Definition Of Groups And Outcome Measures
The coexistence of HBsAg and anti-HBs was defined by the simultaneous positivity for both HBsAg and anti-HBs. The coexistence group included chronic hepatitis B patients who were positive for both HBsAg and anti-HBs during follow-up. The transient or intermittent coexistence of HBsAg and anti-HBs during follow-up was also included in the coexistence group. The dynamic change of HBsAg and anti-HBs of the patients in coexistence group is presented in Supplementary Fig. . The control group include patients who never experienced coexistence of HBsAg and anti-HBs during follow-up.
The primary outcome was HCC incidence. Secondary outcomes were HBsAg seroclearance and all-cause mortality. HBsAg seroclearance was defined as the loss of serum HBsAg, not related to liver transplantation. The follow-up duration for HCC occurrence was calculated from the time of initial visit to the time of last evaluation of the image or the diagnosis of HCC. The follow-up duration for HBsAg seroclearance was calculated from the time of initial evaluation of HBsAg to the time of last HBsAg evaluation or HBsAg seroclearance. Predictors for outcomes were evaluated. All-cause mortality was evaluated in all subjects using the survival data provided by the National Micro Data Service System .
What Is The Difference Between Hepatitis B Surface Antibody And Antigen
An antigen is a substance that induces antibody production. Hepatitis B surface antigen is a protein on the surface of hepatitis B virus.
Hepatitis B surface antibodies are produced by the bodys immune system in response to HBsAg. The presence of adequate hepatitis B surface antibodies in the blood indicates protection against hepatitis B virus infection.
Understanding Your Test Results
Understanding your hepatitis B blood tests can be confusing. It is important to talk to your health care provider so you understand your test results and your hepatitis B status. Are you infected? Protected? Or at risk? The Hepatitis B Panel of blood tests includes 3 tests and all three results must be known in order to confirm your status.
Below is a chart with the most common explanation of the test results, but unusual test results can occur. Please note that this chart is not intended as medical advice, so be sure to talk to your health care provider for a full explanation and obtain a printed copy of your test results. In some cases, a person could be referred to a liver specialist for further evaluation.
More Detailed Information About Hepatitis B Blood Tests
An acute hepatitis B infection follows a relatively long incubation period – from 60 to 150 days with an average of 90 days. It can take up to six months, however, for a person to get rid of the hepatitis B virus. And it can take up to six months for a hepatitis B blood test to show whether as person has recovered from an acute infection or has become chronically infected .
The following graphic from the U.S. Centers for Disease Control and Prevention represents the typical course of an acute hepatitis B infection from first exposure to recovery.
According to the CDC, a hepatitis B blood test result varies depending on whether the infection is a new acute infection or a chronic infection.
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What Do Hepatitis B Test Results Mean
Hepatitis B test results help determine if HBV infection is negative or positive, and if positive, whether the infection is acute or chronic, or if recovery is complete. A combination of results are considered to identify and classify HBV infection status.
The following are some interpretations of hepatitis B test results:
Table: Hepatitis B test results and interpretations
Questions For Your Doctor About Test Results
Patients may find it helpful to ask questions about their hepatitis B test results. Questions that may be helpful include:
- What was my test result?
- Do I have an acute or chronic hepatitis B infection?
- Does the test result suggest that I have immunity for hepatitis B?
- Would I benefit from hepatitis B vaccination?
- Do I need any follow-up tests based on my hepatitis B test results?
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Antibodies To Hepatitis B Surface Antigen Are Acquired After Allogeneic Stem Cell Transplantation In Non
Jinhua Ren, Tingting Xiao, Yingxi Weng, Rong Zheng, Yu Zhang, Jingjing Xu, Xiaofeng Luo, Zhihong Zheng, Zhizhe Chen, Jianda Hu, Ting Yang Antibodies to Hepatitis B Surface Antigen Are Acquired after Allogeneic Stem Cell Transplantation in Non-B Hepatitis Virus-Infected Patients but Disappear over Time. Blood 2020 136 : 38. doi:
There is currently no unified standard protocol for the prevention of hepatitis B virus infection in patients with hematopoietic stem cell transplantation. The incidence of HBV infection is high in China, particularly in the Fujian Province of China. Nevertheless, there are also many transplanted patients who are not infected with HBV as indicated by serology markers . Therefore, there is a need to develop a protocol to prevent hepatitis virus infection in these non-infected patients.
