In the US, millions are living with viral hepatitis infection. Many people are unaware of their infection, making screening even more vital. If left untreated, hepatitis can lead to adverse outcomes, from cirrhosis to liver cancer. Quest's extensive hepatitis portfolio offers screening options for hepatitis B (HBV) and hepatitis C (HCV) in alignment with recent CDC guidance, as well as a comprehensive menu of testing to confirm active infection, guide treatment selection, and monitor therapy response.
Help prevent serious illness with testing to manage hepatitis at every stage
HBV triple panel screening provides a more complete picture
- All adults in the US age 18 years and older, at least once in their lifetime
- Infants born to people who are infected with HBV
- All people who are pregnant (ie, during each pregnancy)
Periodic risk-based testing recommendations include the below.
- People who are currently or have been incarcerated
- People with a history of sexually transmitted infections or multiple sex partners
- People with hepatitis C
- People born in certain countries where HBV is common
- People born in the US and not vaccinated as infants whose parents were born in countries with high rates of HBV
- Men who have sex with men
- People who inject drugs
- People with HIV infection
- Household contacts and sexual contacts of people with known HBV infection
- People who are on immunosuppressive therapy
- People with end-stage renal disease
- People with elevated liver enzymes
The HBV Triple Screen Panel with Reflexes provides clarity with straightforward results and features all the components you need to answer 3 key questions about a patient's HBV status with a single test code.
The HBV-HDV connection
Hepatitis D virus (HDV) only occurs in people already infected with HBV. Symptoms can be severe, so early detection is critical. There are 2 types of HDV infection.
- Coinfection: HBV + HDV at the same time
- Superinfection: HDV develops after HBV infection
Our comprehensive testing can help you diagnose and monitor HDV infection before, during, and after treatment.
- People chronically infected with HBV
- Infants born to mothers infected with HDV
- Sex partners of persons infected with HDV
- Men who have sex with men
- People who inject drugs
- Household contacts of people with HDV infection
- Healthcare and public safety workers
- Hemodialysis patients
Guidelines recommend universal HCV screening
Research estimates that up to 4M Americans had hepatitis C between 2017-2020.4 Nearly half of people with HCV are unaware they are infected, with up to 85% being asymptomatic.5 Screening is imperative for preventing serious illness as well as infection spread. CDC guidance recommends universal HCV screening for all US adults at least once in their lifetime, using an HCV antibody test with reflex to NAAT testing for HCV RNA. Anyone who requests an HCV test should also be screened, regardless of stated risk factors.5
- All adults in the US age 18 years and older, at least once in their lifetime*
- All people who are pregnant (ie, during each pregnancy)*
- Infants born to people who are infected with HCV
*Except in settings where the prevalence of HCV infection is less than 0.1%.
One-time HCV screening is recommended for people with increased risk or exposures.
- People who currently or have previously injected drugs and shared needles
- People with HIV infection
- People with select medical conditions, including those who have received hemodialysis and people with persistently abnormal alanine aminotransferase (ALT) levels
- Prior recipients of transfusions or organ transplants
- Healthcare, emergency medical and public safety personnel after needle sticks, sharps, or mucosal exposures to HCV-positive blood
Periodic risk-based testing recommendations include the below.
- People who currently inject drugs and share needles
- People with select medical conditions, including those receiving maintenance hemodialysis
CDC recommendations for HCV screening include a 2-step testing sequence,5 such as Hepatitis C Antibody with Reflex to HCV, RNA, Quantitative, Real-Time PCR, to automatically test for HCV RNA on all samples reactive for HCV antibody and streamline time to diagnosis and treatment. Hepatitis C Antibody with Reflex to HCV RNA, PCR with Reflex to Genotype, LiPA provides a second reflex to perform genotyping when RNA is detected, a necessary step before starting therapy.
Learn more about how hepatitis screening from Quest aligns with CDC guidance
Other viral hepatitis infections
Hepatitis A virus (HAV) typically spreads through contaminated food and water, but in the US is more commonly spread from person to person.
- People who use injection or non-injection drugs
- People experiencing unstable housing or homelessness
- Men who have sex with men
- People who are currently or were recently incarcerated
- People with chronic liver disease, including cirrhosis, hepatitis B, or hepatitis C
In the US, cases of hepatitis E virus (HEV) are rare, and primarily affect men over the age of 40. HEV infection should be considered in any person with symptoms of viral hepatitis who tests negative for serologic markers of HAV, HBV, HCV, other hepatotropic viruses, and all other causes of acute liver injury. People exhibiting symptoms who have traveled to or from a hepatitis E-endemic area should also be tested.7
- Pregnant people
- People with chronic liver disease
- Organ transplant recipients
References
- Hepatitis B Foundation. Hepatitis B facts and figures. Accessed November 17, 2023. https://www.hepb.org/what-is-hepatitis-b/what-is-hepb/facts-and-figures/
- CDC. National Center for HIV, Viral Hepatitis, STD, and TB Prevention. Significant update to hepatitis B screening and testing recommendations. Last reviewed March 10, 2023. Accessed January 24, 2024. https://www.cdc.gov/nchhstp/dear_colleague/2023/hepatitis-b-screening-and-testing.html
- CDC. Hepatitis D questions and answers for health professionals. Last reviewed March 9, 2020. Accessed June 6, 2024. https://www.cdc.gov/hepatitis/hdv/hdvfaq.htm
- CDC. Hepatitis C Basics. Updated May 30, 2024. Accessed June 6, 2024. https://www.cdc.gov/hepatitis-c/about/index.html
- CDC. Clinical Screening and Diagnosis for Hepatitis C. Updated December 19, 2023. Accessed June 6, 2024. https://www.cdc.gov/hepatitis-c/hcp/diagnosis-testing/index.html
- CDC. Outbreaks of hepatitis A across the US. Last reviewed November 3, 2023. Accessed June 6, 2024. https://www.cdc.gov/hepatitis/outbreaks/2017March-HepatitisA.htm
- CDC. Hepatitis E Questions and Answers for Health Professionals. Last reviewed September 15, 2020. Accessed June 6, 2024. https://www.cdc.gov/hepatitis/hev/hevfaq.htm
Ready to learn more about hepatitis testing from Quest?
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