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AHPS
9022
ancestry. Homozygosity for factor V Leiden is much less common, but may confer a substantially
increased risk for thrombosis. The degree of abnormality of the APC-resistance assay correlates with
heterozygosity or homozygosity for the factor V Leiden mutation; homozygous carriers have a very low
APC-resistance ratio (eg, 1.1-1.4), while the ratio for heterozygous carriers is usually 1.5 to 1.8.
Useful For: Evaluation of patients with incident or recurrent venous thromboembolism (VTE)
Evaluation of individuals with a family history of VTE Evaluation of women with recurrent miscarriage
or complications of pregnancy (eg, severe preeclampsia, abruptio placentae, intrauterine growth
restriction, and stillbirth) Possibly useful for evaluation of individuals with a history of arterial thrombosis
(eg, stroke, acute myocardial infarction, or other acute coronary syndromes), especially among young
patients (ie, 6 months.
REPORTABLE RANGE
1.0-10.0
Clinical References: 1. Nichols WL, Heit JA: Activated protein C resistance and thrombosis. Mayo
Clin Proc 1996;71:897-898 2. Dahlback B: Resistance to activated protein C as risk factor for thrombosis:
molecular mechanisms, laboratory investigation, and clinical management. Semin Hematol
1997;34(3):217-234 3. Rodeghiero F, Tosetto A: Activated protein C resistance and Factor V Leiden
mutation are independent risk factors for venous thromboembolism. Ann Intern Med 1999;130:643-650 4.
Grody WW, Griffin JH, Taylor AK, et al: American College of Medical Genetics consensus statement on
factor V Leiden mutation testing. Genet Med 2001;3:139-148 5. Press RD, Bauer KA, Kujovich JL, Heit
JA: Clinical utility of factor V Leiden (R506Q) testing for the diagnosis and management of
thromboembolic disorders. Arch Pathol Lab Med 2002;126:1304-1318
Acute Hepatitis Profile
Clinical Information: Hepatitis A Hepatitis A virus (HAV) is an RNA virus (enterovirus) that
accounts for 20% to 25% of the viral hepatitis in U.S. adults. HAV infection is spread by the oral/fecal
route and produces acute hepatitis, which follows a benign, self-limited course. Spread of the disease is
usually associated with contaminated food or water caused by poor sanitary conditions. Outbreaks
frequently occur in overcrowded situations and in institutions or high-density centers such as prisons and
health care centers. Epidemics may occur following floods or other disaster situations. Chronic carriers of
HAV have never been observed. Hepatitis B Hepatitis B virus (HBV) is a DNA virus that is endemic
throughout the world. The infection is spread primarily through percutaneous contact with infected blood
products (eg, blood transfusion, sharing of needles by drug addicts). The virus is also found in virtually
every type of human body fluid and is known to be spread through oral and genital contact. HBV can be
transmitted from mother to child during delivery through contact with blood and vaginal secretions; it is
not commonly transmitted transplacentally. After a course of acute illness, HBV persists in approximately
10% of patients. Some of these chronic carriers are asymptomatic; others develop chronic liver disease,
including cirrhosis and hepatocellular carcinoma. Hepatitis C Hepatitis C virus (HCV) is an RNA virus
that is a significant cause of morbidity and mortality worldwide. HCV is transmitted through
contaminated blood or blood products or through other close, personal contacts. It is recognized as the
cause of most cases of posttransfusion hepatitis. HCV shows a high rate of progression (>50%) to chronic
disease. In the United States, HCV infection is quite common, with an estimated 3.5 to 4 million chronic
HCV carriers. Cirrhosis and hepatocellular carcinoma are sequelae of chronic HCV. See Advances in the
Laboratory Diagnosis of Hepatitis C (2002) in Publications, and HBV Infection-Diagnostic Approach and
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