This study aims to determine the changes in HBV immune status after allogeneic hematopoietic stem cell transplantation in patients not infected with HBV for establishing a management protocol to prevent HBV infection in these patients after allo-HSCT.
After allo-HSCT, HBV-negative patients acquired HB surface antibodies, and the HBsAb titer gradually decreased to eventually disappear at the end of follow-up. Therefore, we do not recommend prophylactic anti-hepatitis B virus therapy in the early stage of hematopoietic stem cell transplantation in non-HBV infected patients.
Data At Baseline And During Follow
In total, 2,341 subjects were included in this study. Figure shows a flowchart of study enrollment. The median age of the patients was 46.4 years, and 1,412 subjects were male . The coexistence group accounted for 7.1% of the total population. Table shows the baseline characteristics of the overall cohort, coexistence group and control group. There were no significant differences in age, sex, alanine aminotransferase level, aspartate aminotransferase level, presence of cirrhosis, FIB-4 or history of antiviral medication. The follow-up durations were not different between the groups. Less subjects with qHBsAg> 250 IU/ml were included in the coexistence group.
The authors declare no competing interests.
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Hepatitis B Surface Antibody Qualitative
Presence of antibody to hepatitis B surface antigen is used to determine immune status to HBV or disease progression in individuals infected with HBV. Anti-HBs levels can be measured to determine if vaccination is needed, or following a vaccination regimen, to determine if protective immunity has been achieved.
– Anti-HBs usually can be detected several weeks to several months after HBsAg is no longer found, and it may persist for many years or for life after acute infection has been resolved.
– It may disappear in some patients, with only antibody to core remaining.
– People with this antibody are not overtly infectious.
– Presence of the antibody without the presence of the antigen is evidence for immunity from reinfection, with virus of the same subtype.
What is the Hepatitis B virus?
Hepatitis B virus infection, also known as serum hepatitis, is endemic throughout the world. The infection is spread primarily through blood transfusion or percutaneous contact with infected blood products, such as sharing of needles among injection drug users. The virus is also found in virtually every type of human body fluid and has been 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, but it is not commonly transmitted via the transplacental route.
The incubation period for HBV infection averages 60 to 90 days .
What are common symptoms?
Diagnosis Of Acute And Chronic Hepatitis B
HBsAg is the first serologic marker to appear and may be detected within 1 to 2 weeks after exposure. It precedes the development of symptoms by an average of 4 weeks.106 The presence of HBsAg indicates ongoing infection. Qualitative but not quantitative methods are used by most clinical laboratories because the amount of antigen does not correlate with disease activity or with the presence of an acute or chronic infection.28 Some symptomatic patients may have self-limited, acute HBV infection without detectable HBsAg. These patients, up to 9% in some studies, have other detectable markers of infection.106 HBeAg appears virtually simultaneously, peaks, and then declines in parallel with HBsAg. It usually disappears before HBsAg does. Adult patients who remain persistently positive for HBeAg for more than 10 weeks are likely to become chronically infected. HBeAg indicates a high level of viral replication and infectivity. Most patients with nondetectable HBeAg have resolving, minimal, or no active liver disease.28 Precore mutants of HBV do not express HBeAg they may be responsible for a more severe course and, in some cases, fulminant disease. Serum aminotransferase levels become elevated but are nonspecific. They begin to increase just before the development of symptoms and then peak with the development of jaundice.
