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 patientÃ¢s vein. After blood is collected, the sample is sent to a laboratory for analysis.
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Cautions Discusses Conditions That May Cause Diagnostic Confusion Including Improper Specimen Collection And Handling Inappropriate Test Selection And Interfering Substances
Positive screen results without need for confirmation testing should be interpreted in conjunction with test results of other hepatitis B virus serologic markers .
Positive hepatitis B surface antigen test results should be reported by the health care provider to the State Department of Health, as required by law in some states.
Individuals, especially neonates and children, who recently received hepatitis B vaccination may have transient positive HBsAg test results because of the large dose of HBsAg used in the vaccine relative to the individualâs body mass.
Performance characteristics have not been established for the following specimen characteristics:
-Containing particulate matter
Preparing Clients For Screening
Once clients are comfortable talking about viral , they might be more willing to undergo screening. However, clients might be anxious about the test itself a reassurance that testing is a simple procedure can help allay these concerns. Many substance use treatment facilities do not offer screening, and clients might need to be referred elsewhere. The following strategies can enhance the discussion of the hepatitis screening process and hepatitis prevention:
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Question 1 What Is The Clinical Indication For Hepatitis B Surface Antibody Quantitation
Hepatitis B surface antibody quantitation is used to determine hepatitis B immune status, ie, to determine if the patient has developed immunity against the hepatitis B virus. Such immunity may develop following exposure to the hepatitis B virus or its vaccine.
Patients at higher risk of exposure to the virus include:
- Infants born to infected mothers
- Sex partners of infected persons
- People with more than 1 sex partner in the last 6 months
- People with a history of sexually transmitted infection
- Men who have sex with men
- Injection drug users
- Household contacts of an infected person
- Healthcare and safety workers who have contact with blood and body fluids
- People who have lived or traveled in an area in which hepatitis B is common
- People who live or work in a prison
Testing is not recommended routinely following vaccination. It is advised only for people whose subsequent clinical management depends on knowledge of their immune status. These people include:
- Chronic hemodialysis patients
- Immunocompromised people, including those with HIV infection, hematopoietic stem-cell transplant recipients, and people receiving chemotherapy
- Infants born to women who test positive for the hepatitis B surface antigen
- Sex partners of people who test positive for the hepatitis B surface antigen
- Healthcare and public safety workers who have contact with blood or body fluids
Antibody To Hepatitis B Surface Antigen
Harvest Order Choice: 90640
Synonyms: Anti-HBs HBs Ab Hepatitis B Post-vaccine screen
Unit: Viral Serology
Useful For: Qualitative and quantitative enzyme immunoassay for the detection of antibody to hepatitis B surface antigen in human serum and EDTA, heparin, or citrated plasma. The assay results may be used as an aid in the determination of susceptibility to hepatitis B virus infection in individuals prior to or following HBV vaccination or where vaccination status is unknown. Assay results may be used with other HBV serological markers for the laboratory diagnosis of HBV disease associated with HBV infection.
Method: Enzyme Immunoassay
Request Form: SRD-1
Container/ Tube: The following tube types and anticoagulants, including those in both glass and plastic tubes, have all been evaluated and found to be acceptable: SST, EDTA, sodium citrate, lithium heparin, and sodium heparin.
Type: Human serum or plasma
Volume: Fill tubes as labeling indicates to avoid improper dilution
Collection Instructions: venipuncture
Storage: Serum/ plasma should remain at room temperature for no longer than eight hours. If assays are not completed within eight hours, serum/plasma should be refrigerated at 2-8C. Specimens may be stored at 2-8C for 7 days. For long-term storage, the specimens should be frozen . Specimen should not be used if they have incurred more than 5 freeze-thaw cycles. Mix specimens thoroughly after thawing.
Reference Interval: Negative, non-reactive
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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.
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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Identifying Patterns Of Risky Behavior
Screening is an opportunity to draw attention to the clients behaviors that put him or her at risk for contracting :
- Ask for the clients perception of his or her risk for having contracted : How likely do you think it is that the test will be positive?
