Hepatitis B Surface Antibody Blood Test
This test is used to determine the status of a persons immunity to the Hepatitis B virus . Immunity is determined by screening for antibodies which provide protection against infection. The results of this test are quantitative.
Hepatitis B is a viral infection of the liver spread through contact with contaminated bodily fluids including blood. Transmission can occur through various types of exposure including sexual contact. It is possible for a pregnant woman to spread the infection to her infant during childbirth. More than half of Hep B infections display no symptoms. When symptoms do occur, the most common are loss of appetite, fatigue, nausea, abdominal pain, jaundice, and dark colored urine. Chronic Hepatitis B infections may lead to the development of Cirrhosis or Liver Cancer.
A person can have immunity to Hepatitis B for several reasons.
1.) They have been vaccinated for Hep B. Vaccinations do not always provide permanent immunity. It is possible for a person to have been vaccinated and lose their immunity over time.
2.) They have been infected with Hep B, recovered, and now have a natural immunity. Because Hepatitis B does not always display symptoms, it is possible for a person to have been exposed and not be aware of it.
A person who wishes to screen for a current Hepatitis B infection may want to order the Hep B Surface Antigen test.
The Hepatitis B Surface Antibody test typically sees results in 1 business day.
When Is It Ordered
Hepatitis B tests may be ordered when someone has signs and symptoms associated with acute hepatitis to determine if they are due to infection with HBV. Some of these include:
- Joint pain
Hepatitis B tests may be done as follow up when routine tests results such as ALT and/or AST are elevated. Sometimes acute forms of hepatitis may be detected this way since they may cause only mild symptoms that can be confused with the flu. Chronic hepatitis more often has no symptoms and is more commonly detected when routine test results are abnormal.
A test for hepatitis B surface antigen may be used for screening when someone falls into one of the high-risk categories for chronic hepatitis B. Joint guidelines from the Centers for Disease Control and Prevention and American College of Physicians were published in December 2017 and recommend the following groups be tested for HBsAg:
When hepatitis B tests are used to monitor people with chronic hepatitis B infections, they may be performed on a regular basis. Hepatitis B surface antigen and hepatitis B e antigen , often along with HBV DNA, are usually measured about every 6 months to a year since, in some people, HBeAg will go away on their own. In those who are being treated for chronic HBV, HBeAg and HBV DNA tests can be used to determine whether the treatment is successful.
Can Any Other Factors Cause Inflammation Of The Liver Other Than Hepatitis
While hepatitis A results in irritation and inflammation of the liver, there are factors other than the HAV that can result in such a condition.
- Liver infection
- Chemicals and toxins
- Immune system problems
Even though hepatitis A causes liver inflammation, the infection is not chronic and there is no permanent damage. The healing is complete and patients enjoy immunity for a lifetime. Very rarely do hepatitis A victims get infected with the disease again.
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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.
Common And Local Adverse Events
HB vaccine is well tolerated. Reactions are generally mild and transient, and include: irritability, headache, fatigue and injection site reactions in 10% or more of recipients.
There is no increase in adverse events when HAHB vaccine is compared with HA vaccine given alone or concomitantly with HB vaccine at a different injection site. When the adult formulation of HAHB vaccine is given to children in the 2 dose schedule, there is no increase in adverse events compared with those occurring after administration of the pediatric formulation of HAHB vaccine.
Reactions are usually mild and transient, and include fever, irritability, restlessness and injection site reactions .
Headache, diarrhea, fever, urticaria, angioedema and injection site reactions may occur.
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Who Is Prone To The Risk Of Hepatitis A Infection
Developing nations that are wanting in standards of hygiene or are notorious for abysmal sanitation are at high risk for the hepatitis A virus.
The risk of hepatitis A is high among those that are exposed to places where the chance of fecal-oral transmission is high. Such places include rehabilitation institutions, daycare centers, prisons, and hospitals. Those working in the waste management area are also prone to the attack of the hepatitis A virus.
Although, hepatitis A cannot spread merely by being in close proximity to someone having the infection, yet the role of hygiene and sanitation in the prevention of hepatitis A cannot be overemphasized.
