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Hepatitis B Titer – Hep B Surface Antibody Test Results Overview

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What Is A Hepatitis B Surface Antibody Test

Hepatitis B surface antibody test is part of a panel of blood tests to diagnose HBV infection. Hepatitis B surface antibody test determines the presence and quantity of anti-HBs in the blood serum, which can indicate protection from HBV infection.

Hepatitis B disease affects the liver and commonly spreads through body fluids such as blood, semen, and vaginal secretions.

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.

  • HBsAg – A “positive” or “reactive” HBsAg test result means that the person is infected with hepatitis B. This test can detect the actual presence of the hepatitis B virus in your blood. If a person tests positive, then further testing is needed to determine if this is a new acute infection or a chronic hepatitis B infection. A positive HBsAg test result means that you are infected and can spread the hepatitis B virus to others through your blood.
  • anti-HBs or HBsAb – A “positive” or “reactive” anti-HBs test result indicates that a person is protected against the hepatitis B virus. This protection can be the result of receiving the hepatitis B vaccine or successfully recovering from a past hepatitis B infection. This test is not routinely included in blood bank screenings. A positive anti-HBs test result means you are immune and protected against the hepatitis B virus and cannot be infected. You are not infected and cannot spread hepatitis B to others.
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    Explainer: Lab Results And Their Interpretation

    Dear 174, I am incredibly sad to hear about the loss of your husband to HCC. How devastating to you and the entire family. But as Thomas wrote, your blood test results indicate that you are protected from hepatitis B and have developed protective antibodies against any future exposure to this virus. Fortunately for you, even though you were exposed to the hepatitis B virus, you had a strong healthy immune response that was able to fight off an infection. Please stay in touch with us, especially if you have any other questions. And if you have children, hopefully they were vaccinated at birth. Thanks for posting and we all wish you the strength and comfort to endure your grief. Always, Joan

    Hi,I had my first hepatitis B surface antigen test in Feb. 2019 the value was 832 iu/mL. I repeated the test a year later the value: 870 iu/mL. Both are marked red .My most recent AFP-L3% and total AFP test is 1.5, and the virus DNA is not detected .

    What is your interpretation of the results? What is my risk for HCC?


    Hi Thomas,

    Dear ,

    Welcome to the forum and thanks for sharing your result. Its very difficult for anyone to form an accurate picture of your liver from one low res image – there is generally a ultrasonists report giving an interpretation of ALL the pictures of your liver taken together. That is the thing that will really tell you what is happening.

    I hope this helps,

    Thanks for sharing your results.

    Regarding HCC risk:

    Hope this helps,

    MY results of tests:

    Hi ,

    Discusses Conditions That May Cause Diagnostic Confusion Including Improper Specimen Collection And Handling Inappropriate Test Selection And Interfering Substances

    Firstport ®: Women

    Individuals who have received blood component therapies , plasma, or intravenous immunoglobulin infusion) in the previous 3 to 6 months may have false-positive hepatitis B surface antibody results due to passive transfer of anti-HBs present in these products.

    Individuals possessing IgM anti-rubella virus may have falsely high results with the VITROS Anti-HBs quantitative test.

    Anti-HBs levels from past hepatitis B or hepatitis B virus vaccination may fall below detectable levels over time.

    A positive anti-HBs result does not exclude infection by another hepatitis virus.

    Performance characteristics have not been established for the following specimen characteristics:

    -Grossly icteric

    -Grossly lipemic

    -Grossly hemolyzed

    -Containing particulate matter

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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.

    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.

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    Baseline Characteristics Of Enrolled Participants

    Between 1997 and 1999, 2436 newborns who received a full course of primary vaccination were initially recruited in the study cohort, and 1551 participants were followed in 2017. Of the 1551 individuals, 199 individuals with a history of booster vaccination were excluded, and 1352 participants were included in the final analysis. Of the 1352 participants, 616 were male, and the average age of the enrolled participants was 19.3years . All participants completed primary vaccination at day 187.2 after birth, resulting in an average of 18.8 follow-up years.

    Hepatitis B Vaccine And Surface Antibody Titer Faqs

    PLEASE NOTE: This is program specific some programs require 3 Hepatitis B vaccines AND a positive Hepatitis B Surface Antibody titer while others will accept 3 vaccines OR a titer. Please read the information in your CastleBranch account carefully so that you know exactly what you need to meet your programs requirements. If you have any questions, please email and a team member will respond.

