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Hepatitis Panel

Liver

45 parameters

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Report in 12Hrs

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At Home

nofastingrequire

No Fasting Required

Details

Viral hepatitis screening panel.

₹3,999₹5,286

24% OFF

Parameters

  • List of Tests
    • Alkaline Phosphatase
    • AST or SGOT
    • ALT or SGPT
    • HBsAg
    • GGT
    • Anti Hepatitis A Virus (Anti HAV) - IgM
    • Anti Hepatitis C Virus (HCV) - Total
    • Anti Hepatitis E Virus (HEV) - IgM
    • Bilirubin Direct
    • Bilirubin Indirect
    • Bilirubin Total
    • Total Protein
    • Albumin
    • A/G Ratio
    • Globulin
    • Hba1c
    • eAG
    • CBC - Complete Hemogram

Hepatitis Panel - Comprehensive Medical Guide

  • Why is it done?
    • The Hepatitis Panel is a comprehensive screening tool designed to assess liver function and detect viral hepatitis infections (Hepatitis A, B, C, and E)
    • Liver function tests (AST, ALT, Alkaline Phosphatase, GGT, Bilirubin, Total Protein, Albumin) evaluate hepatic metabolism, synthesis, and excretion functions
    • Viral serological tests (HBsAg, Anti-HAV IgM, Anti-HCV Total, Anti-HEV IgM) identify acute or chronic hepatitis virus infections
    • CBC and HbA1c provide supporting hematologic and metabolic information relevant to liver disease severity and associated complications
    • Recommended for patients with suspected hepatitis, abnormal liver enzymes, jaundice, abdominal pain, elevated liver injury markers, or exposure risk to hepatitis viruses
    • Used for disease screening, diagnostic confirmation, disease monitoring, pre-treatment evaluation, and post-treatment follow-up
    • Individual tests work synergistically: viral markers identify causative agents while liver enzymes assess degree of hepatocellular damage and synthetic dysfunction
  • Normal Range
    • ALT (SGPT): 7-56 U/L (males); 7-45 U/L (females) - elevation indicates hepatocellular injury
    • AST (SGOT): 10-40 U/L - elevation suggests hepatocellular damage or hemolysis
    • Alkaline Phosphatase: 44-147 U/L (males); 34-104 U/L (females) - elevation indicates cholestasis or bone disease
    • GGT: 0-65 U/L (males); 0-36 U/L (females) - sensitive indicator of liver injury and cholestasis
    • Total Bilirubin: 0.1-1.2 mg/dL - elevation indicates impaired conjugation or excretion
    • Direct (Conjugated) Bilirubin: 0.0-0.3 mg/dL - elevation suggests biliary obstruction or cholestasis
    • Indirect (Unconjugated) Bilirubin: 0.1-0.9 mg/dL - elevation indicates hemolysis or hepatic dysfunction
    • Total Protein: 6.0-8.3 g/dL - decreased levels indicate impaired hepatic synthesis
    • Albumin: 3.5-5.0 g/dL - decreased levels indicate chronic liver disease or malnutrition
    • Globulin: 2.3-3.5 g/dL - elevated levels suggest chronic hepatitis or cirrhosis
    • A/G Ratio: 1.0-2.5 - decreased ratio indicates liver dysfunction
    • HBsAg (Hepatitis B Surface Antigen): Negative - positive result indicates active or chronic HBV infection
    • Anti-HAV IgM (Hepatitis A Antibody IgM): Negative - positive result indicates acute HAV infection
    • Anti-HCV Total (Hepatitis C Antibody): Negative - positive result indicates current or past HCV infection
    • Anti-HEV IgM (Hepatitis E Antibody IgM): Negative - positive result indicates acute HEV infection
    • HbA1c: <5.7% - 5.7-6.4% indicates prediabetes; ≥6.5% indicates diabetes
    • eAG: <100 mg/dL is normal; provides average plasma glucose estimate
    • CBC Parameters: WBC 4.5-11.0 K/uL, RBC 4.5-5.9 M/uL (males), Hemoglobin 13.5-17.5 g/dL (males), Platelets 150-400 K/uL - abnormalities suggest liver dysfunction or complications
  • Interpretation
    • ALT Elevation: Indicates acute hepatocellular injury; ALT > AST suggests viral or alcoholic hepatitis; degree of elevation correlates with severity of hepatocyte necrosis
    • AST Elevation: AST > ALT suggests cirrhosis or alcoholic liver disease; significant elevation (>1000 U/L) indicates acute hepatitis or massive necrosis; AST may be elevated from non-hepatic sources (muscle, heart)
    • Alkaline Phosphatase Elevation: Markedly elevated (>400 U/L) suggests biliary obstruction or cholestasis; moderate elevation suggests hepatitis; age and pregnancy affect interpretation
