Tuesday, April 23, 2024

Hepatitis B Titer Quest Diagnostics

Question 2 What Is The Hepatitis B Surface Antibody

Understanding Hepatitis B Serology Results

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.

Scientific Tools And Resources

Interpretation of Hepatitis B Serologic Test Results

One page Summary Table describes the four most common tests used in hepatitis B serologic testing and provides guidance to interpret different patterns of test results.

Screening and Referral Algorithm for Hepatitis B Virus Infection among Pregnant Women

This is a clinical algorithm for screening and referral of pregnant women who are HBsAg-positive.

N/A=not available

*This CPT code corresponds only to the HBsAg screening component additional CPT codes might be associated with other component tests.

Notes: CDC recommends healthcare providers use prenatal HBsAg tests for pregnant women, which allows for reporting of positive results along with pregnancy status to public health jurisdictions. Refer all HBsAg positive pregnant women to Perinatal Hepatitis B Prevention Program coordinators for case management of mother and infant: .

Laboratories reserve the right to add, modify, or stop performing tests at any time providers should review any test notifications from laboratories for changes.

What Do The Results Mean

A hepatitis B blood panel consists of three tests that can be done with just one blood sample:

  • Hepatitis B surface antigen . A positive test indicates that youre infected with hepatitis B and that you can spread it to other people. Further tests are needed to see if you have an acute or chronic infection.
  • Hepatitis B core antibody . A positive result can indicate a past or current hepatitis B infection, but doesnt mean youre immune. A positive result needs to be interpreted by a doctor by examining the results of the other two tests.
  • Hepatitis B surface antibody . A positive test indicates that youre protected from hepatitis B either through previous infection or vaccination .

The combination of these tests can indicate your hepatitis B status and whether you need to be vaccinated. Your test will give a negative or positive result for each category depending on whether your results are above or below the cutoff value.

Most peoples test results fall into the following categories. But its possible to have a result that doesnt fall into one of these groups. If youre reading your results yourself, be careful not to confuse HBsAb with HBcAb.


is associated with hepatitis B immunity after vaccination. But research has found that anti-HBs decline over time.

A found that more than 95 percent of people had anti-HBs levels greater than 10IU/L two years after vaccination. But this rate decreased to 70 percent after eight years.

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Whats The Procedure For A Hepatitis B Titer Test

A hepatitis titer test requires a healthcare professional to draw a small amount of blood for testing.

No special preparation is needed beforehand. If needles or the sight of blood make you anxious, you may want to arrange a drive ahead of time in case you feel faint.

Heres what will typically happen during this test:

  • The person administering the test ties a band around your arm to make your veins easier to find.
  • The person sterilizes the injection site and inserts a small needle into your vein. You may feel a sharp pain, but it should quickly pass.
  • After the needle is removed, the test administrator asks you to apply a gentle pressure with a gauze or a cotton ball.
  • A bandage is applied to the area, and youre free to leave.
  • Home tests that require a fingerpick are also available. The results of your tests are generally available within 3 days.

    Blood Tests And Diagnosis For Hepatitis B

    Pin on Titer Test

    Hepatitis B is diagnosed with a simple blood test that can be done at your doctors office or local health clinic. There are 3 parts to the hepatitis B panel of blood tests, so understanding your test results can be confusing. Are you infected with hepatitis B? Are you protected from hepatitis B because you were vaccinated or have recovered from a past infection? Are you at risk of being infected with hepatitis B? It is very important to understand your hepatitis B blood test results so that you receive the right kind of care and follow-up.

    The hepatitis B blood test requires only one sample of blood and your health care provider should order the Hepatitis B Panel, which includes three parts. You and your health care provider will need to know all three test results in order to fully understand whether you are infected, protected or still at risk for a hepatitis B infection. Your health care provider may ask to check your blood again in six months after your first visit to confirm your hepatitis B status. Remember to ask for a copy of your hepatitis B blood test results so that you fully understand which tests are positive or negative.

    Read Also: Best Medicine For Hepatitis C

    Who Is At Risk For Hepatitis B

    Anyone can contract hepatitis B. However, certain groups are at greater risk. According to the CDC, the following groups are at highest risk for contracting hepatitis B:

    • Infants born to infected mothers
    • People who inject drugs or share needles
    • Sexual partners of people infected with hepatitis B
    • Men who have sex with men
    • People living in close proximity to a person with hepatitis B
    • Health care workers or others exposed to blood in their work environments
    • Hemodialysis patients

    Role Of Clinicians And Health Departments

    Clinicians and Health Departments also play a critical role in laboratory reporting of pregnancy status for Hepatitis B-positive women.