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    Ethical Approval And Informed Consent

    This study protocol conformed to the ethical guidelines of the 1975 Declaration of Helsinki and was approved by the Institutional Review Board of Seoul National University Hospital . The requirement for informed consent from subjects was waived because the researchers accessed only deidentified database entries for analytical purposes.

    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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    Definition Of Hcc Occurrence Cirrhosis And Significant Fibrosis

    HCC was diagnosed according to the guidelines of the American Association for the Study of Liver Disease. The presence of cirrhosis was reviewed according to imaging findings of cirrhotic hepatic change and/or clinical criteria indicating portal hypertension, such as the presence of ascites, esophageal or gastric varix, or splenomegaly with thrombocytopenia.

    Hepatic fibrosis was defined using a noninvasive prediction model Fibrosis-4 index. The equation for FIB-4 index is as follows

    FIB-4=age x AST / x 1/2)

    Subjects with FIB-4> 1.45 were regarded as those who have high probability of advanced fibrosis,.

    What Is The Normal Range For Hepatitis B Surface Antibody

    Firstport ®: Women
  • What Is the Normal Range for Hepatitis B Surface Antibody? Center
  • Hepatitis B surface antibodies are measured in blood samples in milli-International Units/milliliter mIU/mL). The ranges for hepatitis B surface antibodies are:

    • Anti-HBs greater than 10-12 mIU/mL: Protected against hepatitis B virus infection, either from vaccination or successful recovery from a previous HBV infection.
    • Anti-HBs less than 5 mIU/mL: Negative for HBV infection, but susceptible and hence requires vaccination.
    • Anti-HBs from 5-12 mIU/mL: Inconclusive results and the test should be repeated.

    However, there is no standardization of these values so it is advisable to check the manufacturers values it is the reason values are mainly reported as positive or negative.

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    Understanding Of Lab Tests Results

    Please visit the site associated with The American Association for Clinical Chemistry for better understanding of tests. There you will find the most detailed and full information regarding lab tests. In “common questions” tab you will find answers on the most common questions.

    In addition, you can use a special form to ask the question. It is useful, if there is no answer on your question on the web site. A laboratory scientist will answer your question. It is a part of voluntary service provided by the American Society for Clinical Laboratory Science.

    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


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    In Vivo Hbv Suppression By Potent Broadly Neutralizing Antibody Bc1187

    To determine whether potent HBV neutralizers from natural controllers can stably suppress HBV viremia in vivo, HBV-carrier mice were treated for 17 d with Bc1.187 antibody . Viremic mice experienced a decrease in circulating HBsAg levels upon treatment with Bc1.187 but not with the isotype control . However, the development of murine anti-human IgG antibodies rapidly altered therapy effectiveness . To overcome or limit ADA production, we generated a chimeric version of Bc1.187 by combining the antibodys variable domains with the murine Ig2a and IgK constant regions. The chimeric Bc1.187 antibody had a serum half-life of 3.9 d in nontransduced wild-type mice , and led to reproducible viremia drops when administrated weekly in HBV-carrier mice . 16 d of treatment with 0.5 mg i.v. injections of c-Bc1.187 every 2 d but not control antibody led to a loss of circulating HBsAg in all mice from day 4 with an average 2.5 log10 fold decrease compared with the set-point . During c-Bc1.187 therapy, serum HBV DNA content was also drastically diminished by an average 2.5 log10 fold and reached the detection limit by day 21 in all but one mouse . HBsAg and HBV viremia were still suppressed for 2 wk after the last antibody injection before rising back to baseline levels . As expected in this model, serum levels of HBe antigen, a surrogate marker for viral replication, remained unchanged during therapy .

    Discusses Physiology Pathophysiology And General Clinical Aspects As They Relate To A Laboratory Test

    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 . Common symptoms include malaise, fever, gastroenteritis, and jaundice . After acute infection, HBV infection becomes chronic in 30% to 90% of infected children younger than 5 years of age and in 5% to 10% of infected individuals age 5 or older. Some of these chronic carriers are asymptomatic, while others progress to chronic liver disease, including cirrhosis and hepatocellular carcinoma.

    Hepatitis B surface antigen is the first serologic marker, appearing in the serum 6 to 16 weeks following HBV infection. In acute cases, HBsAg usually disappears 1 to 2 months after the onset of symptoms with the appearance of hepatitis B surface antibody . Anti-HBs also appears as the immune response following hepatitis B vaccination.

