The hepatitis virus panel is a series of blood tests used to detect current or past infection by hepatitis A, hepatitis B, or hepatitis C. It can screen blood samples for more than one kind of hepatitis virus at the same time.

Antibody and antigen tests can detect each of the different hepatitis viruses.

Note: Hepatitis D only causes disease in people who also have hepatitis B. It is not routinely checked on a hepatitis antibody panel.

Blood is typically drawn from a vein, usually from the inside of the elbow or the back of the hand. The site is cleaned with germ-killing medicine (antiseptic). The health care provider wraps an elastic band around the upper arm to apply pressure to the area and make the vein swell with blood.

Next, the health care provider gently inserts a needle into the vein. The blood collects into an airtight vial or tube attached to the needle. The elastic band is removed from your arm. Once the blood has been collected, the needle is removed, and the puncture site is covered to stop any bleeding.

In infants or young children, a sharp tool called a lancet may be used to puncture the skin and make it bleed. The blood collects into a small glass tube called a pipette, or onto a slide or test strip. A bandage may be placed over the area if there is any bleeding.

The blood sample is sent to a laboratory for examination. Blood ( serology) tests are used to check for antibodies to each of the hepatitis viruses.

No special preparation is needed.

When the needle is inserted to draw blood, some people feel moderate pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing.

Your doctor may order this test if you have signs of hepatitis. It is used to:

• Detect current or previous hepatitis infection
• Determine how contagious a person with hepatitis is
• Monitor a person who is being treated for hepatitis

Other conditions under which the test may be performed:

• Chronic persistent hepatitis
• Delta agent (hepatitis D)
• Nephrotic syndrome

A normal result means no hepatitis antibodies are found in the blood sample. This is called a negative result.

Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.

There are different tests for hepatitis A and B. A positive test is considered abnormal.

Abnormal results on hepatitis A tests:

• IgM anti-hepatitis A virus (HAV) antibodies -- recent infection with hepatitis A
• Total (IgM and IgG) antibodies to hepatitis A -- previous or current infection, or immunity to hepatitis A

Abnormal results on hepatitis B tests:

• Hepatitis B surface antigen (HBsAg) -- acute or chronic hepatitis B infection
• Antibody to hepatitis B core antigen (Anti-HBc) -- previous hepatitis B infection
• Antibody to HBsAg (Anti-HBs) -- immunity to hepatitis B
• Hepatitis B type E antigen (HBeAg) -- chronic, contagious hepatitis B infection or acute infection

Antibodies to hepatitis C can usually be detected 4 - 10 weeks after the infection occurs.

Veins and arteries vary in size from one patient to another and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others.

Other risks associated with having blood drawn are slight but may include:

• Excessive bleeding
• Fainting or feeling light-headed
• Hematoma (blood accumulating under the skin)
• Infection (a slight risk any time the skin is broken)

Hoofnagle JH. Acute viral hepatitis. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 151.