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Hepatitis B Virus (HBV) Patient Management

CPT: 87340

Synonyms

  • Hepatitis

Test Includes

Hepatitis B Surface Antigen (HBsAg). Specimens positive for HBsAg reflex to Hepatitis Be Antigen (HBeAg), Hepatitis Be Antibody (anti-HBe), HBV Quantitative DNA, and ALT.


Special Instructions

If reflex test is performed, additional charges/CPT code(s) may apply.

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 - 7 days


Related Documents


Specimen Requirements


Specimen

Serum or EDTA plasma


Volume

9.5 mL (2.5 mL for HBV DNA)


Minimum Volume

3.6 mL (0.7 mL for HBV DNA)


Container

Gel-barrier tube, red top tube, or lavender-top (EDTA) tube


Collection

Two samples must be submitted.

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

HBV DNA: Centrifuge sample within 24 hours of collection. Transfer serum/plasma to a screw-cap polypropylene transport tube. Ship frozen (preferred). Plasma from a PPT can be frozen in situ.

To avoid delays in turnaround time when requesting multiple tests on frozen samples, please submit a separate frozen specimen for each test requested.


Storage Instructions

All tests except DNA: Refrigerated (preferred) up to 7 days. Frozen up to 14 days. Room temperature up to 7 days.

HBV DNA: Frozen (preferred) up to 12 weeks. Refrigerated up to 6 days. Room temperature up to 24 hours.


Causes for Rejection

Heat-inactivated specimens; cord blood; cadaveric specimens; or body fluid other than serum or EDTA plasma; gross hemolysis; excessive lipemia; improper labeling


Test Details


Use

This panel is intended for use in the management of patients with chronic hepatitis B and to assess the efficacy of antiviral treatment. A positive HBsAg test will reflex to HBeAg, anti-HBe, HBV quantitative DNA, and ALT.


Limitations

Anti-HBe: Assay performance characteristics have not been established for testing of children less than 17 years of age or pregnant women or in immunocompromized or immunosuppressed patients.

The HBV quantitative real-time PCR assay has a quantitative range of 10 to 1,000,000,000 IU/mL.


References

Abara WE, Oaseem A, Schillie S. McMahon BJ, Harris AM, High Value Care Task Force of the American College of Physicians and the Centers for Disease Control and Prevention. Hepatitis B Vaccination, Screening, and Linkage to Care: Best Practice Advice from the American College of Physicians and the Centers for Disease Control and Prevention. Ann Intern Med. 2017 Dec 5;167(11):794-804.29159414
Centers for Disease Control and Prevention. Hepatitis B. CDC web site: www.cdc.gov/hepatitis/hbv/index.htm. Accessed May 2021.
Schillie S, Vellozzi C, Reingold A, et al. Prevention of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Imunization 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

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