From the Guidelines
A positive Hepatitis A antibody test typically indicates either past infection with Hepatitis A virus or previous vaccination, meaning you have immunity and no further action is needed regarding Hepatitis A specifically. However, it's essential to determine which type of antibody was detected - IgM antibodies suggest recent infection while IgG antibodies indicate past infection or vaccination 1. If IgM antibodies are positive, you should monitor for symptoms like fatigue, nausea, abdominal pain, and jaundice, though most cases resolve without specific treatment. Rest, adequate hydration, and avoiding alcohol are recommended during recovery from active infection. If you're experiencing symptoms, acetaminophen (Tylenol) may help with discomfort, but avoid medications that can stress the liver. Since Hepatitis A is transmitted through contaminated food/water or close contact, if you have an acute infection, practice good hand hygiene and avoid preparing food for others until cleared by your doctor. Consider testing for other hepatitis viruses (B and C) to get a complete picture of your liver health, as infections can sometimes occur together.
Some key points to consider:
- IgG anti-HAV, which appears early in the course of infection, remains detectable for the person's lifetime and provides lifelong protection against the disease 1.
- Total anti-HAV testing is used in epidemiologic studies to measure the prevalence of previous infection or by clinicians to determine whether a person with an indication for pre-exposure prophylaxis is already immune 1.
- If you have a chronic liver disease, such as hepatitis B or C, it is recommended to get vaccinated against hepatitis A to prevent fulminant hepatitis 1.
- It is also important to practice good hygiene, avoid excessive alcohol consumption, and get tested for other hepatitis viruses to ensure overall liver health 1.
From the Research
Hepatitis A Antibody Positive: Next Steps
- A positive hepatitis A antibody test result can indicate either a current or past infection, as well as immunity due to vaccination 2, 3.
- The interpretation of the test results should consider the clinical context, including symptoms and exposure history 4, 5.
- In the absence of clinical acute hepatitis, a positive IgM HAV antibody test result may not necessarily indicate a recent infection 2, 5.
- The accuracy of serological testing for hepatitis A can be improved by using a clinically significant cut-off value for anti-HAV IgM and considering the clinical and epidemiological context 4.
- Total or IgG immunoglobulin to hepatitis A virus tests can be used to assess immunity, but the accuracy and precision of these tests may vary around the immunity threshold 6.
- The following steps may be considered:
- Review the patient's clinical history and symptoms to determine if they are consistent with acute hepatitis A infection 4, 5.
- Consider the patient's exposure history and risk factors for hepatitis A infection 2, 5.
- Use a clinically significant cut-off value for anti-HAV IgM to improve the accuracy of test results 4.
- Assess the patient's immunity to hepatitis A using total or IgG immunoglobulin to hepatitis A virus tests, if necessary 6.