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How To Test Hepatitis B

Emergency Intervention Disclosure Act

Understanding Hepatitis B Serology Results

The following information about the Emergency Intervention Disclosure Act is provided for information purposes and guidance only. If there is a conflict between this website and the Emergency Intervention Disclosure Act or the Emergency Intervention Disclosure Regulation, the Act and Regulation prevail.

The Emergency Intervention Disclosure Act permits individuals, to apply to the court for an order to have another person tested for Hepatitis B, Hepatitis C or HIV if they have come into contact with a persons bodily substance in any of the following circumstances:

  • While providing emergency health services.
  • While performing their duties as a fire fighter, emergency medical assistant or police or other peace officer.
  • When they have reason to believe that they have been the victim of an alleged offence under the Criminal Code and have reported the matter to a law enforcement agency.

The purpose of the Testing Order is to provide information to the exposed individual about the test results of the source individual, which may assist the exposed individual and their physician in managing the possible consequences of the exposure. There are strict timelines to the Testing Order process, please review the information below and Frequently Asked Questions section for additional information.

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.

How Is Hepatitis B Transmitted

Hepatitis B is spread in several distinct ways: sexual contact sharing needles, syringes, or other drug-injection equipment or from mother-to-child at birth.

In the United States, in 2018, injection drug use was the most common risk factor reported among people with an acute HBV infection, followed by having multiple sex partners. Less commonly reported risk factors included accidental needle sticks, surgery, transfusions, and household contact with a person with HBV infection. In the United States, healthcare-related transmission of HBV is rare.

Mother-to-child transmission of HBV is especially concerning, because it is preventable. An estimated 25,000 infants are born to mothers diagnosed with HBV each year in the United States, and approximately 1,000 mothers transmit HBV to their infants. Without appropriate medical care and vaccinations, 90% of HBV-infected newborns will develop chronic infection, remaining infected throughout their lives. Up to 25% of people infected at birth will die prematurely of HBV-related causes. For this reason, the standard of care for pregnant women includes an HBV test during each pregnancy so that the appropriate steps can be taken to prevent HBV-positive mothers from transmitting the disease to her infant.

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Are Hepatitis B Tests Accurate

According to the FDA , home tests can help detect health conditions when people do not have symptoms. However, at-home testing should not replace a doctors visit.

Individuals should also purchase tests from companies that collaborate with CLIA-certified labs. This ensures that manufacturers regulate laboratory testing.

The HBF suggests that people get a printed copy of their blood test results so they can discuss them with a doctor and learn more about the condition.

How Autoimmune Hepatitis Is Diagnosed

How Do I Get Tested for Hepatitis B/HBV?

Autoimmune hepatitis is an autoimmune disease that occurs when the bodys immune system attacks the liver by mistake. The exact cause is unknown but believed to be due to a combination of genetic and environmental factors.

There is no one test to diagnose autoimmune hepatitis. The diagnostic process usually involves a physical exam, detailed history, lab tests, imaging studies, and a liver biopsy.

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Specimen Choice Collection And Transport

The specimen of choice for the diagnosis of HBV infection is blood. Serological tests for viral antigens and antibodies are typically used for diagnostic screening and can be performed on either serum or plasma. Both HBV antigens and antibody are stable at room temperature for days, at 4°C for months, and frozen at -20°C to -70°C for many years. Because modern testing involves automated enzyme immunoassays that depend on colourimetic or chemiluminescence signal measurement, care should be taken to avoid hemolysis of the sample because it may interfere with the ability of the assay to accurately detect these markers.

A number of nucleic acid-based tests, which have been the subject of recent reviews , are available to directly detect HBV-DNA in serum or plasma. Care must be taken to avoid the degradation of the viral nucleic acid in the specimen, which can result in falsely low or no measurable viral load. Serum should therefore be removed from clotted blood within 4 h of collection and stored at -20°C to -70°C , and can be subjected to up to eight short-term freeze-thaw cycles without significant loss of detectable HBV-DNA . Alternatively, the presence of EDTA in plasma is known to stabilize viral nucleic acids. EDTA blood can be stored for up to five days at 4°C without affecting the viral load . Polymerase chain reaction-based tests can use either serum or plasma, while hybridization-based assays recommend the use of serum.

How Long After Hepatitis B Exposure Should You Take A Test

People who think they may have come into contact with HBV and who are not vaccinated should contact a doctor within to get post-exposure prophylaxis treatment.

PEP treatment for hepatitis B can consist of the hepatitis B vaccine, an injection of hepatitis B immune globulin, which contains antibodies against HBV, or both.

