Wednesday, January 25, 2023

How Do You Test For Hepatitis B

What If You Test Positive

Understanding Hepatitis B Serology Results

If a test says you have viral hepatitis, you can take steps to protect the ones you love. For hepatitis A, wash hands frequently. For hepatitis B and C, avoid sharing nail clippers, razors, or toothbrushes. Hepatitis B, and sometimes hepatitis C, can be passed through sexual contact. Make sure everyone in your household gets the hepatitis B vaccine. An important step is to see a specialist to discuss treatment options.

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Detection Of Antiviral Resistance

Lamivudine monotherapy has been reported to be associated with the rapid emergence of antiviral resistance in 15% to 60% of treated individuals . Resistant HBV genomes have mutations in codon 552 within the YMDD motif of the reverse transcriptase/polymerase where a valine or isoleucine replaces the methionine. Resistance is typically clinically manifested by significant elevations in ALT after an initial decline in response to treatment. Prolonged treatment after development of the YMDD mutant is controversial, although improvement in liver pathology with decreased fibrosis may occur with continuation of treatment. Concerns about disease flares after stopping lamivudine have been raised . The development of genotypic resistance can be documented by molecular sequencing or by the INNO-LiPA HBV DR assay , which involves hybridization of amplified HBV-DNA fragments onto specific nucleotide probes that have been immobilized on nitrocellulose strips .

Hepatitis B Profile Test

A Hepatitis B Profile Test, also known as the HBV profile test, is a blood test that determines whether there is an active hepatitis B infection. It may also detect if there was an infection in the past. Hepatitis is a condition characterized by the inflammation and enlargement of the liver. HBV is usually spread by coming in contact with the blood of an infected person. The HBV infections have a varying course range lasting from a mild form that lasts only a few weeks to chronic form, which may last years. The HBV infection may be acute or chronic.

Hepatitis B Profile Test Includes
  • Hepatitis B Envelope Antigen
  • Hepatitis B Surface Antigen
  • Anti Hepatitis B Envelope Antibody -Total
  • Anti-Hepatitis B Surface antibodies
  • Anti Hepatitis B Core Antibody IGM
  • Why is Hepatitis B Profile Test advised?

    The Hepatitis B Profile Test is used for various reasons. It may determine the following, To check whether acute symptoms are because of HBV infection For diagnosing chronic HBV hepatitis To monitor chronic condition of hepatitis B infection and effectiveness of treatment To identify previous exposure to hepatitis B infection To determine if a person is a carrier of the infection during blood transfusion.

    The HBV test detects the level of HBe antigen and antibody and HBV DNA. If HBsAg becomes negative and anti-HBe becomes positive, this shows that treatment is effective. A high result of HBV DNA shows that the virus is actively replicating, and the treatment is not effective.

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    Important Information About Vaccine And Hepatitis B Immunoglobulin Shot Administration

    Where available, the hepatitis B birth-dose and HBIG should be administered within 24 hours of birth in order to prevent the transmission of hepatitis B from mother to child. It is very important that the shots be given in opposite limbs, to ensure the highest effectiveness. Please see chart above for more information.

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    Questions For Your Doctor About Test Results

    Hep B Testing Chart

    Patients may find it helpful to ask questions about their hepatitis B test results. Questions that may be helpful include:

    • What was my test result?
    • Do I have an acute or chronic hepatitis B infection?
    • Does the test result suggest that I have immunity for hepatitis B?
    • Would I benefit from hepatitis B vaccination?
    • Do I need any follow-up tests based on my hepatitis B test results?

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    Is Hepatitis B Curable

    Theres currently no known cure for hepatitis B, but there are many ways you can prevent infection and avoid transmitting the virus to others.

    The most effective and safe way to prevent hepatitis B is to get vaccinated. You can also use barrier methods, like condoms, when having sex and avoid sharing needles.

    For Adults And Children

    This vaccine schedule involves three doses within 2 months, followed by a booster dose at 1 year.

    The initial accelerated doses provide immediate protection from HBV, and the booster dose helps provide long-term protection.

