Table 3

Confirmatory serum tests for viral hepatitis (common patterns)27,28,66

Virus typeAcute infectionChronic infectionRecovered/immune
Hepatitis AIgM anti-HAV+veDoes not occurIgG anti-HAV +ve IgM anti-HAV -ve
Hepatitis BIgM anti-HBc +ve, HBsAg +ve, HBeAg +ve HBV-DNA +veIgM anti-HBc -ve (+ve low titre in flares) HBsAg +ve, HBeAg + or -ve HBV-DNA+ or -veIgG anti-HBc +ve (NB some tests measure combined IgG and IgM) IgG anti-HBs +ve (may become negative) HBsAg -ve
Hepatitis CIgG anti-HCV +ve by ELISA and RIBA tests (but may take up to 3 months or more). HCV-RNA +ve by PCRAs for acute infectionAntibody negative or IgG anti-HCV +ve by ELISA and RIBA tests. HCV-RNA -ve by PCR
Hepatitis DIgG and IgM anti-HDV +ve HDAg +ve, HDV-RNA +ve With markers of acute/chronic hepatitis B infectionAs for acute infectionAntibody, antigen, and RNA tests become negative within months of recovery.