    • Select a test designated as prenatal or on a prenatal/obstetric panel when ordering an HBsAg screening test for a pregnant woman to help ensure confirmatory testing is performed on all positive HBsAg screens.
    • Inform selected laboratory of a womans pregnancy status to ensure confirmatory testing is performed on all positive HBsAg screens.
    • Include any and all ICD-10 diagnosis codes indicating current or recent pregnancy when ordering HBsAg tests.

    Screening and Referral Algorithm for Hepatitis B Virus Infection among Pregnant Women

    This is a clinical algorithm for screening and referral of pregnant women who are HBsAg-positive. Tool pdf icon

    Health Departments:

    • Be aware of how laboratories reporting to your jurisdiction are reporting pregnancy information .
    • Pull these prenatal indicators from both paper-based and electronic laboratory reporting reports.
    • Ensure prenatal indicators are shared with your Perinatal Hepatitis B Prevention Program Coordinators.

    Please contact for prenatal indicator information for ARUP Laboratories, LabCorp, Mayo Medical Laboratories, and Quest Diagnostics.

    Also Check: How Can You Contact Hepatitis C

    Who Is Getting Tested *

    Currently you cannot combine this test with other tests. Because of this, you cannot buy this test unless you update your cart.

    Currently you can only purchase testing for one person in one cart checkout. Or product cannot be purchased because you do not meet the age, gender, or location requirements to purchase the test.

    Because of this, you cannot buy this test unless you update your cart or account setting.

    This product contains duplicate test components to items in your cart. You are already covered by a test that you have in the cart.

    Additionally, COVID-19 tests cannot be combined with other tests at this time.

    Please update your cart before you try again.

    Based on your response, this test is not right for you or not available.

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    Must be 18+ years of age to purchase

    Orders not permitted in: AK, HI, AZ


    How Much Does A Hepatitis B Titer Test Cost

    Hepatitis B: CDC Viral Hepatitis Serology Training

    The cost of a hepatitis B test varies based on where you get the test. Prices range from roughly $24 to $110.

    Your insurance may cover some or all of the cost. Under the Affordable Care Act, all new health plans must cover preventative services including hepatitis B vaccination and testing without a deductible or copay.

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    Chicken Pox Immunity Screen

    Chickenpox is a disease caused by the varicella-zoster virus. It is highly contagious and is most often characterized by a red rash that covers the body within a few weeks of infection. Because of the introduction of a chickenpox vaccine, the disease is now considered rare. For information on vaccination, contact your medical provider or visit the CDC or Arizona Department of Health Services websites.

    What Are My Next Steps Once I Get My Results

    It can be difficult to understand what the results of your test mean. A healthcare provider can help you interpret your results and decide whether you need to take further action:

    • If your results suggest that youre already immune to hepatitis B and arent contagious, you likely wont need to do anything.
    • If your results suggest that youre not immune, a doctor may recommend vaccination, especially if youre somebody whos at a high risk of infection.

    You may also need additional testing if more information is needed to interpret your results.

    Also Check: What R The Symptoms Of Hepatitis A

    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


  • Centers for Disease Control and Prevention. Hepatitis B. . Accessed May 30, 2013.
  • Ganem D, Prince AM. Hepatitis B virus infectionnatural history and clinical consequences. N Engl J Med. 2004 350:1118-1129.
  • 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

    Question 5 What Is The Natural History Of Hepatitis B Surface Antibody During Acute Hepatitis B Infection And Convalescence

    Renal Health Care

    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

    Recommended Reading: Hepatitis C Contagious Through Urine

    Where Can I Find A Hepatitis Titer Test Near Me

    Check our lab finder to locate a collection site in your area.

    Note: Result turn around times are an estimate and are not guaranteed. Our reference lab may need additional time due to weather, holidays, confirmation/repeat testing, or equipment maintenance.


    It may take 6-8 weeks after vaccination for titer tests to be accurate.

    It is recommended that someone taking Biotin stop consumption at least 72 hours prior to the collection of a sample.


