Figure 2. Laboratory Management of Patients with Hepatitis .

A
Diagnosed
HAV infection

ALT levels every

1 to 2 weeks until normal

Acute

ALT levels every

1 to 2 weeks until normal

HBV DNA
HBsAg
HBsAb
after 6 months

Diagnosed
HBV infection

Chronic

HBV DNA
HBsAg
HBsAb+

Resolved
infection

HBsAg+
HBsAb

Chronic
infection

Negative

Probable
resolved
infection

Positive

Chronic
infection

If treated, monitor therapy with HBV DNA,

ALT levels, HBeAg and HBeAb (if initially
HBeAg+), and HBsAg.
If untreated, see Figure 4.

C
Diagnosed chronic
HBV/HDV infection

Monitor therapy with

HBV DNA and HDV RNA

Acute

Monitor ALT levels

periodically for 6 months

Diagnosed
HCV infection

Chronic

HCV RNA
assay after
6 months

See Figure 5

A, Monitoring hepatitis A infection. B, Strategies for monitoring acute and chronic hepatitis B infections. C, Monitoring hepatitis B infection in
the presence of hepatitis D coinfection or superinfection. D, Strategies for monitoring acute and chronic hepatitis C infections. More information
about monitoring chronic hepatitis C therapy using HCV RNA assays can be found in the text. HAV indicates hepatitis A virus; ALT, alanine
aminotransferase; HBV, hepatitis B virus; HBsAg, hepatitis B surface antigen; HBsAb, hepatitis B surface antibody; HBeAg, hepatitis B e
antigen; HBeAb, hepatitis B e antibody; HDV, hepatitis D virus; and HCV, hepatitis C virus.
This figure was developed by Quest Diagnostics and is based in part on references 11, 16, 17, and 18. It is provided for informational purposes
only and is not intended as medical advice. A physicians test selection and interpretation, diagnosis, and patient management decisions should
be based on his/her education, clinical expertise, and assessment of the patient.

Quest, Quest Diagnostics, any associated logos, and all

associated Quest Diagnostics registered or unregistered
trademarks are the property of Quest Diagnostics. All third party
marks - and - are the property of their respective owners.
2015 Quest Diagnostics Incorporated. All rights reserved.

Content reviewed 10/2015