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Hepatitis B Surface Antibody, Qualitative

CPT: 86706
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Synonyms

  • Anti-HBs
  • Antibody to Hepatitis B Surface Antigen
  • HBV

Expected Turnaround Time

1 - 2 days


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


Test Details


Use

Presence of antibody to hepatitis B surface antigen (anti-HBs) is used to determine immune status to HBV or disease progression in individuals infected with HBV. Anti-HBs levels can be measured to determine if vaccination is needed, or following a vaccination regimen, to determine if protective immunity has been achieved.


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.


References

Abara WE, Qaseem A, Schillie S, et al. Hepatitis B Vaccination, Screening, and Likage to Care: Best Practice Advice from American College of Physicians and the Centers for Disease Control and Prevention. Ann Intern Med. 2017 Dec 5;167(11):794-804..29159414
Schillie S, Vellozzi C, Reingold A, et al. Prevention of Hepatitis B Virus Infection in the United States. Recommendations of the Advisory Committee on Immunization Practices. MMWR Recomm Rep. 2018 Jan 12;67(1):1-31.29939980
Terrault NA, Lok ASF, McMahon BJ, et al. Update on Prevention, Diagnosis, and Treatment of Chronic Hepatitis B: AASLD 2018 Hepatitis B Guidance. Hepatology. 2018 Apr;67(4):1560-1599.29405329
Workowski KA, Bolan GA, Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines. MMWR Recomm Rep. 2015 Jun 5;64(RR-03):1-137.26042815

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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