The ABCs of Hepatitis Are Now Available in a Streamlined ARUP Consult Topic

Hepatitis, or inflammation of the liver, affects millions of people worldwide. According to the CDC, viral hepatitis is a serious health concern that leads to thousands of deaths annually in the United States and is a leading cause of liver cancer. May is Hepatitis Awareness Month, a time to educate about the importance of prevention, testing, and treatment and reduce the stigma associated with viral hepatitis infection.

The ARUP Consult^® Viral Hepatitis topic has recently been updated and now contains streamlined information for clinicians to choose the right test at the right time, as laboratory testing is useful for determining diagnosis and appropriate treatment, monitoring treatment, and determining vaccination status.

ARUP’s Consult topic reflects the current testing recommendations from the CDC, which have recently changed. The CDC now recommends testing all individuals for hepatitis B (HBV) at least once in their lifetimes, said Patricia Slev, PhD, ARUP medical director of Immunology.

“ARUP offers comprehensive testing for hepatitis, including the recommended triple panel test for HBV, which consists of three different tests: hepatitis B surface antigen, hepatitis B surface antibody, and hepatitis B core total antibodies,” Slev explained. “Our full menu of hepatitis tests allows for flexibility in testing options for different clinical scenarios.”

Hepatitis may be caused by autoimmune processes or drug toxicity, as well as bacterial and viral infections. Hepatitis A, B, C, D, and E (HAV, HBV, HCV, HDV, and HEV) are the most common causes of viral hepatitis. These viruses infect hepatocytes and can lead to both acute and chronic hepatitis. Symptoms of viral hepatitis are nonspecific and include jaundice, fever, and a lack of appetite. Diagnosis cannot be made by clinical evaluation alone. Laboratory testing is used to screen for infection and inform treatment.

Each type of hepatitis has distinct modes of transmission. HAV and HEV typically spread through contaminated food and water and are usually self-limiting, acute diseases. HBV and HCV are commonly transmitted through blood and bodily fluids and lead to chronic hepatitis infections, which are associated with high morbidity and mortality. Unfortunately, many individuals infected with chronic HBV and HCV remain undiagnosed for decades until severe complications such as cirrhosis or liver cancer develop.

HDV, also known as hepatitis delta, can only occur in patients who are also infected with HBV, but importantly, superinfection of HDV in someone with HBV leads to the most aggressive and deadly form of viral hepatitis. The revised Consult topic highlights the new recommendations for increased testing for HBV and HDV.

“The Consult topic is an excellent distillation of guidelines and recommendations, ARUP’s testing, including the new triple panel test, and viral hepatitis in general,” Slev said.

A free educational resource, ARUP Consult is funded entirely by ARUP Laboratories. ARUP medical directors, who are active faculty members at the Spencer Fox Eccles School of Medicine at the University of Utah and its Department of Pathology, review and contribute to the content on ARUP Consult.

Users can subscribe to receive monthly emails about updates and additions to ARUP Consult. ARUP also welcomes feedback and suggestions via the Feedback page on arupconsult.com.

Learn more about viral hepatitis here.

Bonnie Stray, bonnie.stray@aruplab.com