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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.

    Kinetics And Risk Of De Novo Hepatitis B Infection In Hbsagnegative Patients Undergoing Cytotoxic Chemotherapy

    • CheeKin HuiCorrespondenceAddress requests for reprints to: CheeKin Hui, MD, University of Hong Kong, Queen Mary Hospital, Department of Medicine, 102 Pokfulam Road, Hong Kong SAR, China. fax: 2281 84030.Centre For The Study of Liver Diseases, The University of Hong Kong, Hong Kong SAR, ChinaResearch Centre For Infection and Immunity, The University of Hong Kong, Hong Kong SAR, China
    • HaiYing ZhangAffiliationsCentre For The Study of Liver Diseases, The University of Hong Kong, Hong Kong SAR, ChinaResearch Centre For Infection and Immunity, The University of Hong Kong, Hong Kong SAR, China
    • YuiHung YuengAffiliationsCentre For The Study of Liver Diseases, The University of Hong Kong, Hong Kong SAR, ChinaResearch Centre For Infection and Immunity, The University of Hong Kong, Hong Kong SAR, China
    • John M. LukAffiliationsCentre For The Study of Liver Diseases, The University of Hong Kong, Hong Kong SAR, ChinaDepartment of Surgery, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, China
    • George K.K. LauAffiliationsCentre For The Study of Liver Diseases, The University of Hong Kong, Hong Kong SAR, ChinaResearch Centre For Infection and Immunity, The University of Hong Kong, Hong Kong SAR, China

    Background & Aims:Methods:Results:

    Abbreviations used in this paper:

    Lancet.J Hepatol.

    Liver Transpl Surg.Transplantation.Transplantation.Lancet.J Hepatol.

    • Ishitani M.B.
    • Hoofnagle J.H.

    Gastroenterology.Liver Transpl Surg.

    • Soguero C.
    • Uriz J.

    Liver Transpl.


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    Potent Human Broadly Neutralizing Antibodies To Hepatitis B Virus From Natural Controllers

    Disclosures: V. Hehle reported a patent to anti-HBV antibodies and methods of use, pending. M. Beretta reported a patent to anti-HBV antibodies and methods of use, pending. M. Bourgine reported a patent to anti-HBV antibodies and methods of use, pending. M. Ait-Goughoulte reported a patent planned on the antibodies pending, “Roche.” S. Pol reported personal fees from Gilead, Abbvie, BMS, Janssen, and Roche outside the submitted work. H. Strick-Marchand reported a patent to human neutralizing HBV antibodies and their use thereof, pending. N. Pelletier reported personal fees from Hoffmann-La Roche outside the submitted work in addition, N. Pelletier had a patent planned to be submitted, pending “Roche Innovation Center Basel.” H. Mouquet reported grants from Institut Roche during the conduct of the study in addition, H. Mouquet had a patent to anti-HBV antibodies and methods of use, pending. No other disclosures were reported.

    V. Hehle and M. Beretta contributed equally to this paper.

    H. Strick-Marchand and N. Pelletier contributed equally to this paper.

    J Exp Med

    Study Cohort And Study Design

    Universal HepB immunization in newborns began in 1986 in the community. From then on, a database about the assessment of the immunity efficacy of HepB was established in which data about primary immunization were recorded. Between 1997 and 2001, a CHO-derived HepB with a dosage of 10g/mL was used for the newborns according to the 0, 1, and 6month schedule. In total, 92.9% of individuals maintained positive for anti-HBs in the cross-sectional survey in May 1999. By screening the historical database, participants born between 1997 and 1999 living in seven townships in Zhengding County who completed the full course primary vaccination were enrolled in this study. In the present study, a questionnaire, including name, sex, date of birth, and history of HepB booster vaccination, was completed, and those who underwent a booster dose before this study were excluded from the final analysis. A blood sample was collected from each participant who provided written informed consent, and the serum was isolated aseptically and stored at 20°C until testing.

    Participants who were hepatitis B surface antigen – and hepatitis B core antibody -negative and anti-HBs< 10 mIU/mL were randomly assigned to two groups using the random numbers 1 and 2, receiving a booster dose of HepB derived from either Saccharomyces cerevisiae or CHO . Blood samples were collected 30days after boosting to determine the potential immunological response.

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