Hepatitis Virus Serology: Markers & Interpretation

Instructor: Lori Haag

Lori has teaching experience in the health care setting. She has an associate's degree in Nursing and a bachelor's degree in Psychology.

In this lesson, you will learn about the hepatitis viruses and people at high risk for contracting the disease. We'll explore serologic markers that are present after exposure as well as interpretation of those results.

What's Wrong With Larry?

Larry isn't feeling too well these days. He hasn't had much of an appetite for a month or two, and he's been so tired. He thinks he may be running a fever, but he isn't sure because he doesn't have a thermometer to check his temperature. His joints ache terribly, and he has noticed that his skin is beginning to look a little yellow. He has also been itching a lot. He wonders what could be wrong.

Larry thinks back to what he's done lately that could be making him so sick. He should have told his dialysis nurse yesterday what's been going on. Could it have been the hot dog he ate from the street vendor a couple days ago? He did notice that the vendor didn't wash it hands after urinating on the side of the street. What about that one time he used his buddy's syringe to inject his heroin? That was almost a year ago though, and his buddy didn't seem to be sick. Larry racked his brain searching for an answer. Maybe he better ask his girlfriend how she is feeling. He never uses condoms when having sex, but he thought she took care of that sexually transmitted infection a long time ago. Larry decides it's time to go see the doctor at the medical clinic.

Hepatitis can cause many symptoms

The Top Three Culprits

Larry's lifestyle puts him at high risk for contracting hepatitis, inflammation of the liver caused by one of the hepatitis viruses. The three most common hepatitis viruses that cause illness in people are hepatitis A, hepatitis B, and hepatitis C.

Immune Response to Foreign Invaders

After explaining his symptoms to the doctor, the doctor tells Larry he'd like to run a hepatitis panel on him. This is a blood test that will screen for antibodies to hepatitis A, hepatitis B, and hepatitis C. Antibodies are proteins produced by the immune system in response to an invading virus, the antigen. If antibodies against one of the hepatitis viruses are present in Larry's blood, this means that Larry has been exposed to that specific virus.

Serological Markers and Meaning

Hepatitis A

The presence of the anti-hepatitis A antibody, IgM in the blood is indicative of an acute hepatitis A infection, especially when symptoms are present. The IgM (immunoglobulin) antibody is the first antibody to appear after exposure to an antigen, and in the case of hepatitis A, will persist for about 2-6 weeks. Hepatitis A infections are generally mild and resolve on their own. They do not become chronic infections.

Hepatitis B

Presence of the hepatitis B surface antigen (HbsAg) is the hallmark sign of an active hepatitis B infection. If this antigen is present for 6 months or more, the infection is considered chronic. In response to the infection, the hepatitis surface antibody (HBsAb) will be detectable in the blood. This happens as the body begins to fight the virus and recover. Presence of this antibody can be a result of a present or past infection. If large amounts of the HBsAb are present, it usually means that the body has totally cleared the virus.

Hepatits B antibodies can also be present after receiving the hepatitis B vaccine. The hepatitis vaccine generally provides a lifetime of immunity. Levels of this antibody may wane over time, but this does not mean that a person is no longer immune.

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