Discussing Screening Results With Clients
The medical personnel who ordered or arranged the screening test, not counselors, usually explain the results. Hepatitis screening should be part of the intake physical examination in an opioid treatment program, and medical personnel may report the results. However, the client may want to discuss the results with the counselor or ask the counselor questions.
Anxiety might interfere with some clients ability to comprehend or retain information, which might need to be repeated.
Suggestions for conversations with clients when the test results are negative include the following:
- Explain results clearly and simply: So the HCV screening result was negative? This means that, as of 6 months ago, you did not have .
- Emphasize that a negative result to an HCV test does not indicate to and that the client should take precautions to avoid . If a relapse to drug use occurs, advise clients to avoid sharing any drug paraphernalia or equipment. Specify that this includes cookers, cotton, water, needles, syringes, pipes, and straws.
- Emphasize the importance of getting HAV and HBV vaccinations. Provide information about the availability of low- or no-cost vaccinations.
Clients whose screening test results are positive for will need additional tests and examinationsusually with doctors who specialize in diseases of the liver to get accurate diagnoses and to determine their health status and the extent of liver damage. These tests are described in .
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When Should I Get Hepatitis A Testing
Doctors often recommend testing for hepatitis based on a patients medical history, symptoms, and a physical exam.
Most adults with hepatitis A have symptoms that develop around 28 days after infection. Children under six years old rarely have symptoms. Symptoms of hepatitis A include:
- Dark urine
- Diarrhea and stool that is gray- or clay-colored
- Nausea, vomiting, or loss of appetite
- Yellow eyes and skin, also called jaundice
Doctors may recommend hepatitis A testing in patients with symptoms and a known exposure to HAV or an elevated risk of contracting this disease. Factors that increase the risk of exposure to hepatitis A include:
- Travel, especially to Asia, South America, Central America, Africa, and the Middle East
- Using intravenous drugs and the use of illegal drugs
- Living in a nursing home
- Working in industries involving health care, food, or sewage
- Eating raw shellfish, vegetables, and other foods
In patients who develop symptoms of hepatitis A without a known exposure to the virus, doctors may recommend an acute viral hepatitis panel that looks for hepatitis A, hepatitis B, and hepatitis C in the same blood sample.
How To Get Vaccinated Against Hepatitis B
All babies in the UK born on or after 1 August 2017 are given 3 doses of hepatitis B-containing vaccine as part of the NHS routine vaccination schedule. These doses are given at 8, 12 and 16 weeks of age.
Babies at high risk of developing hepatitis B infection from infected mothers are given additional doses of the hepatitis B vaccine at birth, 4 weeks and 1 year of age.
If you think you’re at risk and need the hepatitis B vaccine, ask your GP to vaccinate you, or visit any sexual health or genitourinary medicine clinic.
If your GP or nurse is unable to offer you the hepatitis B vaccine because of a temporary shortage in supply, you may need to wait longer for the vaccine. For more information, read What to do if you have to wait for a dose of hepatitis B vaccine .
If your job places you at risk of hepatitis B infection, it’s your employer’s responsibility to arrange vaccination for you, rather than your GP. Contact your occupational health department.
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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
Persons New To Canada
Health care providers who see persons newly arrived in Canada should review the immunization status and update immunization for these individuals, as necessary. In many countries outside of Canada, HB vaccine is in limited use.
All persons from a country that is endemic for HB should be assessed and vaccinated against HB if not immune and not infected. Individuals born in developing countries are more likely to be carriers of HB, necessitating vaccination of their sexual and household contacts based on review of their serologic test results. HB vaccine is recommended for all household contacts whose families have immigrated to Canada from areas in which there is a high prevalence of HB and who may be exposed to HB carriers through their extended families or when visiting their country of origin.
Children adopted from countries in which there is a high prevalence of HB infection should be screened for HBsAg and, if positive, household or close contacts in the adopting family should be immunized before adoption or as soon as possible thereafter. Adults going to pick-up children from these countries should be vaccinated before departure. Refer to Immunization of Persons New to Canada in Part 3 for additional information.
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Is There Anything Else I Should Know
Even if you don’t have symptoms, an HBV infection can damage your liver and you can spread the infection to others. For this reason, it is important to get tested if you think you have been exposed to HBV.
