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Hepatitis B (HBV) is a blood-borne virus and one of the most common infectious diseases in the world.
Tests generally appear in the order most useful for common clinical situations
| Test name: Hepatic Function Panel |
| ARUP #: 0020416 |
| Methodology: Refer to individual components. |
| Use: Initial screening for hepatobiliary inflammation Panel includes albumin; ALP; AST; ALT; bilirubin, direct; protein, total; and bilirubin, total |
| Test name: Hepatitis B Virus Surface Antigen with Reflex to Confirmation |
| ARUP #: 0020089 |
| Methodology: Qualitative Chemiluminescent Immunoassay |
| Use: For acute onset of hepatitis, order along with HBV core IgM, HAV IgM and HCV antibodies to diagnose viral causative agent Diagnose chronic HBV; order along with HBV surface antibody and HBV core antibodies (total) Quantification of anti-HBV surface antigen provides useful means of monitoring post-liver-transplant therapy with hepatitis B immunoglobulin in HBV-positive patients and ascertaining response to HBV vaccines |
| Test name: Hepatitis B Virus Core Antibody, IgM |
| ARUP #: 0020092 |
| Methodology: Qualitative Chemiluminescent Immunoassay |
| Use: For acute onset of hepatitis, order along with HBV surface antigen, HAV IgM and HCV antibodies to diagnose viral causative agent |
| Test name: Hepatitis B Virus Core Antibodies (Total) |
| ARUP #: 0020091 |
| Methodology: Qualitative Chemiluminescent Immunoassay |
| Use: Diagnose chronic HBV infection; order along with HBV surface antigen and HBV surface antibody Most useful diagnostic marker for identification of occult HBV infection in HBsAg-negative individuals Useful screening tool in patients about to undergo immunosuppression to identify candidates for prophylactic nucleoside analog therapy to prevent severe life-threatening HBV reactivation |
| Limitations: Tests for IgG and IgM antibodies but does not differentiate between them Approximately 1% of those who have had a blood transfusion will have a positive anti-HBc and negative HBsAg; they should be further evaluated by measuring anti-HBs; however, most will have a negative anti-HBs |
| Test name: Hepatitis Be Virus Antigen |
| ARUP #: 0020094 |
| Methodology: Qualitative Enzyme Immunoassay |
| Use: Monitor HBV therapy; order along with HBV DNA, HBV surface antigen, HBV surface antibody and HBe antibody |
| Limitations: Order only when a patient is known to be positive for HBV surface antigen |
| Follow-up: Surrogate marker for HBV replication and infectivity Quantitative HBeAg measurement allows for monitoring and assessing patient’s response to pegylated interferon therapy |
| Test name: Hepatitis Be Virus Antibody |
| ARUP #: 0020095 |
| Methodology: Qualitative Enzyme Immunoassay |
| Use: Monitor HBV therapy; order along with HBV DNA, HBV surface antigen, HBV surface antibody and HBe antibody Treatment-induced HBeAg seroconversion is an important therapeutic milestone in HBeAg-positive patients and is also an important therapeutic goal |
| Test name: Hepatitis B Virus DNA Quantitative, Real-Time PCR |
| ARUP #: 0056025 |
| Methodology: Quantitative Real-Time Polymerase Chain Reaction |
| Use: Assess viral response to treatment as measured by changes in the HBV DNA levels Monitor HBV therapy; order along with HBV surface antigen, HBV surface antibody, HBe antigen and HBe antibody Monitor patients who were infected with HBV prior to liver transplantation Viral loads are predictive of future risk of developing cirrhosis and HCC |
| Test name: Hepatitis B Virus DNA Quantitative, Real-Time PCR with Reflex to Genotype |
| ARUP #: 2004722 |
| Methodology: Quantitative Real-Time Polymerase Chain Reaction/Sequencing |
| Use: Determine viral load for therapeutic considerations Genotyping may be helpful in selecting antiviral therapies |
| Test name: Hepatitis B Surface Antigen by Immunohistochemistry |
| ARUP #: 2003917 |
| Methodology: Immunohistochemistry |
| Use: Aid in histologic diagnosis of HBV Stained and returned to client pathologist; consultation available if needed Gold standard for diagnosis of HBV infection |
| Test name: Hepatitis Panel, Acute with Reflex to HBsAg Confirmation |
| ARUP #: 0020457 |
| Methodology: Qualitative Chemiluminescent Immunoassay/Qualitative Enzyme Immunoassay |
| Comments: Order when patient has had clinical acute hepatitis of unknown origin for less than 6 months Panel includes HAV IgM, HBV core antibody IgM, HBV surface antigen, HCV antibody Positive HAV IgM shows current or recent infection with 98% sensitivity and specificity |
| Test name: Hepatitis B Virus Surface Antibody |
| ARUP #: 0020090 |
| Methodology: Quantitative Chemiluminescent Immunoassay |
| Comments: Indicates immunity |
| Test name: Hepatitis B Virus Surface Antigen, Confirmation |
| ARUP #: 0020128 |
| Methodology: Chemiluminescent Immunoassay |
| Comments: Indicates whether overt HBV infection is present |
| Test name: Hepatitis B Virus Panel, Chronic with Reflex to HBsAg Confirmation |
| ARUP #: 0020454 |
| Methodology: Qualitative Chemiluminescent Immunoassay/Qualitative Enzyme Immunoassay |
| Comments: Indicates infection |
| Test name: Hepatitis C Virus Antibody by CIA |
| ARUP #: 2002483 |
| Methodology: Qualitative Chemiluminescent Immunoassay |
| Comments: |
| Test name: Hepatitis B Virus Genotype |
| ARUP #: 2001567 |
| Methodology: Polymerase Chain Reaction/Nucleic Acid Sequencing |
| Comments: May be unsuccessful if the HBV viral load is less than log 3.0 or 1,000 IU/mL of plasma |