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HelpTest ID: CORAB Hepatitis B Core Total Antibodies, with Reflex to Hepatitis B Core Antibody IgM, Serum
Reporting Name
HBc Total Ab, w/Reflex, SUseful For
Detection and differentiation between recent and past/resolved or chronic hepatitis B viral (HBV) infection
Diagnosis of recent HBV infection during the "window period" when both hepatitis B surface antigen (HBsAg) and antibodies to HBsAg are negative
This test is not useful for determining immunity to or recovery from hepatitis B viral (HBV) infection.
Clinical Information
During the course of a typical case of acute hepatitis B viral (HBV) infection, IgM antibodies to hepatitis B core antigen (anti-HBc) IgM 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 rises in level and is present during the core window period (ie, after hepatitis B surface antigen disappears and before antibodies to hepatitis B surface antigen appear). Anti-HBc total may be the only serologic marker remaining years after exposure to HBV.
Interpretation
Positive antibodies to hepatitis B core antigen (anti-HBc) total result may indicate recent, past/resolved, or chronic hepatitis B viral (HBV) infection.
Testing for anti-HBc IgM (HBIM / Hepatitis B Core Antibody, IgM, Serum) 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 HBV infection. Differentiation between past/resolved and chronic hepatitis B can be based on the presence of hepatitis B surface antigen (HBsAg) in the latter condition.
Negative anti-HBc total results indicate the absence of recent, past/resolved, or chronic hepatitis B. An inconclusive result for HBc total suggests presence of interfering substance in the patient's serum specimen.
Positive antibodies to 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. Bonino F, Piratvisuth T, Brunetto MR, Liaw YF: Diagnostic markers of chronic hepatitis B infection and disease. Antivir Ther. 2010;15 Suppl 3:35-44. doi: 10.3851/IMP1622
2. Servoss JC, Friedman LS: Serologic and molecular diagnosis of hepatitis B virus. Clin Liver Dis. 2004 May;8(2):267-281. doi: 10.1016/j.cld.2004.02.001
3. Badur S, Akgun A: Diagnosis of hepatitis B infections and monitoring of treatment. J Clin Virol. 2001 Jun;21(3):229-237
4. LeFebre 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 Jul 1;161(1):58-66. doi: 10.7326/M14-1018
5. Jackson K, Locarnini S, Gish R: Diagnostics of hepatitis B virus: Standard of care and investigational. Clin Liver Dis (Hoboken). 2018 Aug 22;12(1):5-11. doi: 10.1002/cld.729
6. Coffin CS, Zhou K, Terrault NA: New and old biomarkers for diagnosis and management of chronic hepatitis B virus infection. Gastroenterology. 2019 Jan;156(2):355-368. doi: 10.1053/j.gastro.2018.11.037
7. World Health Organization: WHO guidelines on hepatitis B and C testing. 2017. Accessed September 8, 2022. Available at www.who.int/publications/i/item/9789241549981
8. Division of Viral Hepatitis, National Center for HIV, Viral Hepatitis, STD, and TB Prevention: Testing and public health management of persons with chronic hepatitis B virus infection. Centers for Disease Control and Prevention. Updated March 28, 2022. Accessed September 8, 2022. Available at www.cdc.gov/hepatitis/hbv/testingchronic.htm
Method Name
Chemiluminescence Immunoassay (CIA)
Specimen Type
Serum SSTSpecimen Required
Necessary Information
Date of collection is required.
Specimen Required
Patient Preparation: For 24 hours before specimen collection do not take multivitamins or dietary supplements containing biotin (vitamin B7), which is commonly found in hair, skin, and nail supplements and multivitamins.
Collection Container/Tube: Serum gel
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL
Collection Instructions: Centrifuge and aliquot serum into plastic vial within 24 hours.
Specimen Minimum Volume
0.4 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum SST | Frozen (preferred) | 28 days | |
| Refrigerated | 7 days | ||
| Ambient | 24 hours |
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 hepatitis B core (HBc) total antibodies is positive, then 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