Test Id : SEAG1
Hepatitis B e Antigen, Serum
Useful For
Suggests clinical disorders or settings where the test may be helpful
Staging of hepatitis B infections when used as a surrogate marker for hepatitis B virus (HBV) replication and infectivity
Monitoring response to therapy in chronic hepatitis B infections (along with HBV DNA, hepatitis B surface [HBs] antigen, and HBs antibody) where seroconversion from hepatitis B e (HBe) antigen to HBe antibody indicates virological response
Method Name
A short description of the method used to perform the test
Only orderable as part of a profile. For more information see SHEAG / Hepatitis B e Profile.
Electrochemiluminescence Immunoassay (ECLIA)
NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.
Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test
Aliases
Lists additional common names for a test, as an aid in searching
HBeAg
HBV (Hepatitis B Virus)
Hepatitis B e
Hepatitis B e Antigen
Hepatitis B Virus (HBV)
Hepatitis Be
Hepatitis Be Antigen
Specimen Type
Describes the specimen type validated for testing
Serum SST
Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing
Only orderable as part of a profile. For more information see SHEAG / Hepatitis B e Profile.
Patient Preparation: Specimens should not be collected from patients receiving therapy with high biotin (vitamin B7) doses (eg, >5 mg/day) until at least 8 hours following the last biotin administration.
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL
Collection Instructions:
1. For serum gel tubes, allow blood to clot in an upright position for at least 30 minutes. Within 2 hours of collection, centrifuge and refrigerate.
2. For red top tubes, allow blood to clot in an upright position for at least 60 minutes. Within 2 hours of collection, centrifuge, aliquot serum into a plastic vial, and refrigerate. Clearly label tube as serum from a plain red top tube.
Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.
See Specimen Required
Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected
| Gross hemolysis | Reject |
| Gross lipemia | Reject |
| Gross icterus | Reject |
Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum SST | Refrigerated (preferred) | 14 days | |
| Ambient | 4 days | ||
| Frozen | 90 days |
Useful For
Suggests clinical disorders or settings where the test may be helpful
Staging of hepatitis B infections when used as a surrogate marker for hepatitis B virus (HBV) replication and infectivity
Monitoring response to therapy in chronic hepatitis B infections (along with HBV DNA, hepatitis B surface [HBs] antigen, and HBs antibody) where seroconversion from hepatitis B e (HBe) antigen to HBe antibody indicates virological response
Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Hepatitis B virus (HBV) is a circular, partially double-stranded DNA virus of the Hepadnaviridae family that 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.
Hepatitis B virus 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) within 6 months of exposure to HBV. In the United States, acute HBV infection leads to chronic disease in 5% of cases, although the percentage is much higher in infections with an onset in infancy and young childhood. Chronic HBV is a serious, lifelong illness that may result in cirrhosis or hepatocellular carcinoma.(1)
Serologic markers specific for HBV 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. Hepatitis B core IgM antibody (HBcAb) is the first antibody to appear following acute HBV infection and is the best serologic marker for acute HBV infection. It is typically ordered as the follow-up test for a positive screening total HBcAb (IgM and IgG) to help differentiate acute infections (<6 months) from chronic/resolved infections.(1)
The incubation period for HBV is 45 to 160 days, with an average of 100 days for symptom onset. 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). The disease may become fulminant in 0.1% to 0.5% of acute HBV infections, and acute clinical deterioration of an individual with the HBV should prompt evaluation for hepatitis D virus superinfection.(2)
Risk factors for HBV transmission include living in a household with a person who is infected with HBV, sexual contact with a person with an HBV infection, men who have sex with men, immigrants from regions of high HBV infectivity, kidney dialysis, concurrent use of immunosuppression medication, HIV infection, abnormal liver enzymes, inmates, and intravenous drug use.(3)
Hepatitis B e antigen (HBeAg) is the second viral marker (coincident with HBV DNA) detected during acute HBV infection, appearing after HBsAg. HBeAg levels rise in parallel with active HBV replication, indicating a high hepatitis B viral load and greater infectivity. HBeAg levels fall at the onset of symptoms (eg, nausea, jaundice), usually becoming undetectable during the period of peak clinical symptoms. HBeAg is usually present for only 3 to 6 weeks, and persistence beyond 10 weeks suggests development of chronic hepatitis, where high levels of HBeAg may be seen during and after a burst of viral replication.
