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Test Code HBSAB Hepatitis B Virus Surface Antibody

Important Note

This test may be affected by biotin interference. Patients on high dose biotin (5mg/day or more) should not have samples drawn until at least 24 hours after the last biotin administration.

Infectious

Specimen and Container/Tube

Specimen Type: Serum

Preferred Specimen: Red Top

Specimen Handling and Transport Instructions

UCMC Onsite Instructions: 

Collect specimen per standard collection procedure and send to laboratory immediately. 

 

UCMC Offsite and UC MedLab Outreach Instructions: 

  • Samples should be centrifuged within 2 hours of collection.
  • Centrifuge specimens at >2500 x g for 10 minutes at room temperature.
  • Aliquot sample into plastic transport tube containing a minimum of 0.2 mL of specimen.
  • Samples must be sent room temperature at 15-25oC.

Rejection Criteria

  • Common specimen rejected situations include: incorrect specimen type, insufficient volume, missing or incomplete specimen identifiers, incorrect specimen transport, or specimens outside stability limits. 
  • Specimens that are clotted or grossly hemolyzed.
  • Specimens that were transported unspun/whole blood and draw time is greater than 6 hours

Reference Values

This is a qualitative test. 

Test

Age

Sex

Reference Range

 Interpretation

HBsAB

All

All

<8.5 COI

Non-Reactive

HBsAB

All

All

≥8.5<11.5 COI

Borderline

HBsAB

All

All

≥11.5

Reactive

 

Critical Values

Analyte

Unit

Low

High

Age

N/A

N/A

N/A

N/A

N/A

CPT Codes

86706

LOINC Codes

10900-9

Volume

Preferred Volume: 0.5 mL

Minimum Volume: 0.2 mL

Specimen Stability

Storage Temperature

Stability

Room Temperature

7 hours

Refrigerated

 6 days

Frozen

3 months

 

Note: May be frozen up to 6 times.

Collection Instructions

Collect specimen per standard laboratory collection procedures. 

Test Components

Hepatitis B surface Antibody

Clinical Indications

Hepatitis B virus (HBV) is a DNA virus that is endemic throughout the world. The infection is spread primarily through blood transfusion or percutaneous contact with infected blood products, such as sharing of needles among injection drug users. The virus is found in virtually every type of human body fluid and has been known to be spread through oral and genital contact. HBV can be transmitted from mother to child during delivery through contact with blood and vaginal secretions, but it is not commonly transmitted via the transplacental route.

 

The incubation period for HBV infection averages 60 to 90 days (range of 45-180 days). Common symptoms include malaise, fever, gastroenteritis, and jaundice (icterus). After acute infection, HBV infection becomes chronic in 30% to 90% of infected children younger than 5 years and in 5% to 10% of infected individuals 5 years or older. Some of these chronic carriers are asymptomatic, while others progress to chronic liver disease, including cirrhosis and hepatocellular carcinoma.

 

Hepatitis B surface antigen (HBsAg) is the first serologic marker, appearing in the serum 6 to 8 weeks following HBV infection. In acute cases, HBsAg usually disappears 1 to 2 months after the onset of symptoms with the appearance of HBs antibody (anti-HBs). Anti-HBs also appears as the immune response following hepatitis B vaccination.

Methodology

Electrochemiluminescence immunoassay (ECLIA) (Roche Diagnostics)

Additional Information

A positive result indicates recovery from acute or chronic hepatitis B virus (HBV) infection or acquired immunity from HBV vaccination. This assay does not differentiate between a vaccine-induced immune response and an immune response induced by HBV. A positive hepatitis B core (anti-HBc) total antibody result would indicate that the hepatitis B surface antibody (anti-HBs) response is due to past HBV infection.

 

Per assay manufacturer's instructions for use, positive results, defined as anti-HBs levels of 11.5 mIU/mL or greater, indicate adequate immunity to HBV from past hepatitis B or HBV vaccination. However, per current Centers for Disease Control and Prevention guidance,(1) individuals with anti-HBs levels greater than 10 mIU/mL after completing an HBV vaccination series are considered protected from hepatitis B infection.

 

Negative results, defined as anti-HBs levels of less than 8.5 mIU/mL, indicate a lack of recovery from acute or chronic hepatitis B or inadequate immune response to HBV vaccination. The US Advisory Committee on Immunization Practices does not recommend more than 2 HBV vaccine series in vaccine nonresponders.

 

Indeterminate results, defined as anti-HBs levels in the range from 8.5 to less than 11.5 mIU/mL, indicate inability to determine if anti-HBs is present at levels consistent with recovery or immunity. Repeat testing is recommended in 1 to 2 months to determine definitive anti-HBs status.

Turnaround Time

Turnaround times are relative to the time the specimen is received in the test laboratory. 

 

STAT Turnaround Time: Not available as STAT test

Routine Turnaround Time: up to 4 hours

Testing Schedule:  24/7

Synonyms/Keyword Search

Antibody to Hepatitis B Surface Ag

HBsAb

Hepatitis B Surface Antibody

Hepatitis Bs Ab

Anti-HBs

HBAB

Hepatitis B Surface Ab

Last Review Date

06/14/2024