Hepatitis B virus (HBV) testing - serum

Last updated: Sunday, 21, May, 2006

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Item	Process
Specimen	5-10 mL blood in plain tube.
Method	Immunoassay. Tests include: HBV surface antigen (HBsAg); antibody to HBsAg (anti-HBs); antibody to HBV core antigen (anti-HBc); HBV e antigen (HBeAg); antibody to HBeAg (anti-HBe); hepatitis B DNA polymerase (HBV DNA-p); and hepatitis B DNA (HBV DNA).
Application	Acute or chronic hepatitis; prognosis for HBV carrier state; testing for infectivity or immunity (including blood, semen and tissue donors, antenatal patients, HIV positive patients). HBeAg should only be requested if it is known that HBsAg is positive. HBV DNA-p and HBV DNA are only available from specialised laboratories and their use is restricted.
Interpretation	Positive HBsAg indicates acute HBV infection or carrier status and implies infectivity. Positive anti-HBs indicates immunity to HBV. Positive anti-HBc IgM indicates recent infection; anti-HBc IgG indicates past infection or HBV carrier status; the significance depends on results for HBsAg and anti-HBs. The detection of HBeAg in HBsAg positive patients indicates greater infectivity and its persistence indicates an increased risk of chronic liver disease (chronic hepatitis, cirrhosis, hepatocellular carcinoma). Positive anti-HBe is associated with a better prognosis and less infectivity. HBV DNA-p and HBV DNA in serum or liver are markers for viral replication.
Reference	Hoofnagle JH and Di Bisceglie AM. Semin Liver Dis 1991; 11: 73-83. Koziel MJ and Siddiqui A. In: Mandell GR et al eds. Principles and Practice of Infectious Diseases. 6th ed. Churchill Livingstone 2005.