    • GGT Elevation: Highly sensitive but non-specific indicator; parallels Alkaline Phosphatase in cholestasis; elevated with alcohol consumption and certain medications; helps differentiate hepatic vs. bone source of ALP
    • Bilirubin Elevation: Total >3 mg/dL produces visible jaundice; Direct elevation suggests obstructive or hepatic cholestasis; Indirect elevation indicates hemolysis or impaired conjugation
    • Total Protein Decrease: <6.0 g/dL indicates impaired hepatic synthesis, malnutrition, or chronic liver disease; critical in assessing liver synthetic function
    • Albumin Decrease: <3.5 g/dL suggests chronic hepatic dysfunction; prognostic marker for cirrhosis severity; low albumin correlates with ascites and hepatic encephalopathy risk
    • Globulin Elevation: >3.5 g/dL suggests chronic hepatitis or autoimmune liver disease; polyclonal hypergammaglobulinemia associated with cirrhosis
    • A/G Ratio Decrease: <1.0 indicates significant liver disease; reversed ratio (A/G <1) is marker of cirrhosis and poor prognosis
    • HBsAg Positive: Indicates active HBV infection; present within 1-10 weeks of acute infection; persistent positivity (>6 months) defines chronic HBV; first marker to appear in acute hepatitis B
    • Anti-HAV IgM Positive: Diagnostic of acute hepatitis A infection; appears at symptom onset; disappears within 6 months; indicates infectivity
    • Anti-HCV Total Positive: Indicates current or past HCV infection; appears 4-10 weeks after infection; does not differentiate active infection from resolved disease; requires HCV RNA confirmation
    • Anti-HEV IgM Positive: Diagnostic of acute hepatitis E infection; appears at symptom onset; predominantly in endemic regions; generally resolves with viral clearance
    • HbA1c Elevation: ≥6.5% indicates diabetes; relevant in liver disease as hepatitis increases diabetes risk; monitors glycemic control over 3-month period
    • CBC Abnormalities: Thrombocytopenia (<150 K/uL) suggests portal hypertension or bone marrow suppression; anemia indicates chronic disease or GI bleeding; leukopenia may indicate splenic sequestration or infection
    • Pattern Recognition: ALT/AST >1000 suggests acute hepatitis; moderate elevation with disproportionate ALP/GGT suggests cholestasis; mild elevation with low albumin suggests cirrhosis
    • Factors Affecting Results: Hemolysis can falsely elevate AST; pregnancy elevates ALP; medications (NSAIDs, statins, acetaminophen) affect liver enzymes; recent exercise elevates AST/ALT
  • Associated Organs
    • Liver (Primary): ALT, AST, GGT, Alkaline Phosphatase, Bilirubin, Total Protein, Albumin assess hepatocyte injury, cholestasis, synthetic function, and metabolism; detects viral hepatitis, cirrhosis, fatty liver disease, and autoimmune hepatitis
    • Biliary System: Alkaline Phosphatase, GGT, Direct Bilirubin elevation indicates obstruction or cholestasis; evaluates gallstones, bile duct strictures, or hepatic cholestasis
    • Blood/Hematologic System: CBC detects anemia from chronic disease or GI bleeding; thrombocytopenia from splenic sequestration or bone marrow suppression; leukopenia from hypersplenism or infection
    • Pancreas: Elevated GGT or liver enzymes may indicate concurrent pancreatitis; liver-pancreas circulatory compromise affects both organs
    • Kidneys: Hepatitis can lead to hepatorenal syndrome; assessment important for treatment planning and prognosis
    • Endocrine System: HbA1c detects diabetes associated with chronic hepatitis or cirrhosis; hepatitis increases diabetes risk; liver dysfunction impairs glucose metabolism
    • Immune System: Viral serologies assess immune response to hepatitis antigens; abnormal immunoglobulin levels (elevated globulin) indicate autoimmune or chronic inflammatory states
    • Gastrointestinal Tract: Advanced liver disease causes portal hypertension leading to esophageal varices and GI bleeding; albumin and synthetic function reflect intestinal health and absorption
    • Associated Complications: Hepatic encephalopathy (ammonia accumulation), ascites (albumin/synthetic failure), variceal bleeding (portal hypertension), hepatorenal syndrome, coagulopathy (factor synthesis impairment)
