title: Guidelines for serological testing in the diagnosis of acute hepatitis A and B.
abstract: This study was performed to determine whether elevation of serum transaminases can be used to eliminate unnecessary serological tests to diagnose acute hepatitis A (HAV) and acute hepatitis B (HBV). Serum samples of 1226 patients were tested for HBsAg, anti-HBc (IgM), and anti-HAV (IgM). Acute hepatitis was diagnosed in 113 (9.2%) patients; 75 were serologically positive for HAV, 36 for HBV, and 2 patients for both HAV and HBV. Serum transaminase levels were elevated in 104 of 107 (97.2%) of seropositive patients in whom the results of biochemical tests were available. A review of the medical records of seropositive patients with normal transaminases revealed that each of the three HAV patients had a remote history of hepatitis. None of the seropositive patients with a recent history of acute viral hepatitis had normal transaminase levels. During this period, serological tests were ordered in 266 of 1054 (25.2%) seronegative patients with normal serum transaminases. We conclude that serum transaminase levels can be reliably used to screen sera for acute HAV and HBV infection.
authors.affiliation: Department of Laboratory Medicine, Carondelet St. Mary's Hospital, Tucson, Arizona 85745, USA.
authors.forename: Y K
authors.initials: YK
authors.lastname: Chitkara
authors.forename: M D
authors.initials: MD
authors.lastname: Fontes
mesh_terms: D000208:Acute Disease; D005240:Feasibility Studies; D006506:Hepatitis A / Q000097:blood / Q000175:diagnosis*; D006509:Hepatitis B / Q000097:blood / Q000175:diagnosis*; D006512:Hepatitis B Core Antigens / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006801:Humans; D007118:Immunoassay; D007075:Immunoglobulin M / Q000097:blood; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012698:Serologic Tests; D000637:Transaminases / Q000097:blood*
chemical_list: D006512:Hepatitis B Core Antigens; D006514:Hepatitis B Surface Antigens; D007075:Immunoglobulin M; D000637:Transaminases