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HelpTest ID: HBABY Hepatitis B Perinatal Exposure Follow-up Panel, Serum
Useful For
Determining hepatitis B virus infection and immunity status (with or without perinatal prophylaxis) in infants born to mothers with chronic hepatitis B
Profile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| HBAG | HBs Antigen, S | Yes | Yes |
| HBC | HBc Total Ab, S | Yes | Yes |
| HBAB | HBs Antibody, S | Yes | Yes |
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| HBGNT | HBs Antigen Confirmation, S | No | No |
Testing Algorithm
If hepatitis B surface antigen (HBsAg) is reactive, then HBsAg confirmation will be performed at an additional charge.
See Hepatitis B: Testing Algorithm for Screening, Diagnosis, and Management.
Special Instructions
Reporting Name
Hepatitis B Perinatal Exposure, SSpecimen Type
Serum SSTNecessary Information
Date of collection is required.
Specimen Required
Collection Container/Tube: Serum gel
Submission Container/Tube: Plastic vial
Specimen Volume: 1.5 mL
Collection Instructions:
1. Centrifuge blood collection tube per collection tube manufacturer's instructions.
2. Aliquot serum into plastic vial.
Specimen Minimum Volume
1 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum SST | Frozen (preferred) | 28 days | |
| Refrigerated | 7 days | ||
| Ambient | 24 hours |
Clinical Information
Hepatitis B virus (HBV) is a DNA virus that is endemic throughout the world. After a course of acute illness, HBV persists in about 10% of patients who were infected during adulthood. Some carriers are asymptomatic; others may develop chronic liver disease including cirrhosis and hepatocellular carcinoma.
HBV can be transmitted from mother to child during delivery through contact with blood and vaginal secretions, but it is not commonly transmitted transplacentally. Infection of the infant can occur if the mother is a chronic hepatitis B surface antigen (HBsAg) carrier or has an acute HBV infection at the time of delivery. Transmission is rare if an acute infection occurs in either the first or second trimester of pregnancy.
Without postexposure prophylaxis (a combination of HBV vaccination and hepatitis B immune globulin), the risk of an infant acquiring HBV from an infected mother as a result of perinatal exposure is 70% to 90% for infants born to mothers who are positive for HBsAg and hepatitis B e antigen (HBeAg). The risk is 5% to 20% for infants born to HBsAg-positive but HBeAg-negative mothers.
HBV is also spread primarily through percutaneous contact with infected blood products (ie, blood transfusion, sharing of needles by drug addicts). The virus is found in virtually every type of human body fluid and also is spread through oral and genital contact.
See the following:
-Hepatitis B: Testing Algorithm for Screening, Diagnosis, and Management
Interpretation
Hepatitis B surface antigen (HBsAg) is the first serologic marker appearing in blood 6 to 16 weeks after exposure to HBV. A confirmed positive HBsAg result is indicative of acute or chronic hepatitis B. In acute cases, HBsAg usually disappears 1 to 2 months after the onset of symptoms. Persistence of HBsAg for more than 6-months duration indicates development of either a chronic carrier state or chronic hepatitis B.
Hepatitis B surface antibody (HBsAb) appears with the resolution of HBV infection and disappearance of HBsAg. A positive result indicates recovery from acute or chronic hepatitis B, or acquired immunity from HBV vaccination. This assay does not differentiate between a vaccine-induced immune response and recovery from HBV infection. Per assay manufacturer’s instructions for use, positive results are defined as HBsAb levels of 12.0 mIU/mL or greater, with adequate immunity to hepatitis B after recovery from past infection or HBV vaccination. Per current CDC guidance, individuals with HBsAb levels of 10 mIU/mL or greater after completing an HBV vaccination series are considered protected from hepatitis B.(1)
Negative results, defined as HBsAb levels of less than 5.0 mIU/mL, indicate a lack of recovery from acute or chronic hepatitis B or inadequate immune response to HBV vaccination. Indeterminate results, defined as HBsAb levels in the range of 5.0 to 11.9 mIU/mL, indicate inability to determine if HBsAb is present at levels consistent with recovery or immunity. Repeat testing is recommended in 1 to 3 months.
Hepatitis B core (HBc) total antibodies (combined IgG and IgM) appear shortly after the onset of symptoms of HBV infection and may be the only serologic marker remaining years after exposure to HBV. A positive result indicates exposure to HBV infection. A positive HBsAb result along with a positive HBc total antibody result is indicative of recovery from HBV infection. A positive HBsAb result with a negative HBc total antibody result is consistent with immunity to hepatitis B from HBV vaccination.
See the following:
-Hepatitis B: Testing Algorithm for Screening, Diagnosis, and Management
Clinical Reference
1. Advisory Committee on Immunization Practices; Centers for Disease Control and Prevention (CDC). Immunization of health-care personnel: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2011 Nov 25;60(RR-7):1-45
2. Mast EE, Margolis HS, Fiore AE, Advisory Committee on Immunization Practices (ACIP), et al:Â A comprehensive immunization strategy to eliminate transmission of hepatitis B virus infection in the United States: recommendations of the Advisory Committee on Immunization Practices (ACIP);Part 1: Immunization of Infants, Children, and Adolescents. MMWR Recomm Rep. 2005 Dec 23;54(RR-16):1-31. Erratum in: MMWR Morb Mortal Wkly Rep. 2006 Feb 17;55(6):158-9. Erratum in: MMWR Morb Mortal Wkly Rep. 2007 Dec 7;56(48):1267
3. Centers for Disease Control and Prevention: Interpretation of hepatitis B serologic test results. Accessed October 2, 2020. Available at www.cdc.gov/hepatitis/HBV/PDFs/SerologicChartv8.pdf
4. Bonino F, Piratvisuth T, Brunetto MR, Liaw YF: Diagnostic markers of chronic hepatitis B infection and disease. Antiviral Ther. 2010;15(3):35-44
5. Centers for Disease Control and Prevention: Testing and public health management of persons with chronic hepatitis B virus infection. Accessed April 8, 2020. Available at www.cdc.gov/hepatitis/hbv/testingchronic.htm
6. Jackson K, Locarnini S, Gish R: Diagnostics of hepatitis B virus: Standard of care and investigational. Clin Liver Dis. 2018 Jul;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
8. WHO Guidelines Development Group: World Health Organization: Guidelines on hepatitis B and C testing.World Health Organization; 2017. Accessed September 29, 2020. Available at www.who.int/hepatitis/publications/guidelines-hepatitis-c-b-testing/en/
Day(s) Performed
Monday through Saturday
Report Available
Same day/1 to 3 daysTest 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
86706
86704
87340
87341 (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| HBABY | Hepatitis B Perinatal Exposure, S | 77190-7 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| HBC | HBc Total Ab, S | 13952-7 |
| HB_AB | HBs Antibody, S | 10900-9 |
| H_BAG | HBs Antigen, S | 5196-1 |
| HBSQN | HBs Antibody, Quantitative, S | 5193-8 |
Method Name
Chemiluminescence Immunoassay (CIA)
Forms
If not ordering electronically, complete, print, and send 1 of the following:
mml-hepatitis