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Anti Hepatitis A Virus (ANTI HAV) - IgM
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No Fasting Required
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The Anti-HAV IgM test detects IgM antibodies produced by the immune system in response to acute Hepatitis A virus (HAV)
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Anti Hepatitis A Virus (ANTI HAV) - IgM Test Guide
- Why is it done?
- Test Purpose: Detects IgM antibodies produced by the immune system in response to acute Hepatitis A Virus (HAV) infection; identifies patients with current or recent acute infection rather than past immunity
- Primary Indications: Suspicion of acute hepatitis A infection; evaluation of patients with jaundice, elevated liver enzymes, or acute hepatitis symptoms; confirmation of HAV infection in immunocompromised patients; assessment of contacts exposed to confirmed HAV cases
- Clinical Presentation Symptoms: Fever, malaise, anorexia, nausea, abdominal pain, dark urine, pale stools, jaundice, fatigue, and elevated transaminase levels (ALT/AST)
- Typical Timing: Ordered during acute illness phase (within 1-2 weeks of symptom onset); IgM antibodies appear early in infection and persist for approximately 5-6 months; useful for acute phase diagnosis
- Normal Range
- Normal/Negative Result: Negative (typically reported as <0.8 mIU/mL or negative/non-reactive); absence of anti-HAV IgM antibodies indicates no acute infection at time of testing
- Positive/Abnormal Result: Positive (typically reported as ≥0.8 mIU/mL or reactive); indicates presence of anti-HAV IgM antibodies consistent with acute or recent HAV infection
- Units of Measurement: mIU/mL (milli-International Units per milliliter) or may be reported as negative/positive or non-reactive/reactive depending on laboratory methodology
- Interpretation Scale: Negative = Absence of acute infection; Borderline/Equivocal (if applicable) = Repeat testing recommended; Positive = Acute or recent HAV infection present
- Clinical Significance: Normal (negative) result excludes acute hepatitis A; positive result confirms acute infection regardless of IgG status; enables differentiation between acute and chronic/past infection
- Interpretation
- Positive Anti-HAV IgM (Acute Infection): Confirms acute hepatitis A infection; indicates patient is currently infectious or recently infected; correlates with clinical symptoms of acute hepatitis; highest levels typically seen 1-2 weeks after symptom onset
- Negative Anti-HAV IgM (No Acute Infection): Rules out acute hepatitis A; patient may have chronic liver disease from other causes or past HAV infection (if IgG positive); indicates patient is not currently in acute phase of HAV disease
- Anti-HAV IgM + Anti-HAV IgG Pattern: IgM positive + IgG positive = Recent acute infection (early convalescence); IgM positive + IgG negative = Early acute infection; IgM negative + IgG positive = Past infection/immunity
- Factors Affecting Results: Timing of blood draw relative to symptom onset; immunosuppression may alter antibody response; false negatives possible very early (<1 week) or late (>6 months) in infection; laboratory methodology and assay sensitivity variations
- Clinical Significance Patterns: Positive result in symptomatic patient with elevated liver enzymes = diagnostic for acute hepatitis A; positive result in asymptomatic contact = likely acute/recent infection; negative result in symptomatic patient = suggests alternative diagnosis
- Temporal Relationship: IgM peaks during acute illness; gradually declines over 3-6 months; rarely detectable beyond 6 months post-infection; useful window for acute infection diagnosis approximately 2 weeks to 6 months after infection onset
- Associated Organs
- Primary Organ System: Liver (hepatic system); gastrointestinal tract; immune system
- Primary Infection Target: Hepatocytes (liver cells); virus replicates in liver causing inflammation and cellular damage
- Associated Diseases with Abnormal Results: Acute hepatitis A; acute liver failure (in severe cases); cholestasis; fulminant hepatic failure (rare); secondary infections if immunocompromised
- Hepatic Manifestations: Hepatic inflammation (hepatitis); elevated transaminases (ALT/AST); hyperbilirubinemia; coagulopathy; hepatomegaly; jaundice
- Extrahepatic Manifestations: Arthralgia/arthritis (especially in adults); glomerulonephritis; vasculitis; cryoglobulinemia; hematologic abnormalities; secondary pancreatic involvement
- Potential Complications: Fulminant hepatic failure (0.5-2% of cases); encephalopathy; ascites; hepatic encephalopathy; death in severe/elderly patients (rare); prolonged cholestasis
- Risk Factors for Severe Disease: Age >50 years; underlying chronic liver disease; immunosuppression; HIV/AIDS; co-infection with hepatitis B or C; pregnancy
- Follow-up Tests
- Recommended If Anti-HAV IgM Positive: Anti-HAV IgG antibody (confirms immunity/past infection trajectory); Hepatitis B and C serologies (rule out co-infection); Liver function tests (ALT, AST, bilirubin, albumin); Prothrombin time (assess synthetic function); Complete metabolic panel
- Recommended If Anti-HAV IgM Negative with Persistent Symptoms: Repeat anti-HAV IgM (if early in illness <1 week); Hepatitis B surface antigen (HBsAg); Hepatitis B core antibody; Hepatitis C antibody; Hepatitis E antibody; EBV and CMV serologies; Autoimmune hepatitis workup (ANA, anti-smooth muscle antibody)
- Monitoring and Serial Testing: Liver function tests every 1-2 weeks during acute phase to monitor recovery; IgM levels not routinely followed (not prognostic); clinical recovery correlates with normalization of liver enzymes
- Imaging Studies: Abdominal ultrasound (assess for cirrhosis, ascites, portal hypertension if severe); CT scan (evaluate for complications if fulminant hepatic failure suspected)
- Complementary Tests: HAV RNA PCR (confirms viremia in complex cases); Anti-HAV total antibody (indicates infection vs. vaccination); Immunoglobulin levels if immunocompromised; Kidney function tests (assess for glomerulonephritis)
- Contact Investigation: Test close contacts for anti-HAV IgM/IgG; test household members and sexual contacts; occupational contacts if applicable; provide post-exposure prophylaxis recommendation
- Long-term Follow-up: Usually not required (HAV does not cause chronic infection); consider IgG testing at 6 months to confirm lifelong immunity; no further testing needed if IgG positive
- Fasting Required?
- Fasting Requirement: No - Fasting is NOT required for anti-HAV IgM testing
- Patient Preparation: No special preparation required; blood draw can be performed at any time of day; patient may eat and drink normally before test
- Medication Considerations: No medications need to be withheld or avoided prior to testing; immunosuppressive medications should be continued as prescribed (note for laboratory); corticosteroids and antivirals do not interfere with antibody detection
- Special Instructions: Bring valid identification and insurance card; inform phlebotomist of any bleeding disorders; report current medications and recent vaccinations; timing of sample collection should be documented relative to symptom onset if possible
- Collection Details: Single venipuncture blood draw; minimum 5 mL serum required; collected in standard serum separator tube; sample should be processed and stored appropriately per laboratory protocol
- Sample Stability: Serum stable at room temperature for 24 hours; refrigerate at 2-8°C if delayed processing expected; freeze at -20°C or below for long-term storage
How our test process works!