The HBF states that it can take up to 9 weeks for HBV to show up in the bloodstream. The organization recommends that individuals who have never received PEP treatment get tested 9 weeks after exposure.

If the result is negative, a doctor may recommend the completion of the hepatitis B vaccine series.

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Questions For Your Doctor About Test Results

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?

Can Hepatitis B Be Prevented

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The hepatitis B vaccine is one of the best ways to control the disease. It is safe, effective and widely available. More than one billion doses of the vaccine have been administered globally since 1982. The World Health Organization says the vaccine is 98-100% effective in guarding against the virus. Newborns should be vaccinated.

The disease has also been more widely prevented thanks to:

  • Widespread global adoption of safe blood-handling practices. WHO says 97% of the blood donated around the world is now screened for HBV and other diseases.
  • Safer blood injection practices, using clean needles.
  • Safe-sex practices.

You can help prevent hepatitis B infections by:

  • Practicing safe sex .
  • Never sharing personal care items like toothbrushes or razors.
  • Getting tattoos or piercings only at shops that employ safe hygiene practices.
  • Not sharing needles to use drugs.
  • Asking your healthcare provider for blood tests to determine if you have HBV or if you are immune.

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Should I Be Vaccinated Against Hepatitis B

Individuals at high risk of infection with hepatitis B are recommended to be vaccinated. For example, people working certain occupations, such as among nursing staff. This also applies to police officers, firefighters, and personnel who work in the funeral industry. This vaccination is also sometimes necessary for travel to certain high-risk countries. Additionally, all children should be vaccinated as children are at much higher risk for chronic hepatitis B. The hepatitis B vaccination is a part of the Dutch national vaccination program for children, as in many other countries.

When To Test For Hepatitis B

If you think youve been exposed to hepatitis B, wait 12 weeks before you do a test. In some cases, it can take up to 6 months after sexual contact for the infection to show up in tests. If you’re not sure when you might have been exposed, do a test now, and another test in a few weeks.

Our clinicians can help you work out when to test again once youve placed your order. If youve had the hepatitis B vaccine, you dont need to take a test. The vaccine is very effective.

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Which Serological Assay To Use

A systematic review compared the diagnostic performance of commercially available serological assays for the detection of HBsAg, when compared to a laboratory-based immunoassay reference standard . The review identified 30 studies from 23 countries with varying prevalence of hepatitis B and evaluated 33 different RDTs. There were five studies of eight different EIAs against an immunoassay reference standard . A mixture of serum, plasma, capillary and venous whole blood specimens were used for RDTs, but only serum or plasma was used for EIAs. Seven studies assessed performance using capillary or venous whole blood . Sample size varied from 25 to 3928, and populations studied included healthy volunteers and blood donors, at-risk populations, pregnant women, incarcerated adults, and patients with confirmed hepatitis B.

RDTs. In 30 studies of 33 different RDTs, the pooled clinical sensitivity of RDTs against different EIA reference standards was 90.0% and pooled specificity was 99.5% .

Summary test accuracy of RDTs and EIAs for HBsAg .

Brands: there was significant variation in performance between RDT brands and within the same brand of RDT, with sensitivity ranging from 50% to 100% and specificity from 69% to 100%.

Specimen type: results for capillary whole blood specimens were comparable to serum but less heterogeneous.

What Is The Danger Of Hepatitis B

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Acute hepatitis B is not dangerous for most people, as the liver inflammation resolves itself within six months in 90% of adults . However, chronic hepatitis B can be dangerous, especially if an individual does not know they have it and take appropriate steps to mitigate liver damage. With time, chronic hepatitis B can lead to severe liver inflammation, cirrhosis, liver failure, or liver cancer.

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Whats The Hepatitis B Titer Test Used For

A hepatitis B titer test measures antibodies in your blood to see if youre immune either due to vaccination or previous infection.

Hepatitis B is a viral infection that targets your liver. It can be transmitted by coming into contact with the bodily fluids of an infected person. A person with the virus can also infect their child during birth.

Hepatitis B can develop into a chronic infection. Chronic infection occurs when your body cant fight off the virus within six months. Chronic hepatitis B infections most commonly develop less than six years old, especially in infants.

Hepatitis B titer tests can be used to evaluate:

  • whether a high-risk person is immune to hepatitis B
  • whether hepatitis B immunoglobulin is needed after a needle prick
  • men who have sex with men
  • people born in countries with a hepatitis B prevalence greater than 2 percent
  • people born in the United States not vaccinated as children and with parents born in regions with more than 8 percent hepatitis B prevalence

You may need your titer test results as proof of hepatitis B immunity in order to get into healthcare programs at many schools for example, the nursing program at Lone Star College. In the United States, employers are not allowed to withdraw a job offer if they learn you have hepatitis B.

