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HelpTest ID: HBC Hepatitis B Virus Core Total Antibodies, Serum
Reporting Name
HBc Total Ab, SUseful For
Diagnosis of recent or past hepatitis B
Determination of occult hepatitis B in otherwise healthy hepatitis B virus carriers with negative test results for hepatitis B surface (HBs) antigen, anti-HBs, anti-HB core IgM, hepatitis Be (HBe) antigen, and anti-HBe
This assay is not useful for differentiating among acute, chronic, and past or resolved hepatitis B.
This test should not be used as a screening or confirmatory test for blood donor specimens.
Clinical Information
Hepatitis B virus core antibodies (anti-HBc) appear shortly after the onset of symptoms of hepatitis B infection and soon after the appearance of hepatitis B virus surface antigen (HBsAg). Initially, anti-HBc consist almost entirely of the IgM antibody class, followed by appearance of anti-HBc IgG for which there is no commercial diagnostic assay.
The anti-HBc total antibody test, which detects both IgM and IgG antibodies, and the test for anti-HBc IgM may be the only markers of recent hepatitis B detectable in the "window period." The window period begins with the clearance of HBsAg and ends with the appearance of anti-HBs. Anti-HBc total may be the only serologic marker remaining years after exposure to hepatitis B virus.
This assay is US Food and Drug Administration-approved for in vitro diagnostic use and not for screening cell, tissue, and blood donors.
Interpretation
Negative hepatitis B virus core total antibody (anti-HBc total) test results indicate the absence of exposure to hepatitis B virus and no evidence of recent, past/resolved, or chronic hepatitis B.
A positive result indicates acute, chronic, or past or resolved hepatitis B.
Positive anti-HBc total test results should be correlated with the presence of other hepatitis B virus serologic markers, elevated liver enzymes, clinical signs and symptoms, and a history of risk factors.
If clinically indicated, testing for anti-HBc IgM (HBIM / Hepatitis B Virus Core Antibody, IgM, Serum) is necessary to confirm an acute or recent infection.
Neonatal patients (<1 month old) with positive anti-HBc total results from this assay should be tested for anti-HBc IgM (HBIM / Hepatitis B Virus Core Antibody, IgM, Serum) to rule out possible maternal anti-HBc causing false-positive results. Repeat testing using this assay for anti-HBc total within 1 month is also recommended for these neonatal patients.
Report Available
Same day/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 September 9, 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 SSTOrdering Guidance
This test should not be used to screen or test pregnant individuals who may or may not have risk factors for hepatitis B virus (HBV) infection. For testing such patients, order HBCPR / Hepatitis B Virus Core Total Antibodies Prenatal, Serum.
This test should not be used to screen or test asymptomatic, non-pregnant individuals with or without risk factors for HBV. For testing such patients, order HBCSN / Hepatitis B Virus Core Total Antibodies Screen, Serum.
If a hepatitis B core total antibody test that reflexes to hepatitis B virus core IgM is needed, order test CORAB / Hepatitis B Virus Core Total Antibodies, with Reflex to Hepatitis B Virus Core Antibody IgM, Serum.
Necessary 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 | ||
| Ambient | 72 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
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| HBC | HBc Total Ab, S | 13952-7 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| HBC | HBc Total Ab, S | 13952-7 |
Testing Algorithm
For more information see Hepatitis B: Testing Algorithm for Screening, Diagnosis, and Management.
Special Instructions
Forms
If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:
mml-hepatitis