    Below is the accelerated vaccination schedule approved for both adults and children:

    Vaccine series
    2 months after the first dose 1 year after the first dose

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    Possible Side Effects Of Hepatitis B Vaccination

    You may experience minor side effects following vaccination. Most reactions are mild and last no more than a couple of days and you will recover without any problems.

    Common side effects of hepatitis B vaccines include:

    • pain, redness and swelling at injection site
    • occasionally an injection-site lump

    Talk to your vaccination provider about possible side effects of hepatitis B vaccines, or if you or your child have possible side effects that worry you.

    The Consumer Medicine Information available on the Therapeutic Goods Administration website lists the ingredients and side effects of each vaccine.

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    Diagnosis Of Hepatitis B Infection

    What you need to know about Hepatitis B

    Acute hepatitis B is a clinical diagnosis identified by the detection of HBsAg, symptoms, high serum aminotransferases. Usually anti-HBc IgM can be detected and HBV DNA is present. HBeAg can also be identified in most acute phase of infections, but has little clinical importance. The diagnosis of chronic infection is based on the persistence of HBsAg for more than 6 months. Patients with chronic HBV infection are commonly diagnosed by laboratory means but not by clinical presentations. Past HBV infection is defined by the coexistence of anti-HBs and IgG anti-HBc.

    Occult HBV infection is defined by persistence of low level of intrahepatic HBV DNA without detectable HBsAg . It is a serological situation defined by the presence of isolated anti-HBc with the absence of HBsAg and anti-HBs antibody . The detection of HBV DNA in the liver is the gold standard of diagnosis for occult HBV infection, since cccDNA remains in the hepatocytes and HBV DNA is occasionally identified in the liver but not in the serum. However, gaining hepatic HBV DNA is difficult in clinical setting since the procedure is invasive. Real-time PCR for serum HBV DNA detection have been shown with adequate sensitivity to identify occult HBV infection in many cases thus, HBV DNA testing is widely used to diagnose occult HBV infection .

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    Hepatitis B Vaccination Schedule For Children And Infants

    The Centers for Disease Control and Prevention recommends that babies and children receive three 0.5 milliliter doses of either Engerix-B or Recombivax HB, starting just after birth.

    The current recommended hepatitis B vaccine schedule for children and infants is as follows:

    Hepatitis B Vaccination Schedule for Infants and Children
    Hepatitis B Vaccine Dose
    3 618 months old

    If your child is undergoing hemodialysis, your healthcare provider may recommend that they receive additional doses of the HBV vaccine.

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    Hepatitis B Blood Test Panel Includes:

    Anti-Hepatitis B Core Antigen is an antibody to the hepatitis B core antigen. The core antigen is found on virus particles but will disappear early in the course of infection. This antibody is produced during and after an acute HBV infection and is normally found in chronic HBV carriers and those who have cleared the virus, and usually persists for life. Anti-HBc testing is either specific for the IgM antibody, anti-HBc, IgM, which will indicate acute infection, or measures total antibody, anti-HBC, which will indicate a past infection, either acute or chronic.

    The Hepatitis B Surface Antibody is the most common test. Its presence will indicate previous exposure to HBV, but the virus is no longer present and the person cannot pass the virus on to others. The antibody will also protect the body from future HBV infection. In addition to exposure to HBV, these antibodies can also be acquired from successful vaccination. This test is performed to determine the need for vaccination , or following the completion of vaccination against the disease, or following an active infection.

    Hepatitis B Surface Antigen is a protein antigen produced by HBV. This antigen is the earliest indicator of acute hepatitis B and often identifies infected people before symptoms appear. HBsAg will disappear from the blood during the recovery period. In some people , chronic infection with HBV may occur and HBsAg will remain positive.

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    Evaluation Of Individuals Suspected Of Having An Hbv Infection

    Given the perinatal and childhood vaccination programs already in place in North America, most HBV-infected individuals will likely present with chronic infection. Such individuals are likely to have risk factors that include immigration from high endemicity regions, injection drug use or sexual contact with an infected person 1) . Therefore, the present guideline will provide diagnostic recommendations first for individuals suspected of having chronic HBV infection and, subsequently, for those with acute infection. The diagnosis of HBV infection in any individual has important management implications, including appropriate counselling, monitoring and/or treating and vaccinating family or at-risk contacts.

