Can I Take The Test At Home
Samples for hepatitis B testing can be collected at home. At-home hepatitis B testing requires a patient to collect a blood sample, typically from a fingerstick using a very small needle provided in the test kit. Once a blood sample is collected, it is prepared according to the instructions contained in the test kit and mailed to a laboratory for testing.
Because there are numerous types of tests for HBV, it is important to look closely at the specific components of any at-home test kit. Many at-home test kits only look for hepatitis B surface antigen .
What Does The Test Measure
Hepatitis B testing looks for antigens, antibodies, or the genetic material of the hepatitis B virus. HBV antigens are substances from the virus that cause a patients body to produce an immune response. Antibodies are substances made by the immune system in response to the hepatitis B virus.
Initial tests for hepatitis B measure antibodies and antigens related to HBV including:
If a patient is diagnosed with hepatitis B based on these initial tests, additional hepatitis B testing may be used to monitor the disease, guide treatment, and determine if a person can spread hepatitis B to others. These additional tests may include:
- Hepatitis B e antigen : Hepatitis B e antigen is a protein from the hepatitis B virus found in some patients who are positive for hepatitis B surface antigen. Measuring this antigen can help doctors understand infectivity, which describes a persons ability to spread HBV to others.
Symptoms Of Hepatitis B
Some people who are infected with the hepatitis B virus have mild, flu-like symptoms and some do not become sick at all. Children who are infected are less likely to have an illness or get sick after getting hepatitis B than adults.
In more severe cases, hepatitis B can cause:
- Loss of appetite.
- Pain in the joints.
Normally, these health problems disappear in a few weeks, but even when the person feels much better, they may still be infectious.
Most adults who become infected with the hepatitis B virus recover completely and do not become infected again. A few people become very ill in the time just after infection and need to go to hospital some may even die.
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High Titers Of Hepatitis B Surface Antibodies Indicating Low Risk Of Hepatitis B Virus
Sung-Nan Pei, Ming-Chung Wang, Ming-Chung Ma, Ching-Yuan Kuo, Chien-Hung Chen, Po-Nan Wang High Titers of Hepatitis B Surface Antibodies Indicating Low Risk of Hepatitis B Virus-Related Hepatitis in Lymphoma Patients Treated with Rituximab-Based Chemotherapy. Blood 2015 126 : 3869. doi:
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Transmission Of Hepatitis B
The hepatitis B virus is transmitted through blood and sexual fluids. This can most commonly occur in the following ways:
Direct contact with infected blood
From an infected pregnant person to their newborn during pregnancy and childbirth
Needles and other medical/dental equipments or procedures that are contaminated or not sterile
Unprotected sex
Use of illegal or street drugs
Body piercing, tattooing, acupuncture and even nail salons are other potential routes of infection unless sterile needles and equipment are used. In addition, sharing sharp instruments such as razors, toothbrushes, nail clippers, earrings and body jewelry can be a source of infection.
Hepatitis B is NOT transmitted casually. It cannot be spread through toilet seats, doorknobs, sneezing, coughing, hugging or eating meals with someone who is infected with hepatitis B.
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What Does A Positive Hepatitis A Total Antibody Mean
The hepatitis A virus is transmitted through ingestion of contaminated food and water or through direct contact with an infectious person. Almost everyone recovers fully from hepatitis A with a lifelong immunity. A safe and effective vaccine is available to prevent hepatitis A.
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Preparation Prior To Transport
Label the specimen container with the patients full name, date of collection and one other unique identifier such as the patients date of birth or Health Card Number. Failure to provide this information may result in rejection or testing delay.
Centrifuge if using SST. Place specimen in biohazard bag and seal. Specimens should be stored at 2-8°C following collection.
Specimens more than the following number of days post collection will not be tested:
- > 6 days for Hepatitis B surface antigen
- > 7 days for Hepatitis B e Antigen and Hepatitis B e Antibody
- > 10 days for Hepatitis B core Antigen and Hepatitis B surface Antibody
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What Are My Next Steps Once I Get My Results
It can be difficult to understand what the results of your test mean. A healthcare provider can help you interpret your results and decide whether you need to take further action:
- If your results suggest that youre already immune to hepatitis B and arent contagious, you likely wont need to do anything.
- If your results suggest that youre not immune, a doctor may recommend vaccination, especially if youre somebody whos at a high risk of infection.
You may also need additional testing if more information is needed to interpret your results.
What Do My Test Results Mean
Test results may vary depending on your age, gender, health history, the method used for the test, and other things. Your test results may not mean you have a problem. Ask your healthcare provider what your test results mean for you.
Normal results are negative or nonreactive, meaning that no hepatitis B surface antigen was found.
