Serology tests

Services include:

  • Hepatitis A, B, C or E 
  • Contact with a rash in pregnancy

Serology contacts and location

Location

Pathology, Floor 5
Royal Derby Hospital
Uttoxeter Road
Derby
DE22 8NE

Contact

Telephone: 01332 788 224

Opening hours

Core opening times
Monday 9am - 5pm
Tuesday 9am - 5pm
Wednesday 9am - 5pm
Thursday 9am - 5pm
Friday 9am - 5pm

On call and urgent samples

On-call biomedical scientist  

The department offers a late booking for Antenatal patients for HIV and Hepatitis B (in 1 hr) and Syphilis (with 24 hr).  

This on-call service is available:

  • Monday to Friday: 5pm - 9am (excluding Bank Holidays)
  • Friday 5pm to Monday 9am (including Bank Holidays)

If there is a significant clinical need for any other specific test, please contact the on-call microbiology consultant for further information. 


On-call consultant

The on-call service is available:

  • Monday to Friday: 5pm - 9am (excluding Bank Holidays)
  • Friday to Monday: 5pm - 9am (including Bank Holidays)

Hepatitis

This is a guide to the range of tests available forHepatitis serology. If you have any specific queries about the testing methods please contact the serology team on 01332 788 224. 

If your question is regarding a specific patient and clinical advice is required, contact on the on-call microbiology consultant via switchboard 01332 340 131.

If you require a screening test for Hepatitis A, B, C or E please send a clotted blood sample (red top). If a hepatitis B DNA is required please send a clotted blood sample (red top). If the patient has had a positive screening test for Hepatitis C and requires a viral load or genotype please send an EDTA sample (purple top). For turnaround times please see the test database.
 

Hepatitis A

Hepatitis A or infectious jaundice is caused by hepatitis A virus (HAV transmitted by the faecal-oral route, often associated with ingestion of raw or partially cooked contaminated food. Several large outbreaks have occurred in injecting drug users (IUDs) and among men who have sex with men.

Hepatitis A total antibody (IgM and IgG)

  • Recent/ current Hepatitis A infection
  • Immunisation to Hepatitis A


Hepatitis A IgM antibodies

  • Presence indicates acute Hepatitis A
     

Hepatitis B

Hepatitis B virus can cause both acute and chronic hepatitis. Methods of transmission include blood (blood transfusion, now rare), intravenous drug use, equipment used for tattooing, sexually or via mother to child. Shaving accessories such as razor blades, or touching wounds on infected persons with exposed broken skin has also been link to transmission of the virus. It is a notifiable disease.

Hepatitis B surface antigen

  • Presence indicated current Hep B infection
  • Does not differentiate between acute and chronic infections
  • Usually the earliest detectable marker for Hep B infection


Hepatitis B surface antibody

  • Presence indicates immunity to Hep B infection
  • This is used for post vaccination levels
  • Does not differentiate between vaccine mediated immunity or post infection immunity (Hepatitis B core will)


Hepatitis B core total antibodies (IgM and IgG)

  • Presence indicates current or past infection
  • Does not differentiate between current and past infection
  • This is NOT produced post vaccine
  • Will usually remain positive for life


Hepatitis B e antigen

  • Presence indicates highly infectious stage of Hepatitis B infection

     

Hepatitis C

Hepatitis C can be transmitted through contact with blood (IVDU) and can also cross the placenta. Hepatitis C usually leads to chronic hepatitis, culminating in cirrhosis in some people. It usually remains asymptomatic for decades.

Hepatitis C antibodies

  • Presence indicates current or past Hepatitis C infection

 
Hepatitis C RNA PCR

  • Presence indicates actively replicating virus
  • Only to be performed on Hepatitis C antibody positive patients


Hepatitis C genotyping

  • Only to be performed on Hepatitis C antibody positive patients
  • Testing usually only carried out to guide treatment


 

Hepatitis E

HEV is transmitted by the faecal-oral route and is common in Asia, Africa and Central America, particularly where sanitation is poor. HEV usually produces mild disease but in rare cases it can prove fatal, particularly in pregnant women. It is a relatively uncommon cause of viral hepatitis in the United Kingdom.

Hepatitis E IgG antibodies

  • Indicates past infection
  • An acute case can be defined by showing IgG seroconversion
     

Hepatitis E IgM antibodies

  • IgM antibodies are usually present at the same time as onset of symptoms and remain detectable for several months.

Contact with a rash in pregnancy

Infections (I°) which may present with a “rash” illness in pregnant females in the UK include:

  • Rubella

  • Parvovirus  B19

  • VZV

  • Measles

  • Enterovirus

  • IMN (EBV or CMV rarely)

  • Syphillis

  • Streptococcus           )           Not considered in this guidance as

  • Meningococcus         )           rash as specific and different guidelines/protocol
     

A range of other I° not endemic within the UK and need to be considered if thee is a history of recent travel to an endemic area (eg, Dengue).
 

At booking, the Midwife (MW) should:

  • Enquire if the patient has previously had chicken pox (CPox) or shingles. If not, make urgent contact if she either has contact with CPox or shingles or   develops CPox type vesicles.

  • Inform her MW, GP or Obstetrician if she has “contact” in pregnancy with  someone who has a rash or if she develops rash in pregnancy. 
     

'Contact' – definition

Being in the same room (eg, house or classroom or 2-4 bed hospital bays for a period of 15 minutes or more or face to face contact.

When calling the Microbiologist, please state whether it is:

  • Significant contact or not

  • Period of gestation

  • Date of contact

  • Description of rash on the index patient or diagnosis