    Concerns About Immunisation Side Effects

    Hepatitis B Foundation: Understanding Your Hepatitis B Test Results

    If the side effect following immunisation is unexpected, persistent or severe, or if you are worried about yourself or your childs condition after a vaccination, see your doctor or immunisation nurse as soon as possible or go directly to a hospital.

    It is important to seek medical advice if you are unwell, as this may be due to other illness, rather than because of the vaccination.

    Immunisation side effects may be reported to SAEFVIC, the Victorian vaccine safety and reporting service. Discuss with your immunisation provider how to report adverse events in other states or territories.

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    What Is Hepatitis D And How Is It Associated With Hepatitis B

    Hepatitis D is another virus that can cause liver infections, but only if hepatitis B is also present. A person may become infected with both viruses at the same time or may first be infected with hepatitis B and then become infected with HDV . In the U.S., the incidence of HDV is low. There is no vaccine for HDV, but since it causes infections only in the presence of HBV, it may be prevented with the HBV vaccine.

    Does Viral Hepatitis Affect Women Differently Than Men

    Yes, certain types of viral hepatitis affect women differently than men.

    Hepatitis A affects women and men in similar ways.

    Hepatitis B affects women differently than men:

    • Birth control. Women with severe liver damage may not be able to use birth control.1 This is because a damaged liver may have problems breaking down estrogen.
    • Pregnancy. The risk of passing hepatitis B to your baby during pregnancy is high. Hepatitis B raises your risk for pregnancy complications.2 Talk to your doctor about taking hepatitis B medicine to lower the risk of passing hepatitis B to your baby. Certain hepatitis B medicines are safe to take during pregnancy but are not recommended for everyone. Learn more about hepatitis B during pregnancy.

    Hepatitis C affects women differently than men:

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    How Common Is Hepatitis B

    One U.S. study following trends in hepatitis B infection over a three-year periodfound that 4.3% of the population had a past or present HBV infection.

    Estimates suggest that about 240 million people around the world have chronic hepatitis B. Up to 1.89 million people in the United States have a chronic HBV infection.

    Treatment For Chronic Hbv Infection

    Hepatitis B: CDC Viral Hepatitis Serology Training

    For chronic HBV infection, antiviral medications are available.

    This is not a cure for chronic HBV. However, it can stop the virus from replicating and prevent its progression into advanced liver disease.

    A person with a chronic HBV infection can develop cirrhosis or liver cancer rapidly and without warning. If a person does not have access to adequate treatment or facilities, liver cancer can be fatal within months of diagnosis.

    People with a chronic HBV infection require ongoing medical evaluation and an ultrasound of the liver

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    What Is Viral Hepatitis

    Hepatitis means inflammation of the liver. The liver is a vital organ that processes nutrients, filters the blood, and fights infections. When the liver is inflamed or damaged, its function can be affected. Heavy alcohol use, toxins, some medications, and certain medical conditions can cause hepatitis. However, hepatitis is often caused by a virus. In the United States, the most common types of viral hepatitis are hepatitis A, hepatitis B, and hepatitis C.

    How Are Hepatitis B And C Diagnosed

    Hepatitis B is diagnosed by a series of blood tests. The test may show an ongoing infection or antibodies that indicate that the patient is protected against hepatitis B. In patients who have a positive screening test that suggests the possibility of ongoing infection, further testing is done to determine the levels of the virus in the bloodstream.

    Hepatitis C is diagnosed via a blood test called a Hepatitis C Antibody Test. A positive result means that hepatitis C antibodies are present in the blood. But a positive antibody test doesnt necessarily mean a person has hepatitis C. A further blood test is needed to confirm the diagnosis. This second blood test quantifies the amount of the virus or the viral load in the liver and the bloodstream.

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    Diagnosis Of Hepatitis B

    Jeong Eun Song, Do Young Kim

    Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea

    Contributions: Conception and design: DY Kim Administrative support: None Provision of study materials or patients: None Collection and assembly of data: None Data analysis and interpretation: None Manuscript writing: All authors Final approval of manuscript: All authors.

