[Skip to content]

Print this page



Hepatitis serology

This is a guide to the range of tests available forHepatitis serology. If you have any specific queries about the testing methods please contact the serology team on 01332 788224. If your question is regarding a specific patient and clinical advice in required contact on the on-call microbiology consultant via the hospital switch board.

If you require a screening test for Hepatitis A, B, C or E please send a clotted blood sample (red top). If a hepatitis B DNA is required please send a clotted blood sample (red top). If the patient has had a positive screening test for Hepatitis C and requires a viral load or genotype please send an EDTA sample (purple top). For turnaround times please see the test database.

Hepatitis A

Hepatitis A or infectious jaundice is caused by hepatitis A virus (HAV transmitted by the faecal-oral route often associated with ingestion of raw or partially cooked contaminated food. Several large outbreaks have occurred in injecting drug users (IUDs) and among men who have sex with men.

 Hepatitis A total antibody (IgM and IgG)

  • Recent/ current Hepatitis A infection
  • Immunisation to Hepatitis A


 Hepatitis A IgM antibodies

  • Presence indicates acute Hepatitis A


Hepatitis B

Hepatitis B virus can cause both acute and chronic hepatitis. Methods of transmission include blood (blood transfusion, now rare), intravenous drug use, equipment used for tattooing, sexually or via mother to child. Shaving accessories such as razor blades, or touching wounds on infected persons with exposed broken skin has also been link to transmission of the virus. It is a notifiable disease.

Hepatitis B surface antigen

  • Presence indicated current Hep B infection
  • Does not differentiate between acute and chronic infections
  • Usually the earliest detectable marker for Hep B infection


Hepatitis B surface antibody

  • Presence indicates immunity to Hep B infection
  • This is used for post vaccination levels
  • Does not differentiate between vaccine mediated immunity or post infection immunity (Hepatitis B core will)


Hepatitis B core total antibodies (IgM and IgG)

  • Presence indicates current or past infection
  • Does not differentiate between current and past infection
  • This is NOT produced post vaccine
  • Will usually remain positive for life


Hepatitis B e antigen

  • Presence indicates highly infectious stage of Hepatitis B infection


Hepatitis C

Hepatitis C can be transmitted through contact with blood (IVDU) and can also cross the placenta. Hepatitis C usually leads to chronic hepatitis, culminating in cirrhosis in some people. It usually remains asymptomatic for decades.

Hepatitis C antibodies

  • Presence indicates current or past Hepatitis C infection

 Hepatitis C RNA PCR

  • Presence indicates actively replicating virus

  • Only to be performed on Hepatitis C antibody positive patients

Hepatitis C genotyping

  • Only to be performed on Hepatitis C antibody positive patients

  • Testing usually only carried out to guide treatment


Hepatitis E

 HEV is transmitted by the faecal-oral route and is common in Asia, Africa and Central America, particularly where sanitation is poor. HEV usually produces mild disease but in rare cases it can prove fatal, particularly in pregnant women. It is a relatively uncommon cause of viral hepatitis in the United Kingdom.


Hepatitis E IgG antibodies

  • Indicates past infection
  • An acute case can be defined by showing IgG seroconversion


Hepatitis E IgM antibodies

  • IgM antibodies are usually present at the same time as onset of symptoms and remain detectable for several months.