  • Follow-up Tests
    • If ALT/AST Elevated: Repeat testing after 1-2 weeks to assess trend; perform viral serology; consider ultrasound or CT imaging; obtain ferritin and iron studies; test for autoimmune markers (ANA, anti-smooth muscle antibody)
    • If Alkaline Phosphatase/GGT Elevated: Obtain abdominal ultrasound to evaluate biliary tree; measure 5'-nucleotidase or 24-hour urine phosphate to confirm hepatic source; consider ERCP or MRCP if obstruction suspected
    • If Bilirubin Elevated: Obtain fractionated bilirubin if total elevated; abdominal imaging to assess for obstruction; liver function tests typically already included; consider indirect hyperbilirubinemia work-up if unconjugated predominance
    • If HBsAg Positive: Confirm with repeat testing; obtain HBeAg, Anti-HBe, HBV DNA quantification; assess for cirrhosis with prothrombin time and platelet count; screen for HDV coinfection; consider liver biopsy or FibroScan
    • If Anti-HAV IgM Positive: Confirms acute hepatitis A; supportive care typically sufficient; IgG anti-HAV indicates immunity; vaccination recommended for non-immune contacts; expect full recovery
    • If Anti-HCV Total Positive: Perform HCV RNA (qualitative) to determine active infection; quantitative HCV RNA to assess viral load; HCV genotyping for treatment selection; assess for cirrhosis; screen for hepatocellular carcinoma if advanced disease
    • If Anti-HEV IgM Positive: Confirms acute hepatitis E; IgG anti-HEV indicates immunity or past infection; supportive care for acute infection; immunocompromised patients need chronic HEV testing; HEV RNA (RT-PCR) for confirmation
    • If Albumin/Total Protein Decreased: Indicates synthetic dysfunction; assess need for diuretics or fluid restriction; perform prothrombin time/INR to evaluate coagulation; consider upper endoscopy for variceal screening
    • Imaging Studies: Abdominal ultrasound is first-line imaging for liver parenchyma evaluation; CT imaging for cirrhosis staging and hepatocellular carcinoma screening; MRCP for biliary tract evaluation; elastography/FibroScan for fibrosis assessment
    • Additional Serology: Anti-HBc, Anti-HBs for HBV immunity status; IgG anti-HAV for immunity; Hepatitis D (Delta) serology if HBsAg positive; test sexual contacts and household members if acute hepatitis diagnosed
    • Coagulation Studies: PT/INR, aPTT if signs of hepatic dysfunction; prolonged PT indicates impaired synthetic function; critical for assessing cirrhosis severity and bleeding risk
    • Monitoring Frequency: Acute hepatitis requires weekly testing until normalization; chronic hepatitis B/C typically monitored every 3-6 months; cirrhosis may require ultrasound every 6 months for HCC screening; post-treatment HCV requires testing at 12 weeks for sustained virologic response
  • Fasting Required?
    • Yes - Fasting is recommended for optimal test accuracy and standardization
    • Fasting Duration: 8-12 hours overnight fasting preferred; minimum 6-8 hours acceptable; fasting ensures stable lipid levels and accurate HbA1c measurement
    • Water Intake: Plain water may be consumed during fasting period; does not affect test results
    • Medications: Continue all regular medications with small amounts of water unless specifically instructed otherwise; avoid alcohol for 24 hours prior to testing
    • Food Restrictions: No food, coffee, or caffeinated beverages; avoid fatty meals for 24 hours prior as lipemia can affect assay accuracy; avoid sugary drinks or energy drinks
    • Strenuous Activity: Avoid vigorous exercise for 12-24 hours prior to testing; heavy exercise elevates liver enzymes and may produce false elevations
    • Collection Timing: Morning blood draws (between 7-10 AM) preferred for consistency; establishes baseline for longitudinal comparisons; fasting labs typically drawn in morning
    • Special Considerations: Viral serology (HBsAg, Anti-HAV, Anti-HCV, Anti-HEV) not affected by fasting; liver function tests and CBC preferably fasted; HbA1c and eAG not affected by fasting
    • Acute Presentations: If acute hepatitis or emergency evaluation, testing may proceed without fasting; note fasting status on lab requisition for result interpretation

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