    Correspondence to:

    Abstract: Hepatitis B virus infection is a major global health problems leading to severe liver disease such as cirrhosis and hepatocellular carcinoma . HBV is a circular, partly double-stranded DNA virus with various serological markers: hepatitis B surface antigen and anti-HBs, anti-HBc IgM and IgG, and hepatitis B e antigen and anti-HBe. It is transmitted by sexual, parenteral and vertical route. One significant method to diminish the burden of this disease is timely diagnosis of acute, chronic and occult cases of HBV. First step of HBV diagnosis is achieved by using serological markers for detecting antigens and antibodies. In order to verify first step of diagnosis, to quantify viral load and to identify genotypes, quantitative or qualitative molecular tests are used. In this article, the serological and molecular tests for diagnosis of HBV infection will be reviewed.

    Keywords: Hepatitis B virus serology molecular diagnosis

    Submitted Aug 01, 2016. Accepted for publication Aug 28, 2016.

    doi: 10.21037/atm.2016.09.11

    Treatment: Chronic Hepatitis B

    Hepatitis B Foundation: Understanding Your Hepatitis B Test Results

    The goal of treating chronic hepatitis B is to control the virus and keep it from damaging the liver. This begins with regular monitoring for signs of liver disease. Antiviral medications may help, but not everyone can take them or needs to be on medication. Be sure to discuss the risks and benefits of antiviral therapy with your doctor.

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    Hepatitis Cases In Children

    The number of cases of hepatitis in children has increased recently. Public health doctors and scientists are looking into what could be causing this.

    See a GP if your child has symptoms of hepatitis, including yellowing of the eyes and skin .

    Good hygiene, including supervising hand washing in young children, can help to prevent infections that can cause hepatitis.

    How Is Hepatitis B Treated

    There is no specific treatment for acute hepatitis B infections. Symptoms are usually treated with supportive care. This usually involves making sure that you are getting plenty of rest and enough fluids and nutrition by eating and drinking small amounts several times a day.

    Chronic forms of hepatitis B may be treated with antiviral medications such as interferon, entecavir, tenofovir, lamivudine, and adefovir. However, some antiviral drugs can have serious side effects and not all people need to be treated. Often, people with chronic hepatitis will be closely monitored to see if they develop cirrhosis or liver cancer. It is important to talk to your healthcare provider about your treatment options and the risks and benefits of those currently available.

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    Hepatitis B Blood Test Panel

    A Hepatitis B Blood Test Panel includes a Hepatitis B Core Antibody Total , Hepatitis B Surface Antigen , Hepatitis B Surface Antibody .

    CPT Code: See Individual Tests

    Also Known As:

    No fasting required. Stop biotin consumption at least 72 hours prior to the collection.

    Test Results:

    2-3 days. May take longer based on weather, holiday or lab delays.

    CPT Code: See Individual Tests

    Also Known As:

    No fasting required. Stop biotin consumption at least 72 hours prior to the collection.

    Test Results:

    2-3 days. May take longer based on weather, holiday or lab delays.

    Molecular Methods For Hbv Infection

    Hepatitis B Infection with Case â Disorders of the Hepatobiliary Tract | Lecturio

    HBV DNA is a direct measurement of the viral load, which reveals the replication activity of the virus. It is detectable at the early stage of infection and increases up to peak level approximately 3 months after the exposure to HBV and then gradually diminishes in chronic infection or disappears at the recovery from HBV infection.

    As the prevalence of serologically negative HBV infection has increased, HBV-DNA detection has obtained more awareness in clinical medicine . The detection of HBV DNA is a reliable marker of replication activity, and higher titers of HBV DNA are related to the more rapid disease progression and higher incidence of HCC . Furthermore, HBV DNA testing is useful in routine clinical setting to determine patients who need antiviral therapy and monitor them for suitable treatment .

    There are two principles of techniques to identify and quantify HBV DNA: signal amplification such as hybrid capture and branched DNA technology target amplification such as polymerase chain reaction . Real-time PCR can detect wide dynamic range of viral load . For this reason, it has come to be the standard method to detect and quantify HBV DNA in clinical setting. Furthermore, it can be fully automated and does not generate carry-over contamination . Table 1 displays the comparison of assays for quantitative measurement of HBV DNA.

    Table 1

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