If your test is positive or reactive, it may mean you are actively infected with HBV. In most cases this means that you will recover within 6 months. If you recover, you will have immunity from the virus and will not be able to pass the virus to others. A positive test may also mean you have chronic hepatitis B infection. If you dont recover in 6 months, the virus may stay in your blood and cause liver problems. You can also infect others. Your healthcare provider may give you medicines if you dont recover after 6 months.
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What Is Hepatitis B Surface Antibody
When you are exposed to HBV, your body mounts an immune defense to specifically target and neutralize the invader. Unlike innate immunity which mounts a generalized defense against all invaders, this type of immunity is disease-specific.
This immune response occurs whether you are exposed to HBV through blood or sexual contact, or if you are vaccinated with the hepatitis B vaccine.
The virus has proteins on its surface, called antigens, that serve as unique identification tags. When HBV enters the body, the immune system “encodes” antibodies specific to these antigens so that it can recognize and attack the virus should it appear again.
There are two types of antibodies produced in response to the virus:
- Immunoglobulin M is the antibody that mounts the initial attack but eventually fades away.
- Immunoglobulin G is the antibody that provides long-lasting immune protection against HBV. The immunity can last for many years, but it gradually wanes over time.
The Treatment Programs Role In The Screening Process
Medical staff members at substance abuse treatment programs might assume the primary role for screening individuals for and explaining the screening process and test results. Opioid treatment programs with medical staff members should screen for and C at intake and periodically as indicated. In programs without onsite medical staff, clients may be referred elsewhere for screening with minimal involvement of the substance abuse treatment program.
Regardless of the type of program, counselors should have a basic understanding of the importance of screening, the screening process, and the meaning of the results. Counselors can encourage clients referred for screening to follow through and complete the screening and evaluation process . Clients might feel anxious about being diagnosed with hepatitis, and they might delay or avoid getting screened.
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Addressing Hepatitis For The First Time
It is crucial that a treatment counselor or health professional use a nonjudgmental and compassionate tone. Clients need to feel comfortable disclosing information about their health and risky behaviors. The following strategies can help initiate the conversation:
- Display posters, literature, or other -related items that could help prompt the client to ask questions about hepatitis. .
- Assess clients ability to discuss , based on their degree of openness in the counseling session, the amount of detail they provide in their responses, and the length of the therapeutic relationship.
- Raise the subject in a way that avoids making clients feel defensive or afraid. Consider introducing the subject by making parallels with other conditions that have been discussed. Say, for example, You said you were tested for HIV several times. Were you ever tested for viral ? or You mentioned that your friend is sick with HIV. Have you been tested for HCV or HIV? Tell me about those tests.
- Be patient and allow time for multiple, short conversations about the subject. This might ease feelings of fear, anxiety, or shame.
What Tests Will You Have To Do
Hepatitis B
You can be tested for hepatitis B at your VA medical center. This test is done by taking a sample of your blood.
Your provider may recommend the following tests:
Hepatitis B surface antibody If this test is positive, it means that:
- you have antibodies against hepatitis B and are safe from getting the disease
- you were either vaccinated against hepatitis B or exposed to it at some point in your lifetime
Hepatitis B core antibody If the test is positive, it means that:
- you have been exposed to hepatitis B and have developed an antibody to only part of the virus
- they will do more tests to find out if you currently have the disease
Hepatitis B surface antigen If the test is positive, it means that:
- you currently have hepatitis B infection
- you can spread the virus to others
Hepatitis B e antigen If the test is positive, it means that:
- you may have active hepatitis B and should be followed closely by your provider and possibly take hepatitis B medications
- you may be very contagious to others
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How Is The Hbcab Test Done
This is a blood test. A clinician will fill a tube with blood taken from a vein in your arm through which a needle is inserted. If you are giving blood, a sample will be taken from the blood you’re donating. The blood is sent to a lab, where it is tested. Sometimes HBcAb will be added on to lab orders when results from other tests indicate there may be a hepatitis B infection.
What Is The Most Challenging Aspect Of Hepatitis B Infection
Hepatitis B can very easily escape diagnosis, as most victims do not know they are suffering can spread the disease. This is because symptoms are almost negligible during the onset of hepatitis B infection. Although the infection is treatable and largely preventable, yet early diagnosis can go a long way in the better prognosis of the condition. Further, even though there are good treatment options for hepatitis B, close to a million people with the infection do not make it.Asian countries portray a high prevalence of hepatitis B. This infection is very common among high-risk groups such as people with multiple sex partners, homosexuals, injection drug users or people staying lose to victims of Hepatitis B.
