Definition

Hepatitis is a liver condition that leads to inflammation of the organ. Hepatitis A, specifically, is a highly contagious form of liver infection caused by the hepatitis A virus (HAV). HAV is typically transmitted through contaminated food or water, direct contact with an infected person, or handling contaminated objects. Mild hepatitis A cases usually resolve without requiring specialized treatment, and most people recover fully without long-term liver damage.

Globally, the incidence of hepatitis A has decreased by 90%, now accounting for only 1.2 cases per 100,000 people, largely due to vaccination efforts introduced in 1999. In 2016, the World Health Organization (WHO) estimated that approximately 7,134 people died from hepatitis A, representing about 0.5% of total mortality from all cases. Indonesia has an intermediate endemic classification for HAV, where transmission often occurs person-to-person, through contaminated food and water, and during outbreaks when cases exceed typical projections.

Upon initial infection with HAV, the body produces antibodies. Symptoms typically appear between 14 and 50 days after infection, with an average onset at around 30 days. Antibodies become detectable in the blood 5 to 10 days before symptoms emerge and can remain in circulation for up to six months post-infection.

A total anti-HAV test identifies whether a person has been infected with HAV by detecting both IgM and IgG antibodies, enabling differentiation between recent and past infections. IgM antibodies usually appear two weeks after symptoms onset and persist for around six months, while IgG antibodies, which provide lifelong immunity, remain present indefinitely, offering protection against future HAV infections.

Indications

Doctors may recommend a total anti-HAV test for several reasons, such as:

• Diagnosing Active Infection: To help identify the cause of hepatitis in symptomatic patients. Hepatitis A symptoms may include dark urine, diarrhea, pale stool, fatigue, mild fever, abdominal and joint pain, nausea, vomiting, loss of appetite, and jaundice (yellowing of the skin and eyes).

• Assessing Immunity: This test is also used for individuals who have recovered from a hepatitis A infection, as antibodies will have formed post-recovery, providing immunity. This test can reveal the presence of antibodies either from past infection or previous vaccination against hepatitis A.

• Post-Travel Testing: Recommended for individuals who have recently traveled to regions where hepatitis A is prevalent, such as Asia, South America, Central America, Africa, and the Middle East.

Contraindications

The total anti-HAV test is considered safe with moderate associated risks. There are no specific contraindications for undergoing this test.

Preparations Before the Test

No special preparation is needed for a total anti-HAV test. If other tests are being conducted concurrently, fasting may be required for several hours beforehand. Certain medications may influence test outcomes, so it is essential to inform your healthcare provider about any medications taken. Remaining hydrated, relaxed, and free of stress is recommended before testing.

Test Procedure

The total anti-HAV test is performed using a blood sample. The laboratory staff will disinfect the arm with an alcohol swab and draw a small amount of blood from a vein in the arm using a sterile syringe. For infants, blood is typically collected from the heel. Afterward, the blood is placed in a tube and analyzed by laboratory staff using specialized equipment.

The risk associated with this procedure is minimal. Some individuals may experience mild discomfort, dizziness, or bruising during the blood collection, but these effects typically resolve quickly. The procedure is straightforward and generally takes only a few minutes to complete the blood draw and necessary preparation.

Normal And Abnormal Values

The total anti-HAV test results are interpreted as either positive or negative. This test is usually performed in conjunction with an IgM antibody test to ensure an accurate diagnosis. A negative result typically indicates no infection, whereas a positive result suggests the presence of a current or past infection.

Results and Recommendations (Further Testing)

Test outcomes may vary based on factors like age, gender, medical history, and the specific testing method employed. The results of the anti-HAV test often need to be followed by additional testing to reach a definitive diagnosis.

Consult the Right Doctor

If your anti-HAV test result is positive, it is recommended to consult a general practitioner for further evaluation. Your doctor may advise additional tests to clarify the diagnosis and assess your health status. Discuss any symptoms you may have experienced during or after the test to help your doctor interpret the results accurately.

If necessary, you may also seek advice from an internist for specialized care and treatment options. The doctor may suggest further examinations to confirm the initial diagnosis.

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