Hepatitis B virus (HBV) core antibody (total) - serum specimen
- LIS Mnemonic: HBVTCORE
Collect
Gold (SST - Clot activator & gel)
Volume Required
2 ml blood
Minimum Required
1 ml serum
Transport
A total of 2-4 ml of blood (for every 2-3 HIV and Hepatitis tests ordered) should be collected and submitted at room temperature to the laboratory.
Days Performed
Monday thru Friday
Reported
Daily
CPT
86704
Methodology
Microparticle Enzyme Immunoassay
Disease Information
Utility:
This assay measures total antibody (IgG + IgM) responses to Hepatitis B virus (HBV) core antigen. The presence of HBc total antibody indicates acute or chronic infection. Total antibody to HBV core antigen (anti-HBc Total) develops within 1-4 weeks of the appearance of HBsAg, rapidly rises to high levels, and is detectable for the remainder of a patient's life. Following the loss of HBV core IgM antibody during acute HBV infection, the total anti-HBc response primarily consists of IgG anti-HBc. Isolated positive results for total anti-HBc with negative results for HBsAg and anti-HBs antibody may indicate (1) a false-positive reaction in the serologic assay for total anti-HBc, (2) passive transfer of total anti-HBc antibody, (3) chronic infection without detectable HBsAg as a result of the development of viral mutant and the subsequent production of undectable levels of antigen in serum, (4) suppression of HBsAg production following HDV superinfection, and (5) acute infection involving the core window" period between the decline of detectable HBsAg and the subsequent rise in anti-HBs antibody. Low levels of total anti-HBc antibody usually represent nonspecific reactions and account for a large number of the isolated total anti-HBc positive results.
Interpretation
The presence of HBV core total antibody is indicative of either a past or present infection with hepatitis B virus. If you suspect an acute HBV infection, please also order hepatitis B core IgM antibody and surface antigen tests. HBV core total antibody will be present in virtually all patients with chronic HBV infection. Negative test results are indicative of no evidence of recent, past or chronic infection with HBV. This does not exclude the possibility of exposure to or early acute infection with HBV. If clinically indicated, please wait 1-2 weeks and submit another specimen for additional HBV core total antibody (IgG & IgM) testing. A hepatitis B surface antigen test and HBV core IgM antibody test may also be ordered on the current and repeat specimens. Recipients of intravenous immunoglobulin, newborn infants possessing pasively acquired maternal antibody, or patients who have received recent blood transfusions may be positive for total antibody to HBV. For diagnostic purposes, anti-HBc total reactivity should be correlated with patient history and other hepatitis markers for diagnosis of past or present infection, or vaccination against HBV.
Reference Values
Negative or nonreactive for hepatitis B virus (HBV) core total antibody (IgG & IgM)
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