Hepatitis B Surface Antigen Test
A hepatitis B surface antigen test shows if youre contagious. A positive result means you have hepatitis B and can spread the virus. A negative result means you dont currently have hepatitis B. This test doesnt distinguish between chronic and acute infection. This test is used together with other hepatitis B tests to determine the .
Hepatitis B Immune Globulin
Hepatitis B immune globulin is prepared from plasma containing high concentrations of anti-HBs and provides short-term protection from infection. Before hepatitis B vaccines were available, HBIG was the only product available for post-exposure prophylaxis. Currently, HBIG, administered in conjunction with hepatitis B vaccine, is recommended for: infants born to HBsAg-positive mothers unvaccinated sexual contacts of a person known or at high risk to be HBsAg-positive and unvaccinated persons with a percutaneous exposure to someone who is known or at high risk to be HBsAg positive. HBIG administration alone is the primary means of protection after exposure to HBV in known nonresponders to hepatitis B vaccination.92
When used for post-exposure prophylaxis, HBIG should be given as soon as possible after exposure, ideally within 12 hours after birth for infants born to HBsAg-positive mothers or within 24 hours after other exposures. Limited data suggest that the efficacy of HBIG is reduced if administered more than 7 days after a percutaneous exposure or 14 days after a sexual exposure.92
J. Peter R. Pelletier MD, FCAP, FASCP, Faisal Mukhtar MBBS, MD, FCAP, FASCP, in, 2020
Mutant Viruses And Chronic Infection
Anti-HBe-positive patients in the reactivated phase of the disease are also referred to as the HBeAg-negative viremic group. Genomic analyses has revealed that such patients carry natural mutants of the virus that have either reduced levels or complete abrogation of HBeAg production. These variants are selected at the time of, or soon after, seroconversion, and become dominant during the reactivation phase. The most common precore mutation is the G1896A substitution, which creates a premature stop codon in the precursor protein from which HBeAg is elaborated. This mutation affects the stem of the encapsidation signal, but leads to stronger base pairing with the A1896 change in genotypes with a T at position 1858 of the precore region, such as B, C, D, and E. The double mutation affecting the core promoter region is thought to result in decreased transcription of the precore mRNA, with a knockon effect on HBeAg production, while pgRNA production remains the same or is even upregulated. It is now apparent that additional mutations in this region may contribute to this phenotype.
Geoffrey M. Dusheiko, in, 2003
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.
The Treatment Programs Role In The Screening Process
Medical staff members at substance abuse treatment programs might assume the primary role for screening individuals for and explaining the screening process and test results. Opioid treatment programs with medical staff members should screen for and C at intake and periodically as indicated. In programs without onsite medical staff, clients may be referred elsewhere for screening with minimal involvement of the substance abuse treatment program.
Regardless of the type of program, counselors should have a basic understanding of the importance of screening, the screening process, and the meaning of the results. Counselors can encourage clients referred for screening to follow through and complete the screening and evaluation process . Clients might feel anxious about being diagnosed with hepatitis, and they might delay or avoid getting screened.
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When Should I Get Hepatitis B Testing
Using hepatitis B tests to screen for HBV is recommended for certain groups that are at an increased risk of infection. Groups that may benefit from hepatitis B screening include:
- Pregnant people
- People born in parts of the world where hepatitis B is more common, including Africa, Asia, Eastern Europe, South America, and parts of the Middle East
- People who didnt receive a hepatitis B vaccine
- HIV-positive people
- Pain in the joints or abdomen
- Loss of appetite, nausea, or vomiting
- Yellowish skin and eyes
Using hepatitis B testing to assess immunity to HBV may be used before or after vaccination. Pre-vaccination testing is not always needed but may be performed if there is a chance that a patient has previously been infected with HBV or has already been vaccinated. Post-vaccination testing is used in certain groups of people who are at an especially elevated risk for HBV infection, including infants born to mothers with a hepatitis B infection.
Hepatitis B Virus Antigens And Antibodies
The Structure of Hepatitis B Virus
The hepatitis B virus is a small DNA virus with unusual features similar to retroviruses, which is a prototype virus of the Hepadnaviridae family. HBV causes acute and chronic hepatitis in humans. The hepatitis B virus consists of an outer lipid envelope and an icosahedral nucleocapsid core composed of protein. The virus is one of the smallest enveloped animal viruses with a virion diameter of 42 nm, and also named Dane particles. Dane particles contains both envelope and core.
The outer envelope contains embedded proteins which are involved in viral binding of susceptible cells. There are three types of proteins: small hepatitis surface proteins, middle hepatitis surface proteins and large hepatitis surface proteins, they are totally composed of hepatitis B surface proteins. The nucleocapsid encloses the viral DNA and a DNA polymerase that has reverse transcriptase activity.
There are three types of Hepatitis B Virus particles in infectious serum by electron microscopy, Dane particles, filamentous particles and spherical particles. Except for Dane particles , there also exist pleomorphic forms, as filamentous particles and spherical particles .
Hepatitis B Virus Antigens
Hepatitis B core antigen-HBcAg
Hepatitis B e antigen-HBeAg
The X gene codes for HBxAg. The product of the X gene is hepatitis B x antigen . It may be involved in carcinogenesis.
Hepatitis B Virus Antibodies
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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 .
What Is Hepatitis B Surface Antibody
When you are exposed to hepatitis B, your body mounts an immune reaction against it as an invader. This happens whether you are exposed due to blood or sexual contact or if you are vaccinated with the hepatitis B vaccine.
The hepatitis B virus has proteins on its surface that cause your immune system to produce antibodies. With the vaccine, the sample contains the protein only and not the virus itself.