Interpretation Of Hbv Serologic Tests

The three major tests used for hepatitis B screening are HBsAg, anti-HBs, and anti-HBc. The following summarizes the interpretation of test results with these three serologic tests . The anti-HBc test may consist of a total anti-HBc or an IgM anti-HBc. The IgM anti-HBc has value primarily when considering acute hepatitis B infection. For diagnostic purposes, testing for HBeAg and anti-HBe is usually not performed, since they typically do not provide additional diagnostic information. For persons who are diagnosed with HBV infection, evaluation of HBeAg, anti-HBe, and HBV DNA are all usually performed and monitoring of these labs can be important in persons on treatment for chronic HBV.

  • Immune from Vaccination: All modern HBV vaccines utilize recombinant HBsAg as the primary immunogen. The host serologic response to the vaccine is the development of anti-HBs. The hepatitis B vaccines do not generate an anti-HBc immune response. A positive anti-HBs in conjunction with negative HBsAg and negative anti-HBc indicates immunity as a result of vaccination, whereas a positive titer for both anti-HBs and anti-HBc indicates immunity from past infection with HBV. An anti-HBs titer greater than 10 to 12 mIU/mL correlates with protective immunity.

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What Should You Know About Hepatitis B Before You Travel

Hepatitis B is quite common in China and other Asian countries, where as many as 1 in 12 people have the virus, though many dont know it. Before traveling to those places, you should make sure youve been vaccinated against the virus.

In addition to getting the vaccine, you can take these additional precautions to reduce your risk of contracting the virus:

  • Refrain from taking illegal drugs.
  • Always use latex or polyurethane condoms during sex.
  • Make sure new, sterile needles are used during all piercings, tattoos and acupuncture sessions.
  • Avoid direct contact with blood and bodily fluids.
  • Know the HBV status of all your sexual partners.
  • Ask your doctor about possible vaccination before you travel to a place where hepatitis B is common.

A note from Cleveland Clinic

Hepatitis B is a liver disease that can cause serious damage to your health. One reason that is dangerous is that it can easily go undetected for years while damaging your liver. Talk with your healthcare provider about being tested for hepatitis B if you have any reason to believe that you were not vaccinated or if you have engaged in risky behavior. If you do test positive, follow the directions from your healthcare provider so that you can live a longer, healthier and happier life.

Last reviewed by a Cleveland Clinic medical professional on 07/09/2020.


Is Hepatitis B Curable

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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.

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Prevent Hepatitis B Infections In Newborns

If you are pregnant and have hepatitis B, talk with your doctor about lowering the risk that the infection will spread to your baby. Your doctor will check your virus levels during pregnancy. If virus levels are high, your doctor may recommend treatment during pregnancy to lower virus levels and reduce the chance that hepatitis B will spread to your baby. Your doctor may refer you to a liver specialist to find out if you need hepatitis B treatment and to check for liver damage.

When it is time to give birth, tell the doctor and staff who deliver your baby that you have hepatitis B. A health care professional should give your baby the hepatitis B vaccine and HBIG right after birth. The vaccine and HBIG will greatly reduce the chance of your baby getting the infection.

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When Should People Contact A Doctor

People should contact a doctor if they have symptoms of hepatitis B. They should also seek medical help if they want to purchase a hepatitis B test, as doctors can help them choose the right test for their condition.

A doctors consultation may also be beneficial to discuss test results. A medical professional may provide a treatment plan or further testing, depending on the persons condition and test results.

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Ashley Flanders Bcba Clinical Director

Hi there! Im Ashley Flanders, a BCBA and Clinical Director of the South Austin clinic. Im originally from Georgia, but after learning more about ABA, we moved to Texas so I could pursue a M.Ed in Special Education at University of Texas. Ive worked with both adults and children, and in many different settings. I have a passion for working with learners with limited communication, as well as those focusing on daily living skills. When Im not at the clinic, I enjoy gardening, playing video games, reading, and spending time with my husband and 2 cats.

I firmly believe that our job is to provide learners with the tools to carve their own path with, and the support they need to help them discover who they want to be. Our team creates opportunities for learning with the use of learner led therapy and their natural interests. A learners strengths are found in what makes them unique, and we foster an environment that embraces those differences while teaching them essential skills. Im very thankful for all the insight our learners have given me, and know they will continue to touch lives.

When I look at you, and you look at me, I wonder what wonderful things you will be.

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