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Hepatitis B Core Antibody, Total

CPT: 86704
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Synonyms

  • Anti-HBc
  • Antibody to Hepatitis B Core Antigen
  • Core Antibody
  • HBV

Special Instructions

This test may exhibit interference when sample is collected from a person who is consuming a supplement with a high dose of biotin (also termed as vitamin B7 or B8, vitamin H, or coenzyme R). It is recommended to ask all patients who may be indicated for this test about biotin supplementation. Patients should be cautioned to stop biotin consumption at least 72 hours prior to the collection of a sample.


Expected Turnaround Time

1 - 2 days


Specimen Requirements


Specimen

Serum or plasma


Volume

1 mL


Minimum Volume

0.4 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

Non-EDTA plasma specimen; PST gel-barrier tube


Test Details


Use

This assay can be used as an aid in the diagnosis of individuals with acute or chronic hepatitis B virus (HBV) infection and in the determination of the clinical status of HBV infected individuals in conjunction with other HBV serological markers associated with HBV infection. This assay can also be used as an aid in the differential diagnosis in individuals displaying signs of hepatitis in whom etiology is unknown.


Limitations

The results from this or any other diagnostic kit should be used and interpreted only in the context of the overall clinical picture. A negative test result does not exclude the possibility of exposure to hepatitis B virus. Levels of anti-HBc may be undetectable both in early infection and later after infection.

This is a qualitative assay; reported antibody level cannot be correlated to an endpoint titer.

Assay performance characteristics have not been established for immunocompromised or immunosuppressed patients.


Methodology

Immunochemiluminometric assay (ICMA)


Reference Interval

Negative


Additional Information

Hepatitis B core antigen (HBcAg), found in liver cells, does not circulate in the bloodstream. However, IgM and IgG antibodies to HBcAg can be detected serologically in HBV infected individuals. Anti-HBc IgM is detectable first and remains detectable for approximately six months. Shortly after the IgM response, anti-HBc IgG appears and can remain detectable indefinitely. The presence of anti-HBc IgM and anti-HBc IgG is characteristic of acute infection, while the presence of anti-HBc IgG without anti-HBc IgM is characteristic of chronic or recovered stages of HBV infection. Anti-HBc Total assays detect both IgM and IgG anti-HBc responses. Most often levels of anti-HBc will coincide with detectable levels of other HBV markers. Rarely, anti-HBc may be the only detectable HBV marker. This may occur during the brief period when hepatitis B surface antigen (HBsAg) has been cleared from the bloodstream and before antibodies to hepatitis B surface antigen (anti-HBs) become detectable. For this reason, the use of anti-HBc Total assays to detect acute infection is not recommended. Anti-HBc Total assays should be used in conjunction with other marker assays to assess current or past exposure to HBV.


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
006718 Hep B Core Ab, Tot 13952-7 006718 Hep B Core Ab, Tot 13952-7

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