The first response your body will make when exposed to hepatitis B is to manufacture hepatitis B IgM antibodies. These early antibodies are produced to fight against several parts of the virus including its core. These antibodies are seen in the initial response, but they eventually fade away.
Your immune system then begins to produce IgG antibodies. It continues to produce these antibodies for the rest of your life. In this way, your immune system is always ready to attack hepatitis B virus when it is exposed to it.
Read Also: How Does A Person Contract Hepatitis
How Common Is Hepatitis B
The number of people who get this disease is down, the CDC says. Rates have dropped from an average of 200,000 per year in the 1980s to around 20,000 in 2016. People between the ages of 20 and 49 are most likely to get it.
About 90% of infants and 25-50% of children between the ages of 1-5 will become chronically infected. In adults, approximately 95% will recover completely and will not go on to have a chronic infection.
As many as 1.2 million people in the U.S. are carriers of the virus.
Antibody Responses During Hepatitis B Viral Infection
Affiliation Department of Mathematics, Virginia Tech, Blacksburg, Virginia, United States of America
Affiliation Theoretical Division, Los Alamos National Laboratory, Los Alamos, New Mexico, United States of America
Affiliation Theoretical Division, Los Alamos National Laboratory, Los Alamos, New Mexico, United States of America
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Vaccine For Hepatitis B
Hepatitis B Vaccine
It takes only a few shots to protect yourself and your loved ones against hepatitis B for a lifetime.
The hepatitis B vaccine is a safe and effective vaccine that is recommended for all infants at birth and for children up to 18 years. The hepatitis B vaccine is also recommended for adults living with diabetes and those at high risk for infection due to their jobs, lifestyle, living situations, or country of birth. Since everyone is at some risk, all adults should seriously consider getting the hepatitis B vaccine for a lifetime protection against a preventable chronic liver disease.
The hepatitis B vaccine is also known as the first anti-cancer vaccine because it prevents hepatitis B, the leading cause of liver cancer worldwide.
You cannot get hepatitis B from the vaccine. All hepatitis B vaccines that have been used since 1986 are made synthetically meaning the hepatitis B vaccines do not contain any blood products. Learn more.
If you have a current HBV infection or have recovered from a past HBV infection, the hepatitis B vaccine series will not benefit you or clear the virus. However, the vaccine can provide a lifetime of protection for loved ones who do not have hepatitis B and get the vaccine as soon as possible. Testing is the only way to know if you or your loved ones have a current infection or have recovered from a past infection.
Hepatitis B Vaccine Recommendations
Three-Dose Hepatitis B Vaccine Schedule
About The Hepatitis B Virus
The hepatitis B virus is a small DNA virus that belongs to the Hepadnaviridae family. Related viruses in this family are also found in woodchucks, ground squirrels, tree squirrels, Peking ducks, and herons.
Structure of the Hepatitis B Virus The hepatitis B virus contains an outer envelope and an inner core.
- The outer envelope of the virus is composed of a surface protein called the hepatitis B surface antigen or “HBsAg”. The HBsAg can be detected by a simple blood test and a positive test result indicates a person is infected with the hepatitis B virus.
- The inner core of the virus is a protein shell referred to as the hepatitis B core antigen or “HBcAg,” which contains the hepatitis B virus DNA and enzymes used in viral replication.
Life Cycle of the Hepatitis B Virus
The hepatitis B virus has a complex life cycle. The virus enters the host liver cell and is transported into the nucleus of the liver cell. Once inside the nucleus, the viral DNA is transformed into a covalently closed circular DNA , which serves as a template for viral replication . New HBV virus is packaged and leaves the liver cell, with the stable viral cccDNA remaining in the nucleus where it can integrate into the DNA of the host liver cell, as well as continue to create new hepatitis B virus. Although the life cycle is not completely understood, parts of this replicative process are error prone, which accounts for different genotypes or genetic codes of the hepatitis B virus.
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Educating Clients About Viral Hepatitis
Clients may believe they know about viral , but their understanding of the disease may not be accurate. It is easy to confuse the three main types of viral , B, and C. Clients may have formed impressions based on limited or incorrect information. Counselors should briefly describe hepatitis A, B, and C, including their prevalence, , and relationship to drug use, as well as to other infections, such as HIV and sexually transmitted diseases. Specific strategies for speaking with clients include:
- Speak clearly and keep the message simple, focused, and brief.
- Use language, examples, and concepts that the client understands.
- Use appropriate visual aids.
- Frame numerical statements in terms that are easy to visualize. Say 5 out of 100 people rather than 5 percent of the population say more than half instead of the majority.
- Repeat the information at different times in different ways. The average client retains only approximately one-third of what he or she is told. Summarize essential points.
- Pay attention to a clients response to the information. For example, if a client stiffens his or her posture, consider saying, I notice that this topic seems to make you uncomfortable. It does for a lot of people. Please tell me what youre feeling right now. Id really like to help you with this.
- Use the opportunity to describe the potential detrimental effects of alcohol and other substance use on the liver of a person who is infected with HCV.
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
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Hepatitis B Vaccine And Surface Antibody Titer Faqs
PLEASE NOTE: This is program specific some programs require 3 Hepatitis B vaccines AND a positive Hepatitis B Surface Antibody titer while others will accept 3 vaccines OR a titer. Please read the information in your CastleBranch account carefully so that you know exactly what you need to meet your programs requirements. If you have any questions, please email and a team member will respond.
Whats The Prognosis For Hepatitis B
Your doctor will know youâve recovered when you no longer have symptoms and blood tests show:
- Your liver is working normally.
- You have hepatitis B surface antibody.
But some people don’t get rid of the infection. If you have it for more than 6 months, youâre whatâs called a carrier, even if you donât have symptoms. This means you can give the disease to someone else through:
- Unprotected sex
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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.