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Hepatitis B Core Antibody, Total with Reflex to IgM

CPT: Call client services.


  • anti-HBc
  • anti-HBc Total and IgM
  • HBV

Special Instructions

Note: Hep B Core AB Total if positive, will reflex to Hep B Core, IgM at an additional charge.

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.

Specimen Requirements


Serum or plasma


1 mL

Minimum Volume

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


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


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

Storage Instructions

Room temperature

Stability Requirements



Room temperature

14 days


14 days


14 days

Freeze/thaw cycles

Stable x3

Test Details


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 for the laboratory diagnosis of HBV disease associated with HBV infection. This assay can also be used as an aid in the differential diagnosis in individuals displaying signs and symptoms of hepatitis in whom etiology is unknown. This panel can be used to differentiate between the presence of anti-HBc IgG and IgM.


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 possiblity of exposure to hepatitis B virus. Levels of anti-HBc may be undetectable both in early infection and late 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.


Immunochemiluminometric assay (ICMA)

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.


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

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