Quest Diagnostics
Taking Hepatitis Testing to New Levels

The Quest Diagnostics Advantage

•	Quality and knowledge from the nation's leader in gene-based testing
•	Over $1.4 billion in gene-based and esoteric tests performed annually
•	Convenient, consolidated test ordering with an extensive molecular test menu for both HCV and HBV
•	Viral load testing that offers unsurpassed sensitivity with optimal precision and reproducibility
•	Genotyping that predicts treatment duration and patient response to therapy
•	Fast turnaround times through local service capabilities

Hepatitis B (HBV) Testing	Hepatitis C (HCV) Testing
HBV DNA Testing • Indicator of chronic hepatitis when still positive 6 months after diagnosis of acute HBV infection3 • Differentiate chronic, inactive carrier, and resolved HBV infection3 • Low Pretreatment HBV DNA levels is an indicator of antiviral response and may predict likelihood of response to therapy3 • Monitor response to therapy • Indicate emergence of resistant variants during antiviral therapy - selection for lamivudine-resistant mutants is the main concern with lamivudine treatment3	Qualitative HCV RNA Testing • Confirm positive antibody (EIA) results and chronic infection with a lower limit of detection (LOD) of 50 IU/mL or less1 – PCR - LOD of 50 IU/mL – Transcription-Mediated Amplification (TMA) - LOD of 10 IU/mL • Immune-compromised patients with false-negative EIA results require HCV RNA testing for diagnosis of chronic infection1
HBV DNA Genotyping • Determine epidemiology and prognosis – Genotype B is associated with a higher rate of IFN-induced HBeAg clearance compared with Genotype C4 – Precore and core promoter mutations may predict more aggressive disease course3 • Identify mutations associated with resistance to antiviral drugs and help improve therapeutic treatment selections – Lamivudine resistance can be detected in 14% to 32% of patients after 1 year of treatment3 – Adefovir has been shown to be effective against lamivudine-resistant HBV mutants3	HEPTIMAX™ Quantitative  HCV RNA Testing • Lower baseline viral levels are associated with successful antiviral therapy1 • Early Viral Response (minimum 2 log decrease in viral load during first 12 weeks of treatment) is predictive of Sustained Viral Response and should be a routine part of monitoring patients with Genotype 1 • Some "non-responders" that achieve a substantial reduction of HCV RNA (1 log unit or more) during therapy have demonstrated improved histology as a response to treatment1 • Confirm end of treatment viral clearance with confidence: – Quantitative TMA assay with a lower limit of 5 IU/mL – TMA detected HCV virus in 36% of "relapsers" that were determined to be virus-negative by PCR methods2
	HCV Genotyping • Predict likelihood of therapeutic response • May help determine the need for liver biopsy in making treatment decisions1 • Determine the duration of treatment1 – Genotype 1 - 48 weeks – Genotype 2 and 3 - 24 weeks

Online Resources for Healthcare Professionals

•	Access our online Test Menu, to obtain test ordering codes and specimen requirements.
•	View our Hepatitis Test Menus in a PDF format:
	–	Hepatitis B Test Menu
	–	Hepatitis C Test Menu
•	Visit our Interpretive Guide, for information relating to test selection, utilization, and interpretation.
•	Learn more about HEPTIMAX Quantitative HCV RNA Testing.
•	View facts and figures about Hepatitis B and Hepatitis C, including risk groups.
•	Simplify test ordering and results reporting with our connectivity solutions.

Online Test Information for Your Patients
Your patients can learn about health conditions and laboratory tests in our online Patient Health Library. The library is founded on evidence-based information, and includes topics such as:

•	Hepatitis C virus (HCV) antibody test
•	Hepatitis C
•	Tests for hepatitis C virus genetic material (RNA)
•	Ask-the-Doctor Checklist
•	Work in Partnership with Your Doctor
•	Share in Every Medical Decision
•	Healthwise Self-Care Checklist
•	Making Wise Health Decisions

Contact a Quest Diagnostics Sales Representative, learn more about our testing services, and become a client

•	Contact a physician sales representative
•	Contact a hospital sales representative or learn about our complete hospital offerings

References
¹ NIH Consensus Statement, September 2002.
² C. Sarrazin, et al. "Detection of Residual Hepatitis C Virus RNA by Transcription-Mediated Amplification in Patients with Complete Virologic Response According to Polymerase Chain Reaction-Based Assays" Hepatology 2000: 32: p. 818-823.
³ Wai CT, et al, "HBV genotype B is associated with better response to interferon therapy in HBeAg (+) chronic hepatitis than genotype C," Hepatology, 2002 Dec; 36 (6): 1425-30.
⁴ AASLD Practice Guidelines for Chronic Hepatitis B, Hepatology, Dec 2001.

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