A negative HBeAg result may indicate either early acute infection before the peak of viral replication, or early convalescence when HBeAg has declined below detectable levels; convalescence is distinguished by the presence of hepatitis B e antibody (HBeAb). Conversion to HBeAg-negative, HBeAb-positive status indicates lower hepatitis B viral loads, decreased hepatic inflammation, and less infectivity.(4)
Certain HBV strains, particularly those present in Asia and the Mediterranean, have been found to have a mutation in the DNA region coding for the core antigen, preventing production of HBeAg. This mutation may lead to HBeAg-negative chronic hepatitis, a finding that implies longer disease duration with a concurrent increased risk for cirrhosis and hepatocellular carcinoma.(2)
Loss of HBeAg does not guarantee resolution of disease; HBV flares may occur in the presence of steroids or other immunosuppressive medications. Reversion to HBeAg-positive status is associated with increased risk of cirrhosis as compared to individuals who remain HBeAg negative.(5)
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.
Only orderable as part of a profile. For more information see SHEAG / Hepatitis B e Profile.
Nonreactive
Interpretation
Provides information to assist in interpretation of the test results
Negative or nonreactive:
Indicates either early acute infection before the peak of viral replication or resolution of infection/suppression of viral replication.
Positive or reactive:
Indicates rapid viral replication usually associated with high hepatitis B virus (HBV) DNA levels and high infectivity risk, which may be seen in either acute or chronic HBV infections.
Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
A negative result does not rule out infectivity or chronic hepatitis B carrier status.
Clinical Reference
Recommendations for in-depth reading of a clinical nature
1. Hepatitis B Resources for Health Professionals. Centers for Disease Control and Prevention; Updated April 30, 2024. Accessed July 2, 2025. Available at www.cdc.gov/hepatitis-b/hcp/provider-resources/
2. Carey W. Hepatitis B. Cleveland Clinic Digestive Disease and Surgery Institute; August 2010. Accessed July 2, 2025. Available at https://my.clevelandclinic.org/departments/digestive/medical-professionals/hepatology/hepatitis-b
3. Hepatitis B. World Health Organization; Updated April 9, 2024. Accessed July 2, 2025. Available at www.who.int/mediacentre/factsheets/fs204/en/
4. Liaw YF. HBeAg seroconversion as an important end point in the treatment of chronic hepatitis B. Hepatol Int. 2009;3(3):425-433. doi:10.1007/s12072-009-9140-3
5. Elgouhari HM, Abu-Rajab Tamimi TI, Carey W. Hepatitis B: a strategy for evaluation and management [published correction appears in Cleve Clin J Med. 2009 Feb;76(2):128]. Cleve Clin J Med. 2009;76(1):19-35. doi:10.3949/ccjm.76a.08025
Method Description
Describes how the test is performed and provides a method-specific reference
The Elecsys Anti-HBc (hepatitis B virus core antibody) IgM assay is based on the sandwich immunoassay principle and performed with an electrochemiluminescence immunoassay on the automated cobas e 801 immunochemistry analyzer. Anti-HBc IgM present in patient's sample is pretreated with anti-Fdy reagent to block specific IgG. After addition of biotinylated monoclonal human IgM-specific antibodies, the complexes formed from reaction of ruthenium-labeled HBc antigen, streptavidin-coated microparticles (solid phase), anti-HBc IgM present in the sample, and the biotinylated anti-human IgM bind to the solid phase via interaction of biotin and streptavidin. The reaction mixture is then aspirated into the measuring cell where the microparticles are magnetically captured onto the surface of the electrode, and unbound substances are washed away. Voltage is applied to the electrode that induces chemiluminescent emissions, which are measured by a photomultiplier. Test result is determined by comparing the electrochemiluminescence signal generated from the sample to the cutoff index value set from reagent lot-specific assay calibration.(Package insert: Elecsys Anti-HBc IgM. Roche Diagnostics; v1.0, 09/2020)
PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information
Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.
Monday through Friday
Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.
Performing Laboratory Location
Indicates the location of the laboratory that performs the test
Fees :
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.
- Authorized users can sign in to Test Prices for detailed fee information.
- Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
- Prospective clients should contact their account representative. For assistance, contact Customer Service.
Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.
This test has been modified from the manufacturer's instructions. Its performance characteristics were determined by the performing lab in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.
CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
CPT codes are provided by the performing laboratory.
CPT codes are provided by the performing laboratory.
87350
LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.
| Test Id | Test Order Name | Order LOINC Value |
|---|---|---|
| SEAG1 | Hepatitis B e Antigen, S | Not Provided |
| Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
|---|---|---|
| SEAG1 | Hepatitis B e Antigen, S | Not Provided |