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Diagnosis of acute hepatitis B infection
Identifying acute hepatitis B virus (HBV) infection in the serologic window period when hepatitis B surface antigen (HBsAg) and antihepatitis B surface (anti-HBs) are negative
Differentiation between acute and chronic or past hepatitis B infection in the presence of positive antihepatitis B core.
Hepatitis B virus (HBV) is a DNA virus that is endemic throughout the world. In the initial (acute) phase of infection, antihepatitis B core antibodies (anti-HBc) consist almost entirely of the IgM antibody class and appear shortly after the onset of symptoms. Anti-HBc IgM antibody can be detected in serum and is usually present for up to 6 months after acute HBV infection. Anti-HBc IgM may be the only serologic marker of a recent hepatitis B infection detectable following the disappearance of hepatitis B surface antigen (HBsAg) and prior to the appearance of hepatitis B surface antibody (anti-HBs) (ie, serologic window period).
See Viral Hepatitis Serologic Profile in Special Instructions and The Laboratory Approach to the Diagnosis and Monitoring of Hepatitis B Infection in Publications.
See Viral Hepatitis Serologic Profiles in Special Instructions.
A positive result indicates recent acute hepatitis B infection.
A negative result suggests lack of recent exposure to the virus in preceding 6 months.
For 24 hours before blood collection, patient should not take multivitamins or dietary supplements containing biotin or vitamin B7 that are commonly found in hair, skin and nail supplements and multivitamins.
The predictive value of a positive antihepatitis B core (anti-HBc) IgM test result is low when used to test specimens from patients with low prevalence of acute hepatitis B virus infection.
Performance characteristics have not been established for the following specimen characteristics:
-Grossly icteric (total bilirubin level of >20 mg/dL)
-Grossly lipemic (triolein level of >3,000 mg/dL)
-Grossly hemolyzed (hemoglobin level of >500 mg/dL)
-Containing particulate matter
1. Bonino F. Piratvisuth T, Brunetto MR, et al: Diagnostic markers of chronic hepatitis B infection and disease. Antiviral Therapy 2010;15(Suppl. 3):35-44
2. Badur S, Akgun A: Diagnosis of hepatitis B infections and monitoring of treatment. J Clin Virol 2001;21:229-237
3. Servoss JC, Friedman LS: Serologic and molecular diagnosis of hepatitis B virus. Clin Liver Dis 2004;8:267-281