Test Catalog

Test ID: HBGCD    
Hepatitis B Surface Antigen for Cadaveric or Hemolyzed Specimens, Serum

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

Testing cadaveric and hemolyzed blood specimens for hepatitis B surface antigen (HBsAG); FDA-licensed for use with hemolyzed specimens


Diagnosis of acute, recent (<6 month duration), or chronic hepatitis B infection; determination of chronic hepatitis B carrier status


This test is not useful during the "window period" of acute hepatitis B virus (HBV) infection, (ie, after disappearance of HBsAg and prior to appearance of anti-HBs antibody).

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

All reactive results are confirmed by a neutralization procedure at an additional charge.

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

Hepatitis B virus (HBV) is endemic throughout the world. The infection is spread primarily through percutaneous contact with infected blood products (eg, blood transfusion, sharing of needles by intravenous drug addicts). The virus is also found in various human body fluids, and it is known to be spread through oral and genital contacts. HBV can be transmitted from mother to child during delivery through contact with blood and vaginal secretions, but it is not commonly transmitted transplacentally.


Hepatitis B surface antigen (HBsAg) is the first serologic marker appearing in the serum at 6 to 16 weeks following HBV infection. In acute infection, HBsAg usually disappears in 1 to 2 months after the onset of symptoms. Persistence of HBsAg for greater than 6 months indicates development of either a chronic carrier or chronic HBV infection.

Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.


Interpretation Provides information to assist in interpretation of the test results

A positive result (reactive screening and confirmed positive by neutralization test) is indicative of acute or chronic hepatitis B virus (HBV) infection, or chronic HBV carrier state.


A positive confirmatory test result is considered the definitive test result for hepatitis B surface antigen (HBsAg). Specimens that are reactive by the screening test but negative (not confirmed) by the confirmatory test are likely to contain cross-reactive antibodies from other infectious or immunologic disorders. These unconfirmed HBsAg screening test results should be interpreted in conjunction with test results of other HBV serological markers (eg, anti-hepatitis B surface antibody, anti-hepatitis B core total antibody).


The presence of HBsAg is frequently associated with HBV infectivity, especially when accompanied by the presence of hepatitis Be antigen or HBV DNA.

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

Positive hepatitis B surface antigen (HBsAg) test results should be reported by the health care provider to the State Department of Health, as required by law in some states.


Individuals, especially neonates and children, who recently received hepatitis B vaccination may have transient-positive HBsAg test results because of the large dose of HBsAg used in the vaccine relative to the individual's body mass.


Performance characteristics have not been established for the following specimen characteristics:

-Icteric cadavers

-Lipemic cadavers

-Containing particulate matter

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

1. Servoss JC, Friedman LS: Serologic and molecular diagnosis of hepatitis B virus. Clin Liver Dis. 2004;8:267-281

2. Badur S, Akgun A: Diagnosis of hepatitis B infections and monitoring of treatment. J Clin Virol. 2001 Jun;21(3):229-237

3. Bonino F, Piratvisuth T, Brunetto MR, Liaw YF: Diagnostic markers of chronic hepatitis B infection and disease. Antivir Ther. 2010;15(3):35-44

4. Terrault NA, Bzowej NH, Chang K-M, et al: AASLD guidelines for treatment of chronic hepatitis B. Hepatology. 2016;63:261-283