Howard C. Thomas, Jennifer A. Waters, in, 1998
How Much Does The Test Cost
The cost of hepatitis B testing depends on the tests that are performed, where the test is conducted, and a patientâs health insurance coverage. When testing is ordered by a doctor, patients with health insurance may find it helpful to discuss the cost of testing with their health insurance company as they may be responsible for testing costs as well as other out-of-pocket costs such as copays and deductibles.
For patients without health insurance or for whom insurance doesnât cover the cost of testing, it may be helpful to discuss the cost of hepatitis B testing with a doctor or hospital administrator.
The cost of at-home hepatitis B testing starts around $45. At-home test kits may also test for additional types of viral hepatitis in the same sample. The cost of test panels that look for more than one type of viral hepatitis start around $80.
An Interesting Case Of Isolated False
The standard serologic markers used to diagnose hepatitis B infection include hepatitis B surface antigen , hepatitis B surface antibody , total hepatitis B core antibody , and IgM antibody to hepatitis B core antigen . Different markers or combinations of markers are used to identify different phases of HBV infection and determine whether a patient has acute or chronic infection or immunity due to prior infection or vaccination or is seronegative and susceptible to future infection. Isolated HBsAg seropositivity is a peculiar serological pattern that requires investigation. Herein, we present a case of an asymptomatic female without a history of liver disease or evident risk factors for hepatitis, who underwent screening for infectious disease prior to resection of basal cell carcinoma involving her eyelid. The patients laboratory testing showed positivity for HBsAg and the HIV 1/2 screen. To investigate, we performed serial dilutions, utilized heterophilicantibody blocking tubes, and repeated analysis using a different commercial assay , all in support of a false-positive result attributed to a heterophilic antibody. Hence, we demonstrate that heterophilic antibody interference can result in isolated HBsAg positivity and recommend considering this form of interference in the differential where there is low clinical suspicion for viral infection.
2. Case Report
Conflicts of Interest
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Taking A Hepatitis B Test
Testing for hepatitis B is performed on a sample of blood. A doctor, nurse, or other health care provider can obtain a blood sample using a small needle to draw blood from a vein.
At-home hepatitis B testing requires that users carefully follow instructions provided in the test kit to collect a small sample of blood, package the sample, and mail it to a lab for testing.
When Should I Get Hepatitis B Testing
Using hepatitis B tests to screen for HBV is recommended for certain groups that are at an increased risk of infection. Groups that may benefit from hepatitis B screening include:
- Pregnant people
- People born in parts of the world where hepatitis B is more common, including Africa, Asia, Eastern Europe, South America, and parts of the Middle East
- People who didnât receive a hepatitis B vaccine
- HIV-positive people
- Pain in the joints or abdomen
- Loss of appetite, nausea, or vomiting
- Yellowish skin and eyes
Using hepatitis B testing to assess immunity to HBV may be used before or after vaccination. Pre-vaccination testing is not always needed but may be performed if there is a chance that a patient has previously been infected with HBV or has already been vaccinated. Post-vaccination testing is used in certain groups of people who are at an especially elevated risk for HBV infection, including infants born to mothers with a hepatitis B infection.
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Does Hepatitis B Show Up In Routine Blood Tests
Routine blood tests do not detect hepatitis B virus infection. Hepatitis B tests are specifically done if blood tests show abnormal liver function results, or if a person experiences symptoms or falls into the high-risk category for HBV infection.
A panel of HBV-specific blood tests are required to detect HBV infection.
Outcome Of Patients Without Hbig Prophylaxis
Six HBsAg negative recipients were not given HBIG prophylaxis: two were anti-HBs positive after efficient vaccination and four were HBV naive . All were serum HBV DNA negative by PCR before transplantation. Anti-HBc seroconversion was detected in 5/6 recipients a mean of three months post-transplantation. None of the vaccinated recipients developed HBV infection. In contrast, the four naive patients developed de novo HBV infection 815 months after transplantation, with high levels of serum HBV DNA measurable by a hybridisation technique. Aminotransferases levels were normal or moderately elevated. Liver biopsies showed mild lobular inflammation. The kinetics of HBV infection were investigated by PCR on all available stored sera. HBV DNA was detectable in 3/4 patients from anti-HBc seroconversion . All de novo infected patients were treated with 100 mg/day lamivudine. After a 1216 month course of antiviral therapy, all developed resistance, with HBV DNA returning to pretreatment levels.
