Test ID: HBABT Hepatitis B Surface Antibody Monitor, Post-Transplant, Serum
Reporting Name
HBs Ab Monitor, Post-transplant, SUseful For
Monitoring serum anti-hepatitis B surface levels during intravenous or intramuscular hepatitis B immune globulin therapy to prevent hepatitis B virus (HBV) reinfection in liver transplant recipients with known previous chronic HBV
Clinical Information
For patients with chronic hepatitis B virus (HBV) infection (hepatitis B surface [HBs] antigen-positive), outcomes following liver transplantation for end-stage liver disease are poor. Recurrent HBV disease is common and associated with decreased liver graft and patient survival (approximately 50% at 5 years). Studies have shown administration of hepatitis B immune globulin (HBIG) in the perioperative and early posttransplant periods could delay or prevent recurrent HBV infection in these transplant recipients.
Since mid-1990, intravenous or intramuscular administration of HBIG has become the standard of care for these liver transplant recipients in most liver transplant programs in the United States. Most therapy protocols administer HBIG in high doses (10,000 IU) during the perioperative period and first week after transplantation with the goal of achieving serum HBs antibody (anti-HBs) levels of above 500 mIU/mL. Serial levels of anti-HBs are obtained to determine the pharmacokinetics of HBIG in each patient to guide frequency of HBIG dosing.
During the first few weeks to months after transplantation, there is a high degree of variability in HBIG dosage required to achieve desirable serum anti-HBs levels among transplant recipients. Patients who were hepatitis B e antigen positive before transplantation usually require more HBIG to achieve the target anti-HBs levels, especially in the first week after transplantation.
Duration of HBIG therapy varies from 6 months to indefinite among different US liver transplant programs. Protocols providing less than 12 months of therapy usually combine HBIG with another effective anti-HBV agent such as lamivudine.
Interpretation
Refer to the healthcare provider's institutional hepatitis B immune globulin (HBIG) therapy protocol for desirable hepatitis B surface antibody (anti-HBs) levels.
Studies indicated that serum anti-HBs levels needed to prevent hepatitis B virus (HBV) reinfection were greater than 500 mIU/mL during the first week after transplantation, greater than 250 mIU/mL during weeks 2 to 12, and greater than 100 mIU/mL after week 12.
For more information see HBV Infection-Monitoring Before and After Liver Transplantation
Report Available
Same day/1 to 3 daysDay(s) Performed
Monday through Saturday
Clinical Reference
1. Samuel D: Management of hepatitis B in liver transplant patients. Semin Liver Dis. 2004;24 Suppl 1:55-62. doi: 10.1055/s-2004-828679
2. Terrault NA, Vyas G: Hepatitis B immune globulin preparations and use in liver transplantation. Clin Liver Dis. 2003 Aug;7(3):537-550. doi: 10.1016/s1089-3261(03)00045-x
3. Lok ASF: Prevention of recurrent hepatitis B post-liver transplantation. Liver Transpl. 2002 Oct;8(Suppl 1):S67-S73. doi: 10.1053/jlts.2002.35780
4. Levitsky J, Doucette K, AST Infectious Diseases Community of Practice: Viral hepatitis in solid organ transplant recipients. Am J Transplant. 2009 Dec;9 Suppl 4:S116-S130. doi: 10.1111/j.1600-6143.2009.02902.x
5. LeFevre ML, US Preventive Services Task Force: Screening for hepatitis B virus infection in nonpregnant adolescents and adults: US Preventive Services Task Force recommendation statement. Ann Intern Med. 2014 Jul 1;161(1):58-66. doi:10.7326/M14-1018
6. Jackson K, Locarnini S, Gish R: Diagnostics of hepatitis B virus: Standard of care and investigational. Clin Liver Dis. 2018 Aug 22;12(1):5-11. doi: 10.1002/cld.729
7. 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
9. 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 9, 2022. Available at www.cdc.gov/hepatitis/hbv/testingchronic.htm
Method Name
Chemiluminescent Immunoassay (CIA)
Specimen Type
Serum SSTNecessary Information
Date of collection is required.
Specimen Required
Collection Container/Tube: Serum gel
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL
1. Centrifuge blood collection tube per collection tube manufacturer's instructions.
2. Aliquot serum into plastic vial.
Specimen Minimum Volume
0.5 mL
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Serum SST | Frozen (preferred) | 28 days | |
Refrigerated | 7 days | ||
Ambient | 24 hours |
Reference Values
Not applicable
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
86317
LOINC Code Information
Test ID | Test Order Name | Order LOINC Value |
---|---|---|
HBABT | HBs Ab Monitor, Post-transplant, S | 5193-8 |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
HBABT | HBs Ab Monitor, Post-transplant, S | 5193-8 |
Testing Algorithm
For more information see HBV Infection-Monitoring Before and After Liver Transplantation.
Special Instructions
Forms
If not ordering electronically, complete, print, and send 1 of the following:
mml-hepatitis