Sequence Following An Initial Negative Hepatitis B Surface Antibody Titer
As you obtain documentation, please submit documentation of each step to CastleBranch
- Initial Hepatitis B titer negative for immunity
- Receive Hepatitis B challenge dose/booster
- Repeat Hepatitis B titer 4-6 weeks after challenge/booster vaccine
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Hbv Dna Hbv Genotype And Hbv Drug Resistance Assays
Specimen: Serum or plasma
Container: Red-top tube, yellow-top tube , gel-barrier tube, plasma preparation tube, or lavender tube
Collection method: Routine venipuncture
The specimen should be transfused to separate plasma/serum from cells within 6 hours and kept frozen when testing cannot be done promptly.
The tests use PCR amplification, DNA probe hybridization, and sequencing method.
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.
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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?
Hepatitis B Surface Antibody Qualitative
Test Code: 499
Methodology: Immunoassay
Clinical Significance: The detection of anti-HBs is indicative of a prior immunologic exposure to the antigen or vaccine. To determine immune status as 10 mIU/mL as per CDC guidelines, please order Hepatitis B Surface Antibody, Quantitative.
Alternative Name: Anti-HBS Anti-HBS Qual Anti-HBSAG Australian Antibody HB Surface Ab
Supply: T01 â Red/Gray SST 8.5mL
Preferred Specimen: Serum
Transport Container: Serum Separator Tube
Transport Temperature: Room Temperature
Specimen Stability: Room Temperature: 5 days
Rejection Criteria: Gross Hemolysis, Gross Lipemia
For additional supply or collection device information, please contact DLOâs Customer Service at 891-2917, option 2.
The information contained here on the Diagnostic Laboratory of Oklahoma website is not to be construed as medical recommendations or professional advice. Neither DLO nor its affiliates, agents or any other party involved in the preparation or publication of the works presented is responsible for any errors or omissions in information from the use of such information. Readers are encouraged to confirm the information contained herein with other reliable sources and to direct any questions concerning personal health care to licensed physicians or other appropriate health care professionals.
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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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Question 2 What Is The Hepatitis B Surface Antibody
The hepatitis B surface antibody is the antibody that is produced in response to hepatitis B surface antigen , a protein present on the surface of the hepatitis B virus. Anti-HBs appears after convalescence from acute infection and lasts for many years. It can also be produced in response to hepatitis B vaccination.
Other hepatitis B antibodies are not produced in response to vaccination. This is because these antigens are not in the vaccine.
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Interpreting Hepatitis B Laboratory Results
Many jurisdictions have regulations requiring laboratories to report all positive HBsAg, HBV DNA, and anti-HBc IgM laboratory results to the HD while a subset might also routinely receive positive total anti-HBc and anti-HBs results.
Additionally, some HDs might receive negative hepatitis B laboratory results, which are useful for determining false-positive results and monitoring patients through their infection and recovery. Table 3-1 shows how to interpret the combinations of laboratory results frequently available in hepatitis B test panels, following the biomarker changes over the course of disease as shown in Figure 3-1.
Table 3-1. Interpretation of hepatitis B laboratory results
| HBsAg |
|---|
- Concurrent ALT and total bilirubin result
- Other hepatitis serological results
- Negative HBsAg and/or negative/undetectable HBV DNA results
Total anti-HBc is detectable, on average, approximately 5 weeks post-HBV exposure, remains detectable indefinitely following exposure, and indicates past or current infection. In the presence of total anti-HBc, a positive HBsAg, HBeAg, or anti-HBc IgM result is a more reliable indication of recent or current infection. Jurisdictions that receive total anti-HBc laboratory results can use these results to clarify a persons HBV infection status.
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.Place specimen in a biohazard bag and seal. It is recommended to ship specimens for testing to PHO Laboratory immediately after collection or processing to avoid delays in testing. Shipping of specimens shall be done by Transportation of Dangerous Goods certified individuals in accordance with TDG regulations.
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Data Analysis And Statistics
All analyses were done using nonparametric statistical software with penalized maximum likelihood to remove first-order bias. A p-value < 0.05 for two-sided tests was considered statistically significant. Continuous variables were expressed as means plus/minus standard deviation or mean , categorical variables as numbers . Conditional logistic regression analysis was used to estimate risk ratios and 95% confidence intervals for loss of anti-HBs putative associated factors included age, sex, type of rheumatic disease, conventional DMARDs, biologic DMARDs , comorbidity, and baseline anti-HBs titer.
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How To Get Tested
Hepatitis B testing is typically prescribed by a doctor and performed in a hospital, lab, or other medical setting. Taking a hepatitis B test requires a blood sample, which can be collected by a health care professional.
For laboratory-based testing, blood is drawn from a patientâs vein. After blood is collected, the sample is sent to a laboratory for analysis.
