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22921 Hepatitis B Panel

Hepatitis B Panel
Test Code: HEPB
Test Components
Hepatitis B Surface Antibody, Hepatitis B Surface Antigen, Hepatitis B Core Antibody Total. A Hepatitis B Core Antibody IgM will be automatically added at extra cost when the Hepatitis B Core Antibody Total is Reactive.
Useful For
Aiding in the diagnosis of hepatitis B and determining the phase of a hepatitis B infection.
Specimen Requirements
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
​No Serum​ Serum Separator Tube (SST)​ Red Top Tube (RTT) 2 mL​ 1.5 mL​ ​1 mL
Collection Processing Instructions
Separate serum from the blood within 60 minutes of venipuncture. Recommended guidelines for optimal sample processing should be followed. Specimen must be free of particulate matter including fibrin. Specimens transported to Marshfield must be removed from the primary collection tube and sent in a labeled daughter tube. Store samples at 2 to 8°C if not tested within 8 hours of collection. The frozen specimens should be completely thawed thoroughly mixed and centrifuged before analysis. 2 freeze/thaw cycles has shown to have no qualitative difference in results.
 
High doses of exogenous biotin (also termed Vitamin B7, Vitamin H or Coenzyme R) may interfere with this assay (HAA). It is recommended that patients refrain from consuming any multivitamin or supplement containing biotin for at least 72 hours prior to collection of a blood sample.
Specimen Stability Information
Specimen Type Temperature Time
​Serum ​ ​ ​Ambient ​< 8 hours
Refrigerate​ 2 days
Frozen​ at -20 °C 6 months
​Frozen at -70 °C ​Longer period
Rejection Criteria
Gross hemolysis & icterus specimens. No interference with gross lipemia has been recognized. Specimen will be rejected if contaminated with microbes, or containing precipitate. Cadaver specimens, heat-inactivated specimens, body fluids other than serum or plasma, such as saliva, urine, amniotic, or pleural fluids.
Interference
Heterophilic antibodies in human serum can react with the immunoglobulins included in the assay components causing interference with immunoassay.
 
High doses of exogenous biotin (also termed Vitamin B7, Vitamin H or Coenzyme R) may interfere with this assay (HAA).
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Marshfield​ Monday through Friday​ 1 day​ Chemiluminometric Immunoassays/Centaur, Siemens    ​
Test Information

If Hepatitis B Panel results are “Reactive” then Hepatitis B Core Antibody IgM will be performed.

Hepatitis B is a viral illness that is transmitted through blood and other body fluids. Both acute and chronic stages occur, with the frequency of progression to chronicity declining with age at time of infection. Chronic hepatitis B often leads to cirrhosis and hepatocellular carcinoma. Hepatitis B is a vaccine-preventable disease.

Limitations
• The results determined by different assays from different manufacturers can vary due to differences in assay specificities and cannot be used interchangeably.
• The performance of the assay has not been established with cord blood, neonatal specimens, infants, children, or adolescent patients, immunocompromised, immunosuppressed, cadaver specimens, heat-inactivated specimens, or body fluids.
• A reactive Anti-Hepatitis B core Total result does not exclude co-infection by another hepatitis virus.

Reference Range Information
Performing Location Reference Range
Marshfield​ Reported as "Reactive" or "Non-reactive"
Hepatitis B Surface Antigen is a reportable disease to the Wisconsin State Lab of Hygiene. ​
Interpretation

Interpretation of panel results is as follows:

 
HBsAg
NON-REAC
No serologic evidence of infection with hepatitis B was detected. 
HBsAb
NON-REAC
HBcAb (Total)
NON-REAC
HBsAg
NON-REAC
This serologic pattern is suggestive of the recovery phase of acute hepatitis B: in such cases, repeat testing once with HEPATITIS B SURFACE ANTIBODY to document seroconversion. This pattern may also rarely represent chronic hepatitis B with undetectable level of hepatitis B surface antigen: consultation with a specialist is suggested if clinical conditions warrant.
HBsAb
NON-REAC
HBcAb (Total)
REACTIVE
HBsAg
NON-REAC
This serologic pattern is consistent with vaccine-induced hepatitis B surface antibody. 
HBsAb
REACTIVE
HBcAb (Total)
NON-REAC
HBsAg
NON-REAC
This serologic pattern is found in resolved acute hepatitis B.
HBsAb
REACTIVE
HBcAb (Total)
REACTIVE
HBsAg
REACTIVE
This serologic pattern is found in late incubation period or early acute hepatitis B.
HBsAb
NON-REAC
HBcAb (Total)
NON-REAC
HBsAg
REACTIVE
 This serologic pattern may be found in either acute or chronic hepatitis B: HEPATITIS B CORE ANTIBODY, IgM has been reflexively ordered to resolve.
HBsAb
NON-REAC
HBcAb (Total)
REACTIVE
HBsAg
REACTIVE
This pattern is not consistent with any phase of hepatitis B infection. Suggest repeating the test once in 2-4 weeks and/or consultation with a specialist if clinical conditions warrant.
HBsAb
REACTIVE
HBcAb (Total)
NON-REAC
HBsAg
REACTIVE
This pattern is not consistent with any phase of hepatitis B infection. Suggest repeating the test once in 2-4 weeks and/or consultation with a specialist if clinical conditions warrant. 
HBsAb
REACTIVE
HBcAb (Total)
REACTIVE

 

HBsAg -Hepatitis B surface antigen; HBsAb - Hepatitis B surface antibody; HBcAb (total) - Hepatitis B core total antibody.

In cases where the HBcAb (total) component is reactive, a hepatitis B core IgM antibody (HBcAb, IgM) test will be performed with an added charge: a reactive HBcAb,IgM result is consistent with acute hepatitis B, while a non-reactive HBcAb,IgM result is consistent with either post-acute convalescent or chronic hepatitis B.

Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
87340​ ​ ​ ​ ​
86704 ​ ​ ​ ​
86705​ ​ ​ Hepatitis B Core Antibody, IgM (if needed)​ ​
​86706 ​ ​ ​ ​
Test Components
Hepatitis B Surface Antibody, Hepatitis B Surface Antigen, Hepatitis B Core Antibody Total. A Hepatitis B Core Antibody IgM will be automatically added at extra cost when the Hepatitis B Core Antibody Total is Reactive.
Specimen Requirements
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
​No Serum​ Serum Separator Tube (SST)​ Red Top Tube (RTT) 2 mL​ 1.5 mL​ ​1 mL
Collection Processing
Separate serum from the blood within 60 minutes of venipuncture. Recommended guidelines for optimal sample processing should be followed. Specimen must be free of particulate matter including fibrin. Specimens transported to Marshfield must be removed from the primary collection tube and sent in a labeled daughter tube. Store samples at 2 to 8°C if not tested within 8 hours of collection. The frozen specimens should be completely thawed thoroughly mixed and centrifuged before analysis. 2 freeze/thaw cycles has shown to have no qualitative difference in results.
 
High doses of exogenous biotin (also termed Vitamin B7, Vitamin H or Coenzyme R) may interfere with this assay (HAA). It is recommended that patients refrain from consuming any multivitamin or supplement containing biotin for at least 72 hours prior to collection of a blood sample.
Specimen Stability Information
Specimen Type Temperature Time
​Serum ​ ​ ​Ambient ​< 8 hours
Refrigerate​ 2 days
Frozen​ at -20 °C 6 months
​Frozen at -70 °C ​Longer period
Rejection Criteria
Gross hemolysis & icterus specimens. No interference with gross lipemia has been recognized. Specimen will be rejected if contaminated with microbes, or containing precipitate. Cadaver specimens, heat-inactivated specimens, body fluids other than serum or plasma, such as saliva, urine, amniotic, or pleural fluids.
Interference
Heterophilic antibodies in human serum can react with the immunoglobulins included in the assay components causing interference with immunoassay.
 
High doses of exogenous biotin (also termed Vitamin B7, Vitamin H or Coenzyme R) may interfere with this assay (HAA).
Useful For
Aiding in the diagnosis of hepatitis B and determining the phase of a hepatitis B infection.
Test Components
Hepatitis B Surface Antibody, Hepatitis B Surface Antigen, Hepatitis B Core Antibody Total. A Hepatitis B Core Antibody IgM will be automatically added at extra cost when the Hepatitis B Core Antibody Total is Reactive.
Reference Range Information
Performing Location Reference Range
Marshfield​ Reported as "Reactive" or "Non-reactive"
Hepatitis B Surface Antigen is a reportable disease to the Wisconsin State Lab of Hygiene. ​
Interpretation

Interpretation of panel results is as follows:

 
HBsAg
NON-REAC
No serologic evidence of infection with hepatitis B was detected. 
HBsAb
NON-REAC
HBcAb (Total)
NON-REAC
HBsAg
NON-REAC
This serologic pattern is suggestive of the recovery phase of acute hepatitis B: in such cases, repeat testing once with HEPATITIS B SURFACE ANTIBODY to document seroconversion. This pattern may also rarely represent chronic hepatitis B with undetectable level of hepatitis B surface antigen: consultation with a specialist is suggested if clinical conditions warrant.
HBsAb
NON-REAC
HBcAb (Total)
REACTIVE
HBsAg
NON-REAC
This serologic pattern is consistent with vaccine-induced hepatitis B surface antibody. 
HBsAb
REACTIVE
HBcAb (Total)
NON-REAC
HBsAg
NON-REAC
This serologic pattern is found in resolved acute hepatitis B.
HBsAb
REACTIVE
HBcAb (Total)
REACTIVE
HBsAg
REACTIVE
This serologic pattern is found in late incubation period or early acute hepatitis B.
HBsAb
NON-REAC
HBcAb (Total)
NON-REAC
HBsAg
REACTIVE
 This serologic pattern may be found in either acute or chronic hepatitis B: HEPATITIS B CORE ANTIBODY, IgM has been reflexively ordered to resolve.
HBsAb
NON-REAC
HBcAb (Total)
REACTIVE
HBsAg
REACTIVE
This pattern is not consistent with any phase of hepatitis B infection. Suggest repeating the test once in 2-4 weeks and/or consultation with a specialist if clinical conditions warrant.
HBsAb
REACTIVE
HBcAb (Total)
NON-REAC
HBsAg
REACTIVE
This pattern is not consistent with any phase of hepatitis B infection. Suggest repeating the test once in 2-4 weeks and/or consultation with a specialist if clinical conditions warrant. 
HBsAb
REACTIVE
HBcAb (Total)
REACTIVE

 

HBsAg -Hepatitis B surface antigen; HBsAb - Hepatitis B surface antibody; HBcAb (total) - Hepatitis B core total antibody.

In cases where the HBcAb (total) component is reactive, a hepatitis B core IgM antibody (HBcAb, IgM) test will be performed with an added charge: a reactive HBcAb,IgM result is consistent with acute hepatitis B, while a non-reactive HBcAb,IgM result is consistent with either post-acute convalescent or chronic hepatitis B.

For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Marshfield​ Monday through Friday​ 1 day​ Chemiluminometric Immunoassays/Centaur, Siemens    ​
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
87340​ ​ ​ ​ ​
86704 ​ ​ ​ ​
86705​ ​ ​ Hepatitis B Core Antibody, IgM (if needed)​ ​
​86706 ​ ​ ​ ​
For most current information refer to the Marshfield Laboratory online reference manual.