    • Hepatitis B Surface Antigen
    • Hepatitis B Core Antibody

    The Hep B Surface Antibody provides numerical results for the antibody level. A positive Surface Antibody typically means that a person has immunity to Hep B. The Hep B Core Antibody will typically be detectable if a person has ever had a Hep B infection. A positive Core Ab with a Positive Surface Ab may mean that a person has a natural immunity due to a previous infection and recovery. The Hepatitis B Surface Antigen is typically used to detect if a person has a current Hep B infection. A positive Hep B Surface Antigen test should be followed up with a doctor.

    The Hepatitis Titer Test can be ordered when a person needs proof of immunity to Hep A and B or just want to check their immune status.

    For additional testing, please see our Titer Category.

    Turnaround is typically 1-3 business days.

    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.

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    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 .

    Find A Quest Lab Near Me

    Hepatitis B Virus: Serology

    Who needs a titer?

    Students in many healthcare programs and clinicians and reps often need to show proof their vaccines have effectively worked and they have immunity to the diseases they may be exposed to in student clinicals or work settings. We are a local business having been in Stafford since 2006 and have provided vaccines, TB testing, Drug testing and titer testing to thousands of individuals in that time. We are recognized by many vendor credentialing services like Castle Branch, Vendormate, Intellicentrics, symplr, Vendormate, Parallon, RepTrax and more.

    There are many titers but, we perform Quantitative titers that display numerical values which is what the schools and employment places require. The results measure the presence and amount of antibodies in blood.

    Most healthcare programs, colleges and universities require students to provide proof that they are up to date on their vaccinations before they can enroll. You may not be able to show proof due to unfortunate events like floods, fires, lost records, etc. So, then a titer is a low cost way and faster alternative to re-immunizing all over again and provides record of immunity.

    If you never had the vaccine to prevent the disease nor had the disease itself you should not waste money on a titer for that disease but, vaccinate.

    When do I get my results?

    What do titers cost?

    We accept payments via Paypal .

    Do I have to pay more at the lab?No. The lab will simply draw your blood.

    How do I get started?

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    How Can I Help Stop The Spread Of Hepatitis B Virus From Mother To Child

    The Problem: Although an estimated 95% of pregnant women receive prenatal hepatitis B surface antigen testing, fewer than half of the expected births to HBsAg-positive women are identified. Laboratory reports are required to include gender and age/date of birth, but pregnancy status is not typically reported to health departments.

    The Solution: All laboratories providing HBsAg-testing services should be encouraged to capture pregnancy status for women tested for HBsAg to aid in identification of HBV-infected pregnant women.

    Results And Next Steps

    The results of a hepatitis B titer panel can help a doctor determine a persons hepatitis B status. The results can be confusing if a person has never been through this type of testing before, but the doctor can explain the findings.

    The results for the titer come back as either negative or positive on each subtest of the panel. Positive means that the virus or antibodies showed up on the test, while negative means that they did not.

    The following table outlines what positive and negative results mean on different parts of the test and the possible next steps.

    The information comes from the Immunization Action Coalition:


    Recommended Reading: Hepatitis C Symptoms In Females

    Quantitative Hepatitis B Test From Quest Diagnostics May Improve Treatment In Us

    NEW YORK Quest Diagnostics has launched a new laboratory-developed assay to quantify hepatitis B surface antigen . Although quantitative HBsAg tests are widely used outside of the US, the test is the first to be offered stateside, potentially improving decision making for US physicians treating chronic HBV.

    Hepatitis B virus infection, which affects up to 2.2 million people in the US, is typically detected and tracked in three ways: using viral DNA and two different viral surface proteins HBsAg, and a surface protein called “e antigen,” or HBeAg.

    Hepatitis B DNA levels have been used as the major marker for monitoring efficacy of therapy, said Rick Pesano, vice-president of research and development at Quest Diagnostics.

    But the DNA measurement estimates viral replication, while quantitative surface antigen testing, on the other hand, can reflect the amount and transcriptional activity of covalently closed circular DNA, or cccDNA, inside liver cells, Pesano said, which can be particularly useful in chronic infections.

    The Quest HBsAg test is essentially an immunoassay, Pesano said, or an immunometric test. It is a straightforward assay using horseradish peroxidase and a fluorescent marker, with levels of light emission correlated with the quantity of antigen present.

    On the other hand, there is stronger evidence for stopping goals using quantified HBsAg, Pesano said, and the Quest test could be useful in this case.

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