Hepatitis B Surface antigen (HBsAg)
- S6037
Rs 435
- Why Get Tested?
Primarily to screen for and diagnose acute or chronic hepatitis B virus (HBV) infection, to detect a previous, resolved hepatitis B infection, or sometimes to guide and monitor treatment - When To Get Tested?
When you have risk factors for HBV infection or when you have signs and symptoms of hepatitis, such as jaundice or unexplained elevated blood levels of alanine aminotransferase (ALT), a liver-associated enzyme; when you have a condition that requires chemotherapy or drugs that suppress your immune system; when you are being treated for HBV or hepatitis C (HCV); when it is unclear whether you have immunity and your healthcare practitioner is considering giving you the hepatitis B vaccine - Sample Type:SERUM (SST or Plain)
- Fasting :NO
- Report Delivery:Same day (if Collected before 12 Noon)
- Components:1 Observations
Tests Detail
| Observations Included |
| Hepatitis B, Surface antigen (HBsAg) * |
| The Test marked with (*) are in our NABL Scope. |
Sample Report
- Also Known As:
HBV Tests Hep B anti-HBs Hepatitis B Surface Antibody HBsAg Hepatitis B Surface Antigen HBeAg Hepat - Formal Name:
Hepatitis B Virus Testing - Sample Instructions:
A blood sample drawn from a vein in your arm - Test Preparation Needed?
None - What Is Being Tested?
Hepatitis B is an infection of the liver caused by the hepatitis B virus (HBV). Hepatitis B blood tests detect viral proteins (antigens), the antibodies that are produced in response to an infection, or detect or evaluate the genetic material (DNA) of the virus. The pattern of test results can identify a person who has a current active infection, was exposed to HBV in the past, or has immunity as a result of vaccination. For details on the various tests, see the table under Common Questions: How is it used? Hepatitis is a condition characterized by inflammation and, sometimes, enlargement of the liver. It has various causes, one of which is infection by a virus. HBV is one of five "hepatitis viruses" identified so far that are known to mainly infect the liver. The other four are hepatitis A, hepatitis C, hepatitis D, and hepatitis E. HBV is spread through contact with blood or other body fluids from an infected person. Exposure can occur, for example, through sharing of needles for IV drug use or through unprotected sex. People who live in or travel to areas of the world where hepatitis B is prevalent are at a greater risk. Mothers who are infected can pass the infection to their babies, usually during or after birth. The virus is not spread through casual contact such as holding hands, coughing or sneezing. However, the virus can survive outside the body for up to seven days, including in dried blood, and can be passed by sharing items such as razors or toothbrushes with an infected person. Effective hepatitis B vaccines have been available in the U.S. since 1981, and beginning in 1991, healthcare providers in the U.S. began vaccinating infants at birth. Still, the Centers for Disease Control and Prevention (CDC) estimates that between 850,000 and 2.2 million people in the U.S. are chronically infected with the virus, most of whom are not aware that they are infected. The course of HBV infections can vary from a mild form that lasts only a few weeks to a more - How Is It Used?
The main uses for hepatitis B virus (HBV) tests include: To determine whether acute signs and symptoms, such as jaundice, fever and fatigue, are due to hepatitis B infection; two tests, hepatitis B surface Ag and hepatitis B core antibody IgM, may be performed as part of an acute viral hepatitis panel along with tests for hepatitis A (HAV) and hepatitis C (HCV) to determine which virus may be causing the infection. To diagnose chronic HBV hepatitis To monitor chronic hepatitis B infection and its treatment To detect a previous, resolved hepatitis B infection, in a person who is immune compromised (when the virus can become reactivated) or who has hepatitis C and in whom treatment is planned Some of the secondary reasons to perform testing include: to screen for hepatitis B infection in at-risk populations or in blood donors, to determine if someone is a carrier, to detect a resolved infection, and to determine if immunity has developed due to vaccination. Generally, one set of tests is used as an initial panel of tests to detect HBV infection or to determine the cause of acute symptoms while another set of tests may be used after a diagnosis is made to monitor possible progression of the disease, to detect chronic infection, and/or to determine carrier status. The following table summarizes the set of tests typically used for initial testing: Test Description Use and Comments Hepatitis B surface antigen (HBsAG) Detects protein that is present on the surface of the virus To screen for, detect, and help diagnose acute and chronic HBV infections; earliest routine indicator of acute hepatitis B and frequently identifies infected people before symptoms appear; undetectable in the blood during the recovery period; it is the primary way of identifying those with chronic infections, including "HBV carrier" state. Hepatitis B surface antibody (anti-HBs) Detects antibody produced in response to HBV surface antigen Used to detect previous exposure to - When Is It Ordered
