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Test ID: CHSBP Chronic Hepatitis Profile (Type B), Serum

Reporting Name

Chronic Hepatitis Profile (Type B)

Useful For

Evaluating patients with suspected or confirmed chronic hepatitis B

 

Monitoring hepatitis B viral infectivity

Profile Information

Test ID Reporting Name Available Separately Always Performed
HBAG HBs Antigen, S Yes Yes
EAG Hepatitis Be Ag, S Yes Yes
HEAB HBe Antibody, S Yes Yes

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
HBGNT HBs Antigen Confirmation, S No No

Testing Algorithm

If hepatitis B surface antigen (HBsAg) is reactive, then HBsAg confirmation will be performed at an additional charge.

 

See HBV Infection-Diagnostic Approach and Management Algorithm in Special Instructions.

Specimen Type

Serum SST


Necessary Information


1. Date of collection is required.

2. Indicate "Type B"



Specimen Required


Patient Preparation: For 24 hours before specimen collection do not take multivitamins or dietary supplements containing biotin (vitamin B7), which is commonly found in hair, skin, and nail supplements and multivitamins.

Collection Container/Tube: Serum gel

Submission Container/Tube: Plastic vial

Specimen Volume: 3.5 mL

Collection Instructions:

1. Centrifuge per collection tube manufacturer's instructions (eg, centrifuge and aliquot within 2 hours of collection for BD Vacutainer tubes).

2. Transfer serum into aliquot tube.


Specimen Minimum Volume

2 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum SST Frozen (preferred) 28 days
  Refrigerated  7 days
  Ambient  24 hours

Reference Values

HEPATITIS B SURFACE ANTIGEN:

Negative

 

HEPATITIS Be ANTIGEN:

Negative

 

HEPATITIS Be ANTIBODY:
Negative

 

Interpretation depends on clinical setting. See Viral Hepatitis Serologic Profiles in Special Instructions.

Day(s) and Time(s) Performed

Monday through Saturday; Varies

CPT Code Information

86707

87340

87350

87341 (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
CHSBP Chronic Hepatitis Profile (Type B) In Process

 

Result ID Test Result Name Result LOINC Value
EAG Hepatitis Be Ag, S 13954-3
HEAB HBe Antibody, S 33463-1
H_BAG HBs Antigen, S 5196-1

Clinical Information

Hepatitis B virus (HBV) is a DNA virus that is endemic throughout the world. The infection is spread primarily through percutaneous contact with infected blood products (eg, blood transfusion and sharing of needles by drug addicts). The virus is also found in virtually every type of human body fluid and is known to be spread through oral and genital contact. HBV can be transmitted from mother to child during delivery through contact with blood and vaginal secretions; it is not commonly transmitted transplacentally.

 

After a course of acute illness, HBV persists in approximately 10% of patients. Some of these carriers are asymptomatic; others develop chronic liver disease including cirrhosis and hepatocellular carcinoma.

 

The following are available in Special Instructions:

-HBV Infection-Diagnostic Approach and Management Algorithm

-Viral Hepatitis Serologic Profiles

Interpretation

Hepatitis B surface antigen (HBsAg) is the first serologic marker appearing in the serum 6 to 16 weeks following hepatitis B viral (HBV) infection. In acute cases, HBsAg usually disappears 1 to 2 months after the onset of symptoms. Persistence of HBsAg for more than 6 months indicates development of either chronic carrier state or chronic liver disease.

 

Hepatitis B surface antibody (anti-HBs) appears with the resolution of HBV infection after the disappearance of HBsAg. Anti-HBs also appears as the immune response following a course of inoculation with the hepatitis B vaccine.

 

Hepatitis B core antibody (anti-HBc) appears shortly after the onset of symptoms of HBV infection and may be the only serologic marker remaining years after exposure to hepatitis B.

 

The presence of hepatitis Be antigen (HBeAg) correlates with infectivity, the number of viral Dane particles, the presence of core antigen in the nucleus of the hepatocyte, and the presence of viral DNA polymerase in serum. Hepatitis Be antibody (anti-HBe) positivity in a carrier is often associated with chronic asymptomatic infection.

 

If the patient has a sudden exacerbation of disease, consider ordering hepatitis C virus antibody (anti-HCV) and hepatitis delta virus antibody (anti-HDV).

 

If HBsAg converts to negative and patient's condition warrants, consider testing for anti-HBs.

 

If HBsAg is positive, consider testing for anti-HDV.

 

The following are available in Special Instructions:

-HBV Infection-Diagnostic Approach and Management Algorithm

-Viral Hepatitis Serologic Profiles

Clinical Reference

1. Bonino F, Piratvisuth T, Brunetto MR, Liaw YF: Diagnostic markers of chronic hepatitis B infection and disease. Antivir Ther. 2010;15(3):35-44

2. Servoss JC, Friedman LS: Serologic and molecular diagnosis of hepatitis B virus. Clin Liver Dis. 2004 May;8(2):267-281

3. Badur S, Akgun A: Diagnosis of hepatitis B infections and monitoring of treatment. J Clin Virol. 2001 Jun;21(3):229-237

4. LeFebre ML, U.S. Preventive Services Task Force: Screening for hepatitis B virus infection in nonpregnant adolescents and adults: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2014 Jul 1;161(1):58-66. doi:10.7326/M14-1018

5. Jackson K, Locarnini S, Gish R: Diagnostics of hepatitis B virus: Standard of care and investigational. Clin Liver Dis (Hoboken). 2018 Jul;12(1):5-11. doi: 10.1002/cld.729

6. Coffin CS, Zhou K, Terrault NA: New and old biomarkers for diagnosis and management of chronic hepatitis B virus infection. Gastroenterol. 2019;156:355-368. doi: 10.1053/j.gastro.2018.11.037

7. WHO Guidelines Development Group: World Health Organization guidelines on hepatitis B and C testing. World Health Organization; 2017. Accessed September 29, 2020. Available at www.who.int/hepatitis/publications/guidelines-hepatitis-c-b-testing/en/

8. Centers for Disease Control and Prevention. Testing and public health management of persons with chronic hepatitis B virus infection. Accessed April 8, 2020. Available at www.cdc.gov/hepatitis/hbv/testingchronic.htm

Analytic Time

1 day

Method Name

Chemiluminescence Immunoassay

Forms

If not ordering electronically, complete, print, and send a Gastroenterology and Hepatology Client Test Request (T728) with the specimen.

Test Classification

This test has been cleared, approved or is exempt by the U.S. Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.
Mayo Clinic Laboratories | Gastroenterology Catalog Additional Information:

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