Hepatitis B Surface Antibody, Qualitative

CPT: 86706
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Test Details

Synonyms

  • Antibody to Hepatitis B Surface Antigen

Use

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.

Limitations

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.

Methodology

Immunochemiluminometric assay (ICMA)

Reference Interval

• Nonreactive: Inconsistent with immunity

• Reactive: Consistent with immunity

Additional Information

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].

Specimen Requirements

Specimen

Serum or plasma

Volume

0.5 mL

Minimum Volume

0.3 mL (Note: This volume does not allow for repeat testing.)

Container

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

Collection

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

Storage Instructions

Room temperature

Stability Requirements

Temperature

Period

Room temperature

14 days

Refrigerated

14 days

Frozen

14 days

Freeze/thaw cycles

Stable x3

Causes for Rejection

Cadaver specimens; heat-inactivated specimens; body fluids other than serum or plasma

Clinical Information

References

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. 2712676
Edwards MS. Hepatitis B serology−Help in interpretation. Pediatr Clin North Am. 1988 Jun; 35(3):503-515 (review). 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. 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. 6810736
Lee HS, Vyas GN. Diagnosis of viral hepatitis. Clin Lab Med. 1987 Dec; 7(4):741-757. 3319367
Protection Against Viral Hepatitis. Recommendations of the Immunization Practices Advisory Committee (ACIP). MMWR Recomm Rep. 1990; 39(RR-2):1-26. 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. 6619284

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
006395 Hep B Surface Ab 22322-2 006408 Hep B Surface Ab, Qual 22322-2

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