Hepatitis B Surface Antibody, Qualitative

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Category:

Turnaround Time: 1 - 2 days
CPT Code:

86706

Test Type: 0.5 mL Serum or plasma
Stability Time:

Temperature

Period

Room temperature

14 days

Refrigerated

14 days

Frozen

14 days

Freeze/thaw cycles

Stable x3
Reference Range:


Nonreactive: Inconsistent with immunity
Reactive: Consistent with immunity

Overview:

Presence of anti−HBs is an indicator of clinical recovery and subsequent immunity to hepatitis B virus. This test is useful for evaluation of possible immunity in individuals who are at increased risks for exposure to the hepatitis B (ie, hemodialysis unit personnel, venipuncturists, etc). Evaluate the need for hepatitis B immune globulin after needlestick injury; evaluate the need for hepatitis B vaccine and follow immune status after hepatitis B vaccine.

Presence of anti-HBs is not an absolute indicator of resolved hepatitis infection, nor of protection from future infection. Since there are different serologic subtypes of hepatitis B virus, it is possible (and has been reported) for a patient to have antibody to one surface antigen type and to be acutely infected with virus of a different subtype. Thus, a patient may have coexisting HBsAg and anti-HBs. Transfused individuals or hemophiliacs receiving plasma components may give false-positive tests for antibody to hepatitis B surface antigen.Anti-HBs usually can be detected several weeks to several months after HBsAg is no longer found, and it may persist for many years or for life after acute infection has been resolved. It may disappear in some patients, with only antibody to core remaining. Patients with this antibody are not overtly infectious. Presence of the antibody without the presence of the antigen is evidence for immunity from reinfection, with virus of the same subtype (vide supra). Anti-HBs can be induced by vaccination with hepatitis vaccine, now genetically engineered and free of any infective material. This vaccine so far has been safe and effective in protecting recipients from acute hepatitis B.  See figure in Hepatitis B Core Antibody, IgM [016881].

Centers for Disease Control and Prevention. Hepatitis B virus: A comprehensive strategy for eliminating transmission in the United States through universal childhood vaccination-Recommendations of the immunization practices advisory committee (ACIP). MMWR. 1991 Nov 22; 40(RR-13):1-25. PubMed 1835756

Devine P, Taswell HF, Moore SB, et al. Passively acquired antibody to hepatitis B surface antigen. Pitfall in evaluating immunity to hepatitis B viral infections. Arch Pathol Lab Med. 1989 May; 113(5):529-531. PubMed 2712676

Edwards MS. Hepatitis B serology-Help in interpretation. Pediatr Clin North Am. 1988 Jun; 35(3):503-515 (review). PubMed 3287312

Foutch PG, Carey WD, Tabor E, et al. Concomitant hepatitis B surface antigen and antibody in 13 patients. Ann Intern Med. 1983 Oct; 99(4):460-463. PubMed 6625377

Francis DP, Hadler SC, Thompson SE, et al. The prevention of hepatitis B with vaccine: Report of the Centers for Disease Control Multi-Center Efficacy Trial Among Homosexual Men. Ann Intern Med. 1982 Sep; 97(3):362-366. PubMed 6810736

Lee HS, Vyas GN. Diagnosis of viral hepatitis. Clin Lab Med. 1987 Dec; 7(4):741-757. PubMed 3319367

Protection Against Viral Hepatitis. Recommendations of the Immunization Practices Advisory Committee (ACIP). MMWR Recomm Rep. 1990; 39(RR-2):1-26. PubMed 2153904

Swenson PD, Escobar MR, Carithers RL Jr, et al. Failure of pre-existing antibody against hepatitis B surface antigen to prevent subsequent hepatitis B infection. J Clin Microbiol. 1983 Aug; 18(2):305-309. PubMed 6619284

Collection Details:

Collection Instructions:

Red-top tube, gel-barrier tube, or lavender-top (EDTA) tube.

If tube other than a gel-barrier tube is used, transfer separated serum or plasma to a plastic transport tube.

Room temperature.