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Virology / Serology - Hepatitis

Hepatitis B serologies are available on a limited basis for diagnosis of acute and chronic disease, for monitoring the course of disease and the effectiveness of therapy, and for screening select patient populations.  Hepatitis A IgM testing is available on a limited basis for the diagnosis of acute disease.

Three types of testing panels are available: diagnostic, screening, and monitoring.

Specimen Acceptance Policy

Serologic testing for hepatitis infection is available only to patients who are seen in local health departments and state-operated health care facilities.  Only serum may be submitted for serologic testing.  Specimens submitted to the Virology/Serology Branch must be accompanied by a fully completed submission DHHS form #3722.  Failure to supply the requested patient information may result in significantly delayed specimen testing.

Specimens submitted for testing that are not labeled with the correct patient identification information will not be tested.  Specimens which, for any reason, are deemed unsuitable or inappropriate for serologic testing will not be tested.  Rejected specimens will be properly stored for seven days pending verbal and/or written notification of the submitter.  Unless alternate arrangements are initiated by the submitter upon notification of specimen rejection, the specimen will be discarded at the end of the holding period.

Specimen Collection

A minimum of 3 mL of serum should be submitted for hepatitis testing.  Aseptically collect whole blood in a red top tube or in a serum separator tube.  Let specimen stand 30 minutes to ensure complete clotting of the blood.  Centrifuge for 5-10 minutes at 1,000-1,500 x g.  Transfer serum to a well constructed plastic screw capped vial with threads on the outside.  Excessively hemolyzed, grossly contaminated, or extremely lipemic sera are unacceptable for hepatitis assays.  Specimens that are not acceptable for testing will be reported as UNSATISFACTORY.

Clearly label each vial of serum with the patient's first and last name, and the date collected.  Complete a submission form DHHS form #3722.  All items on this form must be completed before the specimen can be processed.

Specimen Shipping

Send the properly identified vials of patient sera and the completed form DHHS #3722 in the "HEP SEROLOGY" (buff colored) mailing containers via the State Courier Service to:

State Laboratory of Public Health
Virology/Serology Branch
Bath Building
COURIER #52-41-41

Specimens should be shipped immediately and should arrive in the laboratory within 48 hours of collection.  If transport to the laboratory is to be delayed, specimens can be refrigerated up to seven days or frozen.  Specimens can be mailed at ambient temperature.

DHHS form #3722, 3 mL plastic screw-capped vials and color coded mailers are available from the Laboratory Mailroom, PO Box 28047, Raleigh, North Carolina 27611-8047, telephone (919) 733-7656.

Reporting and Interpretation

The following chart provides information regarding turn-around-times and interpretations

Testing Availability

Hepatitis B virus testing is available to the following patient populations:

• Symptomatic patients
• Prenatal patients
• Refugees
• Sexual or needle sharing contacts of known infected persons
• Patients who are household contacts of hepatitis B carriers and are candidates for vaccine
• Infants born to infected mothers
• Known previous HBsAg positives
• Previously vaccinated health department employees with percutaneous exposure to hepatitis B virus
• Source patient of percutaneous exposure

Hepatitis A virus serology is available to patients who are:

• Symptomatic without an epidemiological link to another case of known hepatitis A infection
• Suspected cases, whether or not epidemiologically-linked, who are:
  • food handlers
  • health care workers
  • day care attendees
  • day care workers
  • at risk of liver disease through IV drug abuse, alcohol abuse, etc.
• Associated with an outbreak situation (prior approval required)

Routine testing for either hepatitis A or B is limited to those groups listed above; however, if you have special needs that are not addressed in the acceptance criteria, please call (919) 733-7544.  Special arrangements for testing can be made on an individual basis.

NOTE: Hepatitis B immune status testing will not be performed to determine immune status of health care workers, dental workers, etc. who are candidates for routine vaccination or to establish routine post-vaccination immunity.

See also:

• About Virology / Serology
• Chlamydia
• HIV
• Hepatitis
• Syphilis
• Special Serology
• CDC Referral
• Arbovirus
• Norovirus

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