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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
| Test |
|---|
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Hepatitis B Virus Dna
Diagnosis of hepatitis B virus infection is primarily based on HBV serologic markers such as hepatitis B surface antigen and hepatitis B core IgM antibody . Measurement of HBV DNA in serum helps to diagnose early acute infections before HBsAg becomes detectable, distinguish active from inactive HBV infection and monitor response to therapy.
The presence of HBV DNA in serum is a reliable marker of active HBV replication. HBV DNA is detectable within 30 days after infection and approximately 21 days before HBsAg becomes detectable. Testing for serum HBV DNA may be useful in diagnosing acute HBV hepatitis in patients with equivocal HBsAg test results.
Patients who do not clear the virus develop chronic HBV infection and remain HBsAg positive. Chronic hepatitis can be classified as chronic active or chronic inactive hepatitis, based on the presence or absence, respectively, of hepatitis Be antigen and HBV DNA. Some patients with chronic inactive hepatitis may reactivate HBV replication, without expressing HBeAg. Detection of HBV DNA is the only way to detect reactivation of HBV replication.
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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 âencodesâ 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.
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Negative But Other Hepatitis Tests Are Positive
Your HBsAb test may be negative even when other hepatitis B tests are positive, showing active or chronic infection. Further testing is necessary, especially for the hepatitis B surface antigen , which shows that the virus itself is circulating in your bloodstream and that you have an active or chronic infection.
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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.
Question 7 Is Hepatitis B Surface Antibody Antibody Always Acquired After A Completed Vaccination Protocol
No. After 3 intramuscular doses of vaccine, > 90% of healthy adults and > 95% of those < 19 years of age develop immunity .1 However, there is an age-specific decline in development of immunity. After age 40 years, about 90% of people become immune, but by age 60 years, only 75% of people become immune.1 Larger vaccine doses or an increased number of doses are required to induce immunity in many hemodialysis patients and in other immunocompromised people.1
References
This FAQ is provided for informational purposes only and is not intended as medical advice. A clinicians test selection and interpretation, diagnosis, and patient management decisions should be based on his/her education, clinical expertise, and assessment of the patient.Document FAQS.105 Revision: 0
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Submission And Collection Notes
Freshly drawn whole blood specimens may be stored and/or transported at 2°C to 25°C for up to 24 hours before centrifugation. Following centrifugation, remove serum from cells immediately, and transfer serum into screw-capped cryovial tubes.. Serum specimens may be stored and/or transported at 2°C to 8°C for up to 6 days or at -18°C for up to 12 weeks. If more extended storage of serum specimens is required, it must be frozen at -60°C.
Unspun whole blood must be received at Public Health Ontarios Laboratory within 24 hours of collection before 2:00 p.m. Monday Friday.
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Diagnosed With Chronic Hepatitis B What Does Your Hbv Dna Test Tell You
If you have been diagnosed with chronic hepatitis B, your doctor has probably run several blood tests that show if the infection is harming your liver and identify what stage of infection you are in. Doctors consider all of these results when deciding if you need treatment and how often you should be monitored.
In this blog, well examine how one of the tests the HBV DNA or viral load test can give you a snapshot into your hepatitis B infection and your health. The HBV DNA test is performed on a blood sample using a Polymerase Chain Reaction technique that rapidly generates HBV DNA fragments so they can be measured. Today, viral load is usually measured using international units per milliliter . However, in the past it was measured in copies per milliliter , and in some regions and labs, it is still used.
If you ever need to convert copies into international units, there are about 5.6 copies in one international unit, so 5,000 copies/mL equals about 893 IU/mL. Remember to keep copies of your lab information on file so you can track your status. An Excel spreadsheet works great.
The sensitivity of HBV DNA tests may vary with each lab so its a good idea to use the same lab for your test. Labs usually measure down to less than 200 IU/mL. Below the threshold, the viral load is considered undetectable something everyone with chronic hepatitis B wants to hear.
Hepatitis B Titer Test Panelmost Popular
The Hepatitis B Titer Test Panel panel contains 3 tests with 4 biomarkers.
Hepatitis B Titer Test
- Hepatitis B Surface Antigen with Reflex Confirmation
- Hepatitis B Surface Antibody Immunity, Quantitative
- Hepatitis B Core Antibody, Total
The Hepatitis B Titer Test is ordered when a person needs proof of immunity to Hepatitis B or just want to check their immune status.
The Hepatitis Titer Test includes immunity testing for Hepatitis B. Hepatitis is a viral disease which affects the liver. Vaccinations for Hepatitis B can provide protective antibodies which immunize a person from catching the virus. Additionally, a person who has been affected by Hepatitis B and recovers can develop natural immunity. Titer testing looks for the antibodies which typically indicate that a person is immune to a particular virus or infection.
Hepatitis B Immunity
Not Immune and no active or prior infection may be a good candidate for vaccine
- Hepatitis B Surface Antigen = Negative
- Hepatitis B Surface Antibody = Negative
- Hepatitis B Core Antibody, Total = Negative
Immunity due to vaccination
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