- Listen for and identify behaviors that put the client at risk for contracting , B, and C and HIV, especially unprotected sex and sharing injection drug paraphernalia.
- Assess the clients alcohol consumption.
What Is Hepatitis A
Hepatitis A, also called hep A, is a contagious liver infection caused by the hepatitis A virus. Some people have only a mild illness that lasts a few weeks. Others have more severe problems that can last months. You usually get the disease when you eat or drink something contaminated by poop from a person who has the virus.
The hepatitis A virus usually isnât dangerous. Almost everyone who has it gets better. But because it can take a while to go away, youâll need to take care of yourself in the meantime.
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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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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.
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Treatment Options For Hepatitis B
Acute hepatitis B usually doesnt require treatment. Most people will overcome an acute infection on their own. However, rest and hydration will help you recover.
Antiviral medications are used to treat chronic hepatitis B. These help you fight the virus. They may also reduce the risk of future liver complications.
You may need a liver transplant if hepatitis B has severely damaged your liver. A liver transplant means a surgeon will remove your liver and replace it with a donor liver. Most donor livers come from deceased donors.
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.
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Are Test Results Accurate
While no blood test is accurate all of the time, hepatitis A testing is the standard and accepted method of determining whether or not a person has an active hepatitis A infection or formed immunity.
Although a positive result on an IgM anti-HAV antibody test is considered diagnostic for an acute infection with hepatitis A, this result may be less helpful in patients who arent experiencing symptoms of hepatitis. In patients without symptoms, finding IgM anti-HAV antibodies may reflect a prior hepatitis A infection in which IgM antibodies have remained in the body for longer than usual or an asymptomatic infection.
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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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.
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 Does Hepatitis B Surface Antibody Ql Reactive Mean
If this test is positive or reactive, then your immune system has successfully developed a protective antibody against the hepatitis B virus. This will provide long-term protection against future hepatitis B infection. Someone who is HBsAb+ is not infected and cannot pass the virus to others.
Can reactive hepatitis B be cured?
Most adults with hepatitis B recover fully, even if their signs and symptoms are severe. Infants and children are more likely to develop a chronic hepatitis B infection. A vaccine can prevent hepatitis B, but theres no cure if you have the condition.
What is the normal level for Hep B surface AB?
For hepatitis B surface antibody , a level less than 5 mIU is considered negative, while a level more than 12 mIU is considered protective. Any value between 5 and 12 mIU is indeterminate and should be repeated.
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It means that the test result was positive for the antibody thatwas being tested.
If it is the Hepatitis B surface antibody then it means you havebeen exposed to either the infection of gotten the immunizations.
If it is other antibodies, such as the core or envelope, then itmeans you have been exposed to the infection at some point.
About 90% of adults who catch Hepatitis B get better on theirown so if you are antibody positive in order to know if you stillhave the infection you need to check a surface antigen or do a DNAtest.
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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 2-8Â°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
What Does The Test Measure
To determine if viral hepatitis is caused by the hepatitis A virus, hepatitis A testing looks for certain antibodies. Antibodies are substances made by the immune system in response to infection with a virus such as hepatitis A.
Hepatitis A testing looks for two types of antibodies. Antibodies are part of the bodys protective response to a viral infection, and hepatitis A virus antibodies may be measured by a few different tests:
- Hepatitis A immunoglobulin M antibody test: When a person is first infected with hepatitis A, the body produces IgM anti-HAV antibodies. These antibodies are usually detectable from two weeks after symptoms begin to around six months later.
- Hepatitis A immunoglobulin G antibody test: The IgG anti-HAV antibody test detects IgG antibodies that develop later in the course of the disease. IgG antibodies are detectable in the body for life, providing protection against a future hepatitis A virus infection. The IgG anti-HAV test is used to detect past HAV infections and may occasionally be used to determine if an individual has developed immunity from a previous infection or vaccination.
- Total hepatitis A antibody test: The total HAV antibody test detects both IgM and IgG antibodies and thus is used to identify both current and past infections.
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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
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