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 patientâs 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 personâs ability to spread HBV to others.
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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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.
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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:
-Grossly icteric
-Containing particulate matter
Hepatitis B Surface Antibody Ql Reactive
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Hepatitis B Antibody Reactive Means
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HealthTap doctors are based in the U.S., board certified, and available by text or video.
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.
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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.
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Can Hbsag And Hbsab Be Positive
Both in vitro simulation and in vivo animal models demonstrated that HBsAg antigen and HBsAb of the same serotypes could not coexist, but HBsAg antigen and HBsAb of different serotype could coexist. HBsAg/HBsAb double positive hepatitis B virus infection could be due to infection of viruses of different serotypes.
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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
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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What Is The Difference Between The Hepatitis B Surface Antigen And The Hepatitis B Surface Antibody
The basic blood test for hepatitis B consists of three screening tests: a hepatitis B surface antigen test, which determines whether a person currently has the infection a hepatitis B core antibody test, which determines whether a person has ever been infected and a hepatitis B surface antibody test, which determines
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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Reactivation Risk In Anti
Table 1 American Gastroenterological Association classification of reactivation risk in HBsAg/anti-HBc patients Full size table
The risk of HBV reactivation can be assessed based on positivity for HBV serum biomarkers and the type, duration, combination of agents, and dosing of immunosuppressive or chemotherapeutic agents . HBV reactivation risk can be as high as 4070% in anti-HBc-only, patients who are undergoing chemotherapy with B cell depleting antibodies like rituximab .
Noting that reactivation after immunosuppressive therapy is associated with significant morbidity and mortality, the AGA recommends antiviral prophylaxis for patients classified as at either moderate or high risk for reactivation for low-risk patients, there is no prophylaxis recommendation monitoring is per provider preference but seemingly sufficient . Entecavir and tenofovir prodrugs should be used as first-line prophylaxis or therapy due to their stronger antiviral potency and high threshold for resistance.
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Clinical Information Discusses Physiology Pathophysiology And General Clinical Aspects As They Relate To A Laboratory Test
Hepatitis B e antigen is a small polypeptide that exists in a free form in the serum of individuals during the early phase of hepatitis B infection, soon after hepatitis B surface antigen becomes detectable. Serum levels of both HBeAg and HBsAg rise rapidly during the period of viral replication. The presence of HBeAg in serum correlates with hepatitis B virus infectivity, the number of infectious virions, and the presence of HBV core antigen in the infected hepatocytes.
During recovery from acute hepatitis B, HBeAg level declines and becomes undetectable in the serum, while hepatitis B e antibody appears and becomes detectable in the serum. Anti-HBe usually remains detectable for many years after recovery from acute HBV infection.
In HBV carriers and patients with chronic hepatitis B, positive HBeAg results usually indicate presence of active HBV replication and high infectivity. A negative HBeAg result indicates very minimal or no HBV replication. Positive anti-HBe results usually indicate inactivity of the virus and low infectivity. Positive anti-HBe results in the presence of detectable HBV DNA in serum also indicate active viral replication in these patients.
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Addressing Hepatitis For The First Time
It is crucial that a treatment counselor or health professional use a nonjudgmental and compassionate tone. Clients need to feel comfortable disclosing information about their health and risky behaviors. The following strategies can help initiate the conversation:
- Display posters, literature, or other -related items that could help prompt the client to ask questions about hepatitis. .
- Assess clients ability to discuss , based on their degree of openness in the counseling session, the amount of detail they provide in their responses, and the length of the therapeutic relationship.
- Raise the subject in a way that avoids making clients feel defensive or afraid. Consider introducing the subject by making parallels with other conditions that have been discussed. Say, for example, You said you were tested for HIV several times. Were you ever tested for viral ? or You mentioned that your friend is sick with HIV. Have you been tested for HCV or HIV? Tell me about those tests.
- Be patient and allow time for multiple, short conversations about the subject. This might ease feelings of fear, anxiety, or shame.
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.
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Question 5 What Is The Natural History Of Hepatitis B Surface Antibody During Acute Hepatitis B Infection And Convalescence
HBsAg can be detected in the blood 4 to 10 weeks after exposure. This corresponds to onset of symptoms and viremia detectable by nucleic acid amplification methods. Most hepatitis B infections are self-limited and are associated with disappearance of HBsAg within 4 weeks of onset of symptoms. The anti-HBs then appears and increases to a plateau level that persists indefinitely.2
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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 Is A Hepatitis B Surface Antibody Titer
The hepatitis B surface antibody test , looks for antibodies that your immune system makes in response to the surface protein of the hepatitis B virus. The hepatitis B surface antibody is also referred to as anti-HBs and should not be confused with HBsAg, which stands for hepatitis B surface antigen.
Question 3 How Is The Quantitative Hepatitis B Surface Antibody Test Performed
An immunometric technique is used. The anti-HBs binds to HBsAg ad and ay subtypes, which are coated on the test wells. Binding of a horseradish peroxidase-labeled HBsAg conjugate to the anti-HBs completes the sandwich formation. Unbound materials are then washed away. In the next step, the horseradish peroxidase catalyzes oxidation of a luminogenic substrate, producing light. Light signals are detected and quantified. Intensity of the light is proportional to the amount of anti-HBs present in the patient sample. The result is standardized to an international unit system and reported as milliinternational units per milliliter .
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Question 7 Is Hepatitis B Surface Antibody Antibody Always Acquired After A Completed Vaccination Protocol
No. After three 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
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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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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.