Blood banks screen all donated blood for the hepatitis B virus , hepatitis B surface antigen , and hepatitis B core antibody . Donors are notified of any confirmed positive reactions. People who receive a notice regarding possible infection with hepatitis B after donating should visit their healthcare provider for further testing. The healthcare practitioner will order additional tests to make a proper diagnosis and determine if treatment is necessary.
If exposed to HBV and you haven’t been vaccinated, an infection can be avoided by getting a shot of hepatitis B immune globulin within 24 hours and typically you will also be given the first dose of the hepatitis B vaccine.
A test is available to determine the specific type of hepatitis B virus that is causing a person’s infection. This is called HBV genotyping. However, this testing is currently mainly used in research settings and not for clinical purposes.
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How It Is Done
The health professional taking a sample of your blood will:
- Wrap an elastic band around your upper arm to stop the flow of blood. This makes the veins below the band larger so it is easier to put a needle into the vein.
- Clean the needle site with alcohol.
- Put the needle into the vein. More than one needle stick may be needed.
- Attach a tube to the needle to fill it with blood.
- Remove the band from your arm when enough blood is collected.
- Apply a gauze pad or cotton ball over the needle site as the needle is removed.
- Put pressure on the site and then put on a bandage.
What Is The Treatment For Hepatitis B Infection
The need for hepatitis B treatment arises only if a person has not been previously vaccinated for the virus. For others, there is no sure shot treatment, but the patient can be given an HBV vaccination and hepatitis B immunoglobulin shot as well. It is important that the immunoglobulin or hepatitis B antibody should be administered within 12 hours of the exposure. This might help in preventing the infection after the initial exposure. If the patient is diagnosed with acute infection, there is no major treatment needed. Drinking plenty of fluids, having proper rest and nutritional food should be sufficient to prevent any future complication. In case of acute infection, the body is doing the job of fighting the infection on its own.
If the patient is suffering from a chronic case of the infection antiviral medications, interferon injections and lastly liver transplant could be the possible option for treatment. An important question arises here is hepatitis B curable? The treatment might not 100% cure the infection, but it reduces the progression of the disease and also prevents it from being transmitted to others.
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What Is Hepatitis A Virus Total Antibody Test
Hepatitis A virus total antibody is a diagnostic examination that looks for the presence of both IgM and IgG antibodies in the blood. Antibodies are produced by the immune system in the body to spot and neutralize the hepatitis A virus.
Detection of IgG antibodies is particularly a serological indication of Hepatitis A infection in the past or points to the use of vaccination. The HAV total antibody test evaluates the presence of both IgG and IgM antibodies without clear-cut distinction in these two types.
What Hepatitis B Immunisation Involves
Full protection involves having 3 injections of the hepatitis B vaccine at the recommended intervals.
Babies born to mothers with hepatitis B infection will be given 6 doses of hepatitis B-containing vaccine to ensure long-lasting protection.
If you’re a healthcare worker or you have kidney failure, you’ll have a follow-up appointment to see if you’ve responded to the vaccine.
If you’ve been vaccinated by your employer’s occupational health service you can request a blood test to see if you’ve responded to the vaccine.
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Can Hepatitis C Be Treated
Yes, since 2010 enormous progress has been made in the treatment of chronic hepatitis C. New therapies called direct-acting antivirals are pills that act on the virus itself to eradicate it from the body, unlike older medicines like interferon injections which work by stimulating an immune response. These new treatments are very effective and can achieve cure rates of over 90%. In most situations now, there is no need for interferon, which was responsible for many of the side effects previously associated with HCV treatment. The new treatment combinations require shorter treatment durations , have reduced side effects and appear to be effective at all stages of the disease.
Because these new therapies are very new, they remain very expensive. As such, drug coverage from both government and private companies may require that your liver disease has progressed to a certain stage before they are willing to cover the cost of these drugs.
Your primary care physician may refer you to a specialist to determine whether you are eligible for treatment. A specialist will help you decide which drug therapy is best for you based on the severity of your liver disease, your virus genotype and whether or not you have been treated in the past.
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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