Hepatitis B tests may be ordered when someone has signs and symptoms associated with acute hepatitis to determine if they are due to infection with HBV. Some of these include: Fever Fatigue Loss of appetite Nausea, vomiting Abdominal pain Dark urine Pale stools Joint pain Jaundice Hepatitis B tests may be done as follow up when routine tests results such as ALT and/or AST are elevated. Sometimes acute forms of hepatitis may be detected this way since they may cause only mild symptoms that can be confused with the flu. Chronic hepatitis more often has no symptoms and is more commonly detected when routine test results are abnormal. A test for hepatitis B surface antigen (HBsAg) may be used for screening when someone falls into one of the high-risk categories for chronic hepatitis B. Joint guidelines from the Centers for Disease Control and Prevention (CDC) and American College of Physicians were published in December 2017 and recommend the following groups be tested for HBsAg: People born in areas of the world that have a greater than 2% prevalence of HbsAg (for example, much of Asia and Africa) People born in the U.S. but who were not vaccinated and whose parents are from an area with greater than 8% prevalence of HbsAg Men who have sex with men People who have elevated liver enzymes (ALT and AST) with no known cause People with certain medical conditions that require that their immune system be suppressed, such as organ transplant recipients People with end-stage kidney disease Pregnant women Infants born to women with hepatitis B infection People who live with a person with hepatitis B infection (household contact) or who have sexual partners with HBV Those infected with HIV or HCV Individuals living in correctional facilities People who inject drugs People who donate blood, plasma, tissue, organs or semen When hepatitis B tests are used to monitor people with chronic hepa - What Does The Test Result Mean?
The tests for hepatitis B may be ordered individually but are often ordered in some combination, depending on the reason for testing. Results of the tests are typically evaluated together. Sometimes the meaning of one result depends on the result of another test. However, not all tests are performed for all people. The table below summarizes possible interpretations of some common patterns of results. Initial Tests Follow-up Tests Hep B surface antigen (HBsAg) Hep B surface antibody (Anti-HBs) Hep B core antibody Total (Anti-HBc IgG+IgM) Hep B core antibody (Anti-HBc IgM) Hep B e antigen (HBeAg)* Hep B e antibody (Anti-HBe) HBV DNA Possible Interpretation / Stage of Infection Negative Negative Negative Negative Not performed Not performed Not performed No active or prior infection; not immune — may be good candidate for vaccine; possibly in the incubation stage Negative Positive Negative Not performed Not performed Not performed Not performed Immunity due to vaccination Negative Positive Positive Not performed Not performed Not performed Not performed Infection resolved; virus can reactivate if immune system suppressed Positive Negative Positive or Negative Positive Positive or negative Negative Detected Acute infection, usually with symptoms; contagious; could also be flare of chronic infection Negative Negative Positive Positive Negative* Positive None detected Acute infection is resolving (convalescent) Positive Negative Positive Negative Positive* or Negative Negative or Positive Detected Usually indicates an active chronic infection (liver damage likely) Positive Negative Positive Negative Negative Positive None detected or detected at very low level Chronic infection but low risk of liver damage — carrier state *Note: There are some types (strains) of HBV that do not make e-antigen. In areas where these strains of HBV are common (in the Middle East and Asia), testing for HBeAg is not - Is There Anything Else I Should Known?
Even if you don't have symptoms, an HBV infection can damage your liver and you can spread the infection to others. For this reason, it is important to get tested if you think you have been exposed to HBV. Blood banks screen all donated blood for the hepatitis B virus (HBV DNA), hepatitis B surface antigen (HbSAg), and hepatitis B core antibody (anti-HBc). Donors are notified of any confirmed positive reactions. People who receive a notice regarding possible infection with hepatitis B after donating should visit their healthcare provider for further testing. The healthcare practitioner will order additional tests to make a proper diagnosis and determine if treatment is necessary. If exposed to HBV and you haven't been vaccinated, an infection can be avoided by getting a shot of hepatitis B immune globulin (HBIG) within 24 hours and typically you will also be given the first dose of the hepatitis B vaccine. A test is available to determine the specific type (strain) of hepatitis B virus that is causing a person's infection. This is called HBV genotyping. However, this testing is currently mainly used in research settings and not for clinical purposes.
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