Viral hepatitis
An algorithmic approach to expedite diagnosis
Several laboratory tests may be performed in cases of known or suspected viral hepatitis to help diagnose and monitor patients. Our algorithmic approach to viral test ordering focuses on proper test utilization, taking the guesswork out of test ordering, saving time and money. Developed collaboratively by physicians and laboratorians, our hepatitis-focused algorithms assist with diagnosis, treatment, and monitoring.
To complement our algorithmic test approach and ensure patients have the highest level of care, we offer a comprehensive test menu with more than 40 viral hepatitis-specific tests that includes all aspects of testing, from screening to therapeutic-response monitoring.
Viral hepatitis Test menu
Detection, confirmation, and quantification
The U.S. Preventative Services Task Force recommends one-time screening for HCV infection for adults born between 1945 and 1965 and for those determined to be at high risk for infection. Our reflexive suite of comprehensive testing for the detection and confirmation of both acute and chronic HCV infection enables clarity on disease presence and progression.
Key testing
- HCVDX | Hepatitis C Virus (HCV) Antibody with Reflex to HCV RNA by PCR, Symptomatic, Serum
- Identifies HCV antibodies in blood in patients who present with symptoms and/or signs of illness.
- If results are reactive, testing automatically reflexes to confirmatory HCV RNA by RT-PCR and is performed at an additional charge.
- HCSRN | Hepatitis C Virus (HCV) Antibody Screen with Reflex to HCV RNA, PCR, Asymptomatic, Serum
- Identifies HCV antibodies in blood in asymptomatic patients.
- If results are reactive, testing automatically reflexes to confirmatory HCV RNA by RT-PCR and is performed at an additional charge.
- Uses an additional CPT code to comply with Medicare billing requirements.
- HCVQN | Hepatitis C Virus (HCV) RNA Detection and Quantification by Real-Time Reverse Transcription-PCR, Serum
- Confirms diagnosis of chronic hepatitis C.
- Can be used to establish a baseline HCV viral load (quantification) before initiating antiviral therapy and during therapy to measure response to therapy.
- HEVG | Hepatitis E Virus IgG Antibody, Serum
- HEVM | Hepatitis E Virus IgM Antibody Screen with Reflex to Confirmation, Serum
Genotyping
Unique nucleotide sequences of 5’ noncoding (5’ NC), core, and NS5B regions of the HCV genome allow classification of the virus into six major genotypes or clades (1 to 6). In the United States, the most encountered HCV genotypes/subtypes are 1a and 1b, followed by genotypes 2 and 3. Genotypes worldwide differ based on geographic distribution, disease outcome, and response to antiviral therapy differ. Therefore, reliable methods for genotype determination are important for proper selection of antiviral therapy and optimal patient management, including the use of direct-acting antiviral (DAA) drugs.
Key testing
- HCVG | Hepatitis C Virus Genotype, Serum
- Determines HCV genotype (1 to 5) to guide antiviral therapy in patients with chronic hepatitis C.
- Differentiates between HCV subtypes 1a and 1b.
- HCVDR | Hepatitis C Virus Genotypic Antiviral Drug Resistance, Serum
- Uses next-generation sequencing to detect and identify HCV antiviral drug resistance in patients with chronic hepatitis C and those being considered for direct-acting antiviral (DAA) drug combination therapy.
- Can predict the likelihood of a curative response to current FDA-approved DAA drug combinations used for treatment of chronic hepatitis C.
Highlights
Joseph Yao, M.D., gives an overview of this new test available through Mayo Clinic Laboratories. He discusses when this testing should be ordered, how this testing improves upon other testing approaches, and what clinical action can be taken due to the results of this testing.