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HelpTest ID: CORAB Hepatitis B Virus Core Total Antibodies, with Reflex to Hepatitis B Virus Core IgM Antibody, Serum
Reporting Name
HBc Total Ab, w/Reflex, SUseful For
Detection and differentiation between recent, past/resolved, or chronic hepatitis B
Diagnosis of recent hepatitis B virus (HBV) infection during the "window period" when both hepatitis B surface (HBs) antigen and anti-HBs are negative
This test is not useful for determining immunity to or recovery from HBV infection.
Clinical Information
During the course of a typical case of acute hepatitis B, hepatitis B virus (HBV) core IgM antibodies (anti-HBc IgM) to hepatitis B virus core antigen are present in the serum shortly before clinical symptoms appear. Anti-HBc total is detectable during the prodromal, acute, and early convalescent phases when it exists as anti-HBc IgM. Anti-HBc IgM increase in level and are present during the core window period (ie, after hepatitis B virus surface (HBs) antigen disappears and before anti-HBs appear). Anti-HBc total may be the only serologic marker remaining years after exposure to HBV.
Interpretation
Negative hepatitis B virus core total antibody (anti-HBc total) results indicate the absence of recent, past/resolved, or chronic hepatitis B.
Positive anti-HBc total result may indicate recent, past/resolved, or chronic hepatitis B.
Testing for anti-HBc IgM is necessary to confirm the presence of acute or recent hepatitis B. A positive anti-HBc total result with a negative anti-HBc IgM result indicates past or chronic hepatitis B virus (HBV) infection. Differentiation between past/resolved and chronic hepatitis B can be based on the presence of hepatitis B virus surface antigen (HBsAg) in the latter condition.
Positive anti-HBc total results with negative anti-HBc IgM results in infants younger than 18 months may be due to passively acquired maternal IgG antibodies. Additional testing, such as HBsAg, anti-HBc IgM, and hepatitis Be antigen, are necessary to confirm a diagnosis of acute or recent hepatitis B in these infants.
Report Available
1 to 3 daysDay(s) Performed
Monday through Saturday
Clinical Reference
1. LeFevre ML. U.S. Preventive Services Task Force. Screening for hepatitis B virus infection in nonpregnant adolescents and adults: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2014;161(1):58-66. doi:10.7326/M14-1018
2. WHO guidelines on hepatitis B and C testing. Geneva: World Health Organization; February 2017. Accessed December 22, 2023. Available at www.who.int/publications/i/item/9789241549981
3. Jackson K, Locarnini S, Gish R. Diagnostics of hepatitis B virus: Standard of care and investigational. Clin Liver Dis. 2018;12(1):5-11. doi:10.1002/cld.729
4. Coffin CS, Zhou K, Terrault NA. New and old biomarkers for diagnosis and management of chronic hepatitis B virus infection. Gastroenterology. 2019;156(2):355-368. doi:10.1053/j.gastro.2018.11.037
5. Conners EE, Panagiotakopoulos L, Hofmeister MG, et al. Screening and Testing for Hepatitis B Virus Infection: CDC Recommendations - United States, 2023. MMWR Recomm Rep. 2023;72(1):1-25. doi:10.15585/mmwr.rr7201a1
Method Name
Electrochemiluminescence Immunoassay (ECLIA)
Specimen Type
Serum SSTNecessary Information
Date of collection is required.
Specimen Required
Patient Preparation: For 24 hours before specimen collection, patient should not take multivitamins or dietary supplements (eg, hair, skin, and nail supplements) containing biotin (vitamin B7).
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Collection Container/Tube: Serum gel (red-top tubes are not acceptable)
Submission Container/Tube: Plastic vial
Specimen Volume: 0.7 mL
Collection Instructions:
1. Centrifuge blood collection tube per manufacturer's instructions (eg, centrifuge and aliquot within 2 hours of collection for BD Vacutainer tubes).
2. Aliquot serum into a plastic vial.
Specimen Minimum Volume
0.6 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum SST | Frozen (preferred) | 90 days | |
| Refrigerated | 6 days |
Reference Values
Negative
Interpretation depends on clinical setting.
Test Classification
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.CPT Code Information
86704
86705 (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| CORAB | HBc Total Ab, w/Reflex, S | 13952-7 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| CORAB | HBc Total Ab, w/Reflex, S | 13952-7 |
Testing Algorithm
If the hepatitis B virus core (HBc) total antibodies test result is positive, then anti-HBc IgM is performed at an additional charge.
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| HBIM | HBc IgM Ab, S | Yes | No |
Special Instructions
Forms
If not ordering electronically, complete, print, and send 1 of the following:
mml-hepatitis