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Hepatitis B Surface Antigen Test

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About Our Hepatitis B Surface Antigen Test

This blood test checks for Hepatitis B Surface Antigen, which is the earliest indicator of the presence of acute infection. This test also indicates chronic infection and is useful in the differential diagnosis of hepatitis. The incubation period for HBV is 45 to 160 days, with an average of 100 days for symptom onset. The acute illness is typically mild (especially in young children), however 30% to 50% of adolescents and adults will present with symptoms (jaundice, anorexia, nausea, vomiting).

Hepatitis B Overview

Hepatitis B virus (HBV) is a circular, partially double-stranded DNA virus of the Hepadnaviridae family which is unrelated to the viruses causing Hepatitis A or Hepatitis C. HBV is transmitted by exposure to infected bodily fluids during sexual activity, sharing intravenous drug injection equipment, or exposure to infected maternal blood at birth.

Symptoms of Hep B

HBV illness is characterized as either acute or chronic, with hepatic injury resulting from the body's immune response to clear the infection. Acute HBV infection typically causes short-term symptoms (eg, jaundice, nausea, vomiting, stomach pain) within 6 months of exposure to the HBV. Chronic HBV is a serious, lifelong illness that may result in cirrhosis or hepatocellular carcinoma (CDC, 2012).

Testing Information

Serologic markers specific for the Hepatitis B virus are used to diagnose HBV infection. The markers identify the stage of the infection (past, present or chronic) and those who are at highest risk for complications. The presence of hepatitis B surface antibody (HBsAb) indicates either recovery and immunity in a previously infected person, or successful immunization by vaccination. Infection is differentiated from vaccination by the concurrent presence of hepatitis B core antibody (either Total IgM and IgG, or IgM alone) (CDC, 2012).

Risk Factors

Risk factors for HBV transmission include living in a household with an HBV-infected person, sexual contact with an HBV-infected person, men who have sex with men, immigrants from regions of high HBV infectivity, renal dialysis, concurrent use of immunosuppression medication, HIV infection, abnormal liver enzymes, inmates, intravenous drug use (WHO 2014).


Hepatitis B surface antibody (HBsAb) is produced in response to the hepatitis B surface antigen (HBsAg). It is detectable approximately six months after infection, and as early as 8-10 weeks after symptom onset. In serologic testing, the time interval between the clearance of HBsAg and the appearance of HBsAb is termed the ‘window-period’. The advent of the HBsAb, which is a neutralizing antibody and protective against reinfection, indicates clearance of the HBV and noninfectivity. HBsAb persists for life.

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Medically Reviewed by: 2019-11-12

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