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Test ID: HEAG Hepatitis B e Antigen and Hepatitis B e Antibody, Serum

Reporting Name

Hepatitis Be Ag and Ab, S

Useful For

Determining infectivity of hepatitis B virus (HBV) carriers

 

Monitoring infection status of individuals with chronic hepatitis B

 

Monitoring serologic response of chronically HBV-infected patients receiving antiviral therapy

 

Determining the levels of both hepatitis B e antigen and antibody

Profile Information

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

Specimen Type

Serum SST


Additional Testing Requirements


If ordered with HBVQN / Hepatitis B Virus (HBV) DNA Detection and Quantification by Real-Time PCR, Serum; send separate vials.



Necessary Information


Date of collection 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: 1.5 mL

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


Specimen Minimum Volume

1 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

HEPATITIS Be ANTIGEN

Negative

 

HEPATITIS Be ANTIBODY

Negative

 

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

86707

87350

LOINC Code Information

Test ID Test Order Name Order LOINC Value
HEAG Hepatitis Be Ag and Ab, S 77176-6

 

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

Clinical Information

Hepatitis B e antigen (HBeAg) is a small polypeptide that exists in a free form in the serum of individuals during the early phase of hepatitis B infection, soon after hepatitis B surface antigen (HBsAg) becomes detectable. Serum levels of both HBeAg and HBsAg rise rapidly during the period of viral replication. The presence of HBeAg in serum correlates with hepatitis B virus (HBV) infectivity, the number of infectious virions, and the presence of HBV core antigen in the infected hepatocytes.

 

During recovery from acute hepatitis B, HBeAg level declines and becomes undetectable in the serum, while hepatitis B e antibody (anti-HBe) appears and becomes detectable in the serum. Anti-HBe usually remains detectable for many years after recovery from acute HBV infection.

 

In HBV carriers and patients with chronic hepatitis B, positive HBeAg results usually indicate presence of active HBV replication and high infectivity. A negative HBeAg result indicates very minimal or no HBV replication. Positive anti-HBe results usually indicate inactivity of the virus and low infectivity. Positive anti-HBe results in the presence of detectable HBV DNA in serum also indicate active viral replication in these patients.

Interpretation

Presence of hepatitis B e antigen (HBeAg) and absence of HBe antibody (anti-HBe) usually indicate active hepatitis B virus (HBV) replication and high infectivity.

 

Absence of HBeAg with appearance of anti-HBe is consistent with loss of HBV infectivity.

 

Although resolution of chronic HBV infection generally follows the appearance of anti-HBe, the HBV carrier state may persist.

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. Terrault NA, Bzowej NH, Chang KM, et al: AASLD guidelines for treatment of chronic hepatitis B. Hepatology. 2016;63:261-283

4. 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/

5. 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

6. 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.

7. 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.

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:

mml-gi-liver-hepatitis