Skip to main content

Hepatitis B Surface Antigen (HBsAg) Screen, Qualitative

CPT 87340
Synonyms
  • HBsAg
  • HBV
  • Hepatitis-associated Antigen
  • Qualitative HBV surface antigen

Test Details

Methodology

Immunochemiluminometric assay (ICMA)

Result Turnaround Time

1 - 2 days

Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.

Related Documents

Test Includes

Confirmation of positive results is performed as indicated, by a neutralization assay at no additional charge.

• Samples with an index value greater than an established threshold and with positive results for other hepatitis B markers are considered positive for Hepatitis B Surface Antigen without further testing (neutralization testing is not performed).

• Samples with an index value greater than an established threshold but with no other positive results for hepatitis B markers, or with an index value less than an established threshold but above the cutoff for positivity, are confirmed by neutralization.

Use

This assay can be used in conjunction with other serological and clinical information to diagnose individuals with acute or chronic hepatitis B infection. This assay may also be used to screen for hepatitis B infection in pregnant women to identify neonates who are at risk of acquiring hepatitis B during the perinatal period.

Special Instructions

This test may exhibit interference when sample is collected from a person who is consuming a supplement with a high dose of biotin (also termed as vitamin B7 or B8, vitamin H, or coenzyme R). It is recommended to ask all patients who may be indicated for this test about biotin supplementation. Patients should be cautioned to stop biotin consumption at least 72 hours prior to the collection of a sample.

Limitations

Patients who are negative for HBsAg may still have acute type B viral hepatitis. There is sometimes a “core window” stage when HBsAg has become negative and the patient has not yet developed the antibody (anti-HBs). On such occasions, both tests for anti-HBc are usually positive and anti-HBc, IgM is the only specific marker for the diagnosis of acute infection with hepatitis B. In cases with strong clinical suspicion of viral hepatitis, serologic testing should not be limited to detecting HBsAg, but should include a battery of tests to evaluate different stages of acute and convalescent hepatitis.

References

Abara WE, Oaseem A, Schillie S. McMahon BJ, Harris AM, High Value Care Task Force of the American College of Physicians and the Centers for Disease Control and Prevention. Hepatitis B Vaccination, Screening, and Linkage to Care: Best Practice Advice from the American College of Physicians and the Centers for Disease Control and Prevention. Ann Intern Med. 2017 Dec 5;167(11):794-804.29159414
Centers for Disease Control and Prevention. Screening Pregnant Women for Hepatitis B Virus (HBV) Infection and Screening and Referral Algorithm for Hepatitis B Virus (HBV) Infection Among Pregnant Women. CDC Web site. https://www.cdc.gov/hepatitis/hbv/perinatalxmtn.htm#section1. Accessed August 2020.
Schillie S, Vellozzi C, Reingold A, et al. Prevention of Hepatitis B Virus Infection in the United States. Recommendations of the Advisory Committee on Immunization Practices. MMWR Recomm Rep. 2018 Jan 12;67(1):1-31.29939980
Terrault NA, Lok ASF, McMahon BJ, et al. Update on Prevention, Diagnosis, and Treatment of Chronic Hepatitis B: AASLD 2018 Hepatitis B Guidance. Hepatology. 2018 Apr;67(4):1560-1599.29405329
Workowski KA, Bolan GA, Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines. MMWR Recomm Rep. 2015 Jun 5;64(RR-03):1-137.26042815

Custom Additional Information

Hepatitis B surface antigen (HBsAg) is a distinctive serological marker of acute or chronic hepatitis B infection. HBsAg is the first antigen to appear following infection with HBV and is generally detected 1-10 weeks after the onset of clinical symptoms. HBsAg assays are routinely used to diagnose suspected HBV infection and monitor the status of infected individuals to determine whether the infection has resolved or the patient has become a chronic carrier of the virus. In patients that recover from HBV infection, HBsAg is undetectable 3-5 months after the onset of infection. In patients with chronic HBV infection, HBsAg remains detectable for life. Prenatal HBsAg screening has been recommended so that newborns from HBV carrier mothers may obtain prophylactic treatment. Persistence of HBsAg, without anti-HBs, with combinations of positivity of anti-HBc, HBeAg, or anti-HBe indicates infectivity and need for investigation for chronic persistent or chronic aggressive hepatitis.

Specimen Requirements

Specimen

Serum or plasma

Volume

3.5 mL

Minimum Volume

1.5 mL (Note: This volume does not allow for repeat testing.)

Container

Red-top tube, gel-barrier tube, or lavender-top (EDTA) tube

Collection Instructions

If tube other than a gel-barrier tube is used, transfer separated serum or plasma to a plastic transport tube.

Stability Requirements

Temperature

Period

Room temperature

14 days

Refrigerated

14 days

Frozen

14 days

Freeze/thaw cycles

Stable x3

Reference Range

Negative

Storage Instructions

Room temperature

Causes for Rejection

Non-EDTA plasma specimen; PST gel-barrier tube

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
006510 HBsAg Screen 5196-1 006510 HBsAg Screen 5196-1
Order Code006510
Order Code NameHBsAg Screen
Order Loinc5196-1
Result Code006510
Result Code NameHBsAg Screen
UofM
Result LOINC5196-1
Reflex Table for HBsAg Screen
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 016105 HBsAg Confirmation 016105 HBsAg Confirmation 7905-3
Reflex 1
Order Code016105
Order NameHBsAg Confirmation
Result Code016105
Result NameHBsAg Confirmation
UofM
Result LOINC7905-3