Hepatitis A: Test and Diagnosis

Laboratory parameters of 1st order – obligatory laboratory tests.

• Serology* – detection of hepatitis A-specific antibodies.
  • HAV antigen detection in blood or stool.
    • Indicates fresh hepatitis A infection in the incubation phase (detectable: 1-3 weeks before to 3-6 weeks after onset of disease)
  • Anti-HAV IgM
    • Evidence of fresh hepatitis A infection.
    • Antibodies are detectable from the onset of disease symptoms for 3-6 months
  • Anti-HAV IgG – indicates fresh or expired infection or vaccination performed; antibodies:
    • Are detectable from the onset of disease symptoms.
    • Usually persists throughout life; serves as a parameter for the rate of contamination
• Sequencing of the HAV genome – performed only in special cases.
• Liver parameters – alanine aminotransferase (ALT, GPT), aspartate aminotransferase (AST, GOT), glutamate dehydrogenase (GLDH) and gamma-glutamyl transferase (γ-GT, gamma-GT; GGT); alkaline phosphatase, bilirubin [ALT > AST].

* In particular, in terms of the Protection against Infection Act, the suspected disease, the disease as well as death from acute viral hepatitis must be reported.

Laboratory parameters 2nd order – depending on the results of the history, physical examination, etc. – for differential diagnostic clarification.

• Antibodies against hepatitis virus B, C, D, E.
• Bacteria
  • Borrelia
  • Brucella
  • Chlamydia
  • Gonococcus
  • Leptospires
  • Mycobaterium tuberculosis
  • Rickettsiae (e.g., Coxiella burnetii)
  • Salmonella
  • Shigella
  • Treponema pallidum (lues)
• Helminths
  • Ascaris
  • Bilharzia (schistosomiasis)
  • Liver fluke
  • Trichinae
• Protozoa
  • Amoebae
  • Leishmania (leishmaniasis)
  • Plasmodia (malaria)
  • Toxoplasmosis
• Viruses
  • Adeno viruses
  • Coxsackie viruses
  • Cytomegalovirus (CMV)
  • Epstein-Barr virus (EBV)
  • Yellow fever virus
  • Herpes simplex virus (HSV)
  • Mumps virus
  • Rubella virus
  • Varicella zoster virus (VZV)
• Autoimmune diagnostics: ANA, AMA, ASMA (anti-SMA = AAK against smooth muscle), anti-LKM, anti-LC-1, anti-SLA, anti-LSP, anti-LMA.
• Gamma-glutamyl transferase (γ-GT, gamma-GT; GGT) – for suspected alcohol abuse.
• Aspartate aminotransferase (AST, GOT), alanine aminotransferase (ALT, GPT) [↑ only in case of liver parenchyma damage].
• Carbodeficient transferrin (CDT) [↑ in chronic alcoholism]* .
• Transferrin saturation [suspected in men > 45%, pre-menopausal women > 35%] – in suspected hemochromatosis (iron storage disease).
• Coeruloplasmin, total copper, free copper, copper in urine – if Wilson’s disease is suspected.

Vaccination status – control of vaccination titers