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Hepatitis B Blood Tests
The Hepatitis B Panel of Blood Tests
Only one sample of blood is needed for a hepatitis B blood test, but the Hepatitis B Panel includes three parts. All three test results are needed to fully understand whether a person is infected or not. Below is an explanation of the 3-part Hepatitis B Panel of blood test results.
Clinical And Laboratory Assessments
Demographic data, medication history including antiviral agents and comorbidities such as malignancy were assessed based on electronic medical records.
Laboratory tests included assessments of serology associated with HBV infection, liver function, AFP levels, platelet counts, and antibodies against hepatitis C virus and human immunodeficiency virus. Serologic markers for HBV including HBsAg, anti-HBs, hepatitis B e antigen , and anti-HBe were assessed by chemiluminescent microparticle immunoassays . The concentration of HBsAg was determined using a previously generated Architect HBsAg calibration curve , and the samples with higher than 250 IU/ml HBsAg levels were diluted to 1:5001:1000. By June 2010, qHBsAg more than 250 were expressed as > 250 IU/ml without presenting an exact value. Thus, we divided subjects into 2 groups as those with qHBsAg> 250 IU/ml and those with qHBsAg250 IU/ml in this study.
Serum HBV DNA levels were measured with Roche COBAS TaqMan quantitative PCR assay, which has a low detection limit of 20 IU/mL. The threshold for anti-HBs positivity was an anti-HBs titer > 10 IU/mL. Blood samples were collected before 10:00 AM after the patients had completed a 12-h overnight fast. All laboratory tests were conducted using standard methods.
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Virological And Histological Assessment Of Anti
Sera and pre-reperfusion liver graft biopsies were available from all 22 donors. All were HBsAg negative and anti-HBc positive, and 19 were also anti-HBs positive. Serum HBV DNA detection by PCR was negative in all but one donor. Immunostaining for HBs, HBc, and pre-S1 antigens was negative on all biopsy specimens. The liver globin gene was amplified in 21/22 biopsy specimens. HBV DNA was positive in 11 of these 21 biopsy specimens . Five grafts showed mild inflammation and/or fibrosis while the remaining 17 were normal.
What Is The Purpose Of A Hepatitis B Test
Hepatitis B test is performed to detect, classify, and treat hepatitis B virus infection.
Hepatitis B blood tests involve the measurement of several HBV-specific antigens and antibodies. In addition, HBV blood tests also include liver enzymes and liver function tests to assess and monitor the condition of the liver and provide appropriate treatment.
The HBV specific tests include the following:
- HBsAg: HBsAg is an antigen found on the surface of hepatitis B virus. HBsAg may be detected in the blood any time after 1 week post-exposure to HB virus, but usually appears after 4 weeks.
- Anti-HBs: Anti-HBs are antibodies produced by the bodys immune system to fight HBsAg. Anti-HBs from a prior infection or vaccination provides immunity against further infection.
- Hepatitis B core antigen : HBcAg is an antigen found in the core layer which covers the hepatitis B viral DNA.
- Hepatitis B core antibody : Anti-HBc is the antibody that fights HBcAg. Anti-HBc is the first detectable antibody after HBV infection. There are two kinds of Anti-HBc:
- Immunoglobulin M hepatitis B core antibody : IgM anti-HBc indicates acute or reactivated recent infection within the previous 6 months.
- Immunoglobulin G hepatitis B core antibody : IgG anti-HBc may indicate previous or chronic infection. Once present, IgG anti-HBc persists for a lifetime.
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