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Test ID: CORAB Hepatitis B Core Total Antibodies, with Reflex to Hepatitis B Core Antibody IgM, Serum

Reporting Name

HBc Total Ab, w/Reflex, S

Useful For

Detection and differentiation between recent and past/resolved or chronic hepatitis B viral (HBV) infection

 

Diagnosis of recent HBV infection during the "window period" when both hepatitis B surface antigen (HBsAg) and antibodies to HBsAg are negative

 

This test is not useful for determining immunity to or recovery from hepatitis B viral (HBV) infection.

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
HBIM HBc IgM Ab, S Yes No

Testing Algorithm

If hepatitis B core (HBc) total antibodies is positive, then HBc IgM is performed at an additional charge.

Specimen Type

Serum SST


Necessary Information


Date of draw is required.



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: 1 mL

Collection Instructions: Centrifuge and aliquot serum into plastic vial within 24 hours.


Specimen Minimum Volume

0.4 mL

Specimen Stability Information

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

Special Instructions

Reference Values

Negative

Interpretation depends on clinical setting.

See Viral Hepatitis Serologic Profiles in Special Instructions.

Day(s) and Time(s) Performed

Monday through Saturday; Varies

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.

CPT Code Information

86704

86705 (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
CORAB HBc Total Ab, w/Reflex, S 13952-7

 

Result ID Test Result Name Result LOINC Value
CORAB HBc Total Ab, w/Reflex, S 13952-7

Clinical Information

During the course of a typical case of acute hepatitis B viral (HBV) infection, IgM antibodies to hepatitis B core antigen (anti-HBc IgM) are present in the serum shortly before clinical symptoms appear. Anti-HBc total is detectable during the prodromal, acute, and early convalescent phases when it exists as immunoglobulin M (IgM) anti-HBc. Anti-HBc IgM rises in level and is present during the core window period, ie, after hepatitis B surface antigen disappears and before antibodies to hepatitis B surface antigen appear. Anti-HBc total may be the only serologic marker remaining years after exposure to HBV.

Interpretation

Positive antibodies to hepatitis B core antigen (anti-HBc) total result may indicate recent, past/resolved, or chronic hepatitis B viral (HBV) infection.

 

Testing for anti-HBc IgM (HBIM / Hepatitis B Core Antibody, IgM, Serum) is necessary to confirm the presence of acute or recent hepatitis B. A positive anti-HBc total result with a negative anti-HBc IgM result indicates past or chronic HBV infection. Differentiation between past/resolved and chronic hepatitis B can be based on the presence of hepatitis B surface antigen (HBsAg) in the latter condition.

 

Negative anti-HBc total results indicate the absence of recent, past/resolved, or chronic hepatitis B. An inconclusive result for HBc total suggests presence of interfering substance in the patient's serum specimen.

 

Positive antibodies to anti-HBc total results with negative anti-HBc IgM results in infants younger than 18 months may be due to passively acquired maternal IgG antibodies. Additional testing, such as HBsAg, anti-HBc IgM, and hepatitis Be antigen, are necessary to confirm a diagnosis of acute or recent hepatitis B in these infants.

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;8:267-281

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

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;161:58-66. 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;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. Geneva: 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.

Mayo Clinic Laboratories | Gastroenterology Catalog Additional Information:

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