (if all 4 are not performed)

87522 (if appropriate)

87341 (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
AHEP Acute Hepatitis Profile 24363-4


Result ID Test Result Name Result LOINC Value
HCVA4 HCV Ab, S 40726-2
HBIM HBc IgM Ab, S 24113-3
H_BAG HBs Antigen, S 5196-1
HAIGM Hepatitis A IgM Ab, S 13950-1

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
HBGNT HBs Antigen Confirmation, S No No
HCVQN HCV RNA Detect/Quant, S Yes No


If not ordering electronically, complete, print, and send 1 of the following:

-Gastroenterology and Hepatology Client Test Request (T728)

-Infectious Disease Serology Test Request (T916)

Clinical Information

Hepatitis A:

Hepatitis A virus (HAV) is an RNA virus that accounts for 20% to 25% of viral hepatitis in adults in the United States. HAV infection is spread by the oral/fecal route and produces acute hepatitis, which follows a benign, self-limited course. Spread of the disease is usually associated with contaminated food or water caused by poor sanitary conditions. Outbreaks frequently occur in overcrowded situations and institutions or high-density centers such as prisons and healthcare centers. Epidemics may occur following floods or other disaster situations. Chronic carriers of HAV have never been observed.


Hepatitis B:

Hepatitis B virus (HBV) is an endemic DNA virus throughout the world. The infection is spread primarily through percutaneous contact with infected blood products (eg, blood transfusion, sharing of needles by drug addicts). The virus is also found in virtually every human body fluid and is known to be spread through oral and genital contact. HBV can be transmitted from mother to child during delivery through contact with blood and vaginal secretions; it is not commonly transmitted transplacentally. After a course of acute illness, HBV persists in approximately 10% of patients. Some chronic carriers are asymptomatic; others develop chronic liver disease, including cirrhosis and hepatocellular carcinoma.


Hepatitis C:

Hepatitis C virus (HCV) is an RNA virus that is a significant cause of morbidity and mortality worldwide. HCV is transmitted through contaminated blood or blood products or other close, personal contacts. It is recognized as the cause of most cases of posttransfusion hepatitis. HCV shows a high rate of progression (>50%) to chronic disease. In the United States, HCV infection is quite common, with an estimated 3.5 to 4 million chronic HCV carriers. Cirrhosis and hepatocellular carcinoma are sequelae of chronic HCV.

Mayo Clinic Laboratories | Microbiology and Infectious Disease Catalog Additional Information: