Test Catalog

Test ID: HEPBS    
Hepatitis B Surface (HBs) Antigen Immunostain, Technical Component Only

Useful For Suggests clinical disorders or settings where the test may be helpful

Aiding in the identification of hepatitis B infection (carrier state)

Testing Algorithm Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

For the initial technical component only immunohistochemical (IHC) stain performed, the appropriate bill-only test ID will be reflexed and charged (IHTOI). For each additional technical component only IHC stain performed, an additional bill-only test ID will be reflexed and charged (IHTOA).

Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Hepatitis B surface antigen (HBsAg) stains the cytoplasm of hepatitis B-infected hepatocytes in a granular pattern. The complete infective virion consists of a core of double-stranded DNA, a specific DNA polymerase, and structural proteins. The nucleocapsid contains 2 serologically distinct antigens, the core antigen (HBcAg) and envelope antigen (HBeAG). These are surrounded by an outer envelope of surface protein that is recognized serologically as hepatitis B virus surface antigen. Core antigen is most often demonstrated in chronic active hepatitis, compared to surface antigen in the carrier state.

Interpretation Provides information to assist in interpretation of the test results

This test does not include pathologist interpretation; only technical performance of the stain. If interpretation is required, order PATHC / Pathology Consultation for a full diagnostic evaluation or second opinion of the case.


The positive and negative controls are verified as showing appropriate immunoreactivity and documentation is retained at Mayo Clinic Rochester. If a control tissue is not included on the slide, a scanned image of the relevant quality control tissue is available upon request, call 855-516-8404.


Interpretation of this test should be performed in the context of the patient's clinical history and other diagnostic tests by a qualified pathologist.

Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

Age of a cut paraffin section can affect immunoreactivity. Stability thresholds vary widely among published literature and are antigen-dependent. Best practice is for paraffin sections to be cut within 6 weeks.

Clinical Reference Recommendations for in-depth reading of a clinical nature

1. He Z, Chen J, Wang J, et al: Expression of hepatitis B surface antigen in liver tissues can serve as a predictor of prognosis for hepatitis B virus-related hepatocellular carcinoma patients after liver resection. Eur J Gastroenterol Hepatol. 2021 Jan;33(1):76-82 doi: 10.1097/MEG.0000000000001698

2. Wang Q, Sachse P, Semmo M, et al: T- and B-cell responses and previous exposure to hepatitis B virus in 'anti-HBc alone' patients. J Viral Hepat. 2015 Dec;22(12):1068-1078. doi: 10.1111/jvh.12428

3. Kabaçam G, Wedemeyer H, Savas B, et al: Role of immunohistochemistry for hepatitis D and hepatitis B virus in hepatitis delta. Liver Int. 2014 Sep;34(8):1207-1215. doi: 10.1111/liv.12376