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Where Is Your Patient From
This is a figure of a map of the world within Module 1 that is meant to assist clinicians in determining whether a patient is from a country of low , intermediate , or high prevalence of hepatitis B infection. Clinicians are advised that individuals born in regions with intermediate or high endemicity are at particular risk of having chronic hepatitis B infection and that screening populations at high risk of chronic infection is essential to identify anyone who can benefit from monitoring and treatment.
Reproduced with permission from NEJM 359:14 October 2008Endnote 8
Screening populations at high risk of chronic HBV infection is essential to identify anyone who can benefit from monitoring and treatment.
Counseling Practices That Educate Support And Motivate Clients Undergoing Screening
Clients might need help deciding whether to get screened, understanding the test results, and determining their next steps. Even when services offered through the substance abuse treatment program are limited, discussing testing with clients presents an opportunity for counselors to motivate clients for change by confronting substance use and by making choices that improve their overall health. However, this may also be true when services are offered on-site through substance abuse treatment programs. A study at one methadone clinic that offered hepatitis screening and vaccination revealed that although the majority of clients completed screening , only 54.7 percent of clients who lacked for hepatitis A received vaccinations and only 2.9 percent of clients who lacked immunity for received vaccinations .
The Consensus Panel makes the following general recommendations while recognizing that, in some programs, the counselors role may be limited:
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How The Test Is Performed
Blood is most often drawn from a vein from the inside of the elbow or the back of the hand. The site is cleaned with germ-killing medicine . The health care provider wraps an elastic band around the upper arm to apply pressure to the area and make the vein swell with blood.
Next, the provider gently inserts a needle into the vein. The blood collects into an airtight tube attached to the needle. The elastic band is removed from your arm. Once the blood has been collected, the needle is removed. The puncture site is covered to stop any bleeding.
In infants or young children, a sharp tool called a lancet may be used to puncture the skin and make it bleed. The blood collects into a small glass tube, or onto a slide or test strip. A bandage may be placed over the area if there is any bleeding.
The blood sample is sent to a lab to be examined. Blood tests are used to check for antibodies to each of the hepatitis viruses.
Transmission Symptoms And Treatment
How is HBV transmitted?
HBV is transmitted through activities that involve percutaneous or mucosal contact with infectious blood or body fluids , including
- sex with a partner who has HBV infection
- injection drug use that involves sharing needles, syringes, or drug-preparation equipment
- birth to a person who has HBV infection
- contact with blood from or open sores on a person who has HBV infection
- exposures to needle sticks or sharp instruments and
- sharing certain items with a person who has HBV infection that can break the skin or mucous membranes , potentially resulting in exposure to blood.
How long does HBV survive outside the body?
HBV can survive outside the body and remains infectious for at least 7 days .
What should be used to clean environmental surfaces potentially contaminated with HBV?
Any blood spills should be disinfected using a 1:10 dilution of one part household bleach to 9 parts water. Gloves should be worn when cleaning up any blood spills.
Who is at risk for HBV infection?
The following populations are at increased risk for becoming infected with HBV:
- Infants born to people with HBV infection
- Sex partners of people with HBV infection
- Men who have sex with men
- People who inject drugs
- Household contacts or sexual partners of known people with chronic HBV infection
- Health care and public safety workers at risk for occupational exposure to blood or blood-contaminated body fluids
- Patients on hemodialysis
Who should be screened for HBV?
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Hbc Antibody Positive/hbs Antigen Negative/hbs Antibody Negative
The HBc antibody positive/HBs antigen negative serotype is further divided into naïve and occult types . However, since HBV reactivation is often observed in HBc antibody positive/HBs antigen negative cases, it may be preferable to divide HBc antibody positive/HBs antigen negative cases based on whether they are positive or negative for HBs antibodies. For HBc antibody positive patients, perhaps HBV reactivation is induced by rituximab. Although Hui et al reported a 3%-25% reactivation rate, prophylactic treatment may be desirable since the mortality is relatively high after reactivation occurs. In 2013, Huang et al conducted a randomized controlled trial to evaluate the effect of the prophylactic administration of entecavir on the frequency of HBV reactivation in HBc antibody positive patients. In their report, unlike in retrospective analyses, the prophylactic administration of entecavir was the most important factor, at least for HBc antibody positive patients. Furthermore, Seto et al recently reported frequent reactivation of HBV in patients with 10 mIU/mL HBs antibody prior to rituximab treatment. In HBc antibody positive patients, prophylactic treatment is necessary, at least for those who are antibody negative prior to rituximab treatment . We believe that the prophylactic administration of a nucleic acid analog is preferable in HBc antibody positive/HBs antigen negative/HBs antibody negative cases.