Monitoring serum anti-hepatitis B surface levels during intravenous or intramuscular hepatitis B immune globulin therapy to prevent hepatitis B virus (HBV) reinfection in liver transplant recipients with known previous chronic HBV
This test provides quantitative results only; this test does not provide interpretation of the hepatitis B surface antibody level detected.
For more information see HBV Infection-Monitoring Before and After Liver Transplantation.
Chemiluminescent Immunoassay (CIA)
Anti-Hepatitis Bs
Antibody Titer to Hep B Surface Ag
Antibody to Hepatitis B Surface Antigen
HBV (Hepatitis B Virus)
Hepatitis B Surface Antibody-Quant
Hepatitis B Virus (HBV)
Hepatitis Bs
Hep B Surface Ab (Anti-HBs) Titer
HBABT
For more information see HBV Infection-Monitoring Before and After Liver Transplantation.
Serum SST
Date of collection is required.
Collection Container/Tube: Serum gel
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL
Collection Instructions:
1. Centrifuge blood collection tube per collection tube manufacturer's instructions (eg, centrifuge and aliquot within 2 hours of collection for BD Vacutainer tubes).
2. Aliquot serum into plastic vial.
If not ordering electronically, complete, print, and send 1 of the following:
0.5 mL
Gross hemolysis | Reject |
Gross lipemia | Reject |
Gross icterus | Reject |
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Serum SST | Frozen (preferred) | 28 days | |
Refrigerated | 7 days | ||
Ambient | 24 hours |
Monitoring serum anti-hepatitis B surface levels during intravenous or intramuscular hepatitis B immune globulin therapy to prevent hepatitis B virus (HBV) reinfection in liver transplant recipients with known previous chronic HBV
For more information see HBV Infection-Monitoring Before and After Liver Transplantation.
For patients with chronic hepatitis B virus (HBV) infection (hepatitis B surface [HBs] antigen-positive), outcomes following liver transplantation for end-stage liver disease are poor. Recurrent HBV disease is common and associated with decreased liver graft and patient survival (approximately 50% at 5 years). Studies have shown administration of hepatitis B immune globulin (HBIG) in the perioperative and early posttransplant periods could delay or prevent recurrent HBV infection in these transplant recipients.
Since mid-1990, intravenous or intramuscular administration of HBIG has become the standard of care for these liver transplant recipients in most liver transplant programs in the United States. Most therapy protocols administer HBIG in high doses (10,000 IU) during the perioperative period and first week after transplantation with the goal of achieving serum HBs antibody (anti-HBs) levels of above 500 mIU/mL. Serial levels of anti-HBs are obtained to determine the pharmacokinetics of HBIG in each patient to guide frequency of HBIG dosing.
During the first few weeks to months after transplantation, there is a high degree of variability in HBIG dosage required to achieve desirable serum anti-HBs levels among transplant recipients. Patients who were hepatitis B e antigen positive before transplantation usually require more HBIG to achieve the target anti-HBs levels, especially in the first week after transplantation.
Duration of HBIG therapy varies from 6 months to indefinite among different US liver transplant programs. Protocols providing less than 12 months of therapy usually combine HBIG with another effective anti-HBV agent such as lamivudine.
Not applicable
Refer to the healthcare provider's institutional hepatitis B immune globulin (HBIG) therapy protocol for desirable hepatitis B surface antibody (anti-HBs) levels.
Studies indicated that serum anti-HBs levels needed to prevent hepatitis B virus (HBV) reinfection were greater than 500 mIU/mL during the first week after transplantation, greater than 250 mIU/mL during weeks 2 to 12, and greater than 100 mIU/mL after week 12.
For more information see HBV Infection-Monitoring Before and After Liver Transplantation
Individuals who have received blood component therapies (eg, whole blood), plasma, or intravenous immunoglobulin infusion in the previous 3 to 6 months may have false-positive anti-hepatitis B surface (anti-HBs) results due to passive transfer of anti-HBs present in these products.
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 >3000 mg/dL)
-Grossly hemolyzed (hemoglobin level of >500 mg/dL)
-Containing particulate matter
-Cadaveric specimens
-Body fluids other than serum (eg, saliva, urine, spinal fluid, amniotic, peritoneal, or pleural fluids)
1. Samuel D: Management of hepatitis B in liver transplant patients. Semin Liver Dis. 2004;24 Suppl 1:55-62. doi: 10.1055/s-2004-828679
2. Terrault NA, Vyas G: Hepatitis B immune globulin preparations and use in liver transplantation. Clin Liver Dis. 2003 Aug;7(3):537-550. doi: 10.1016/s1089-3261(03)00045-x
3. Lok ASF: Prevention of recurrent hepatitis B post-liver transplantation. Liver Transpl. 2002 Oct;8(Suppl 1):S67-S73. doi: 10.1053/jlts.2002.35780
4. Levitsky J, Doucette K, AST Infectious Diseases Community of Practice: Viral hepatitis in solid organ transplant recipients. Am J Transplant. 2009 Dec;9 Suppl 4:S116-S130. doi: 10.1111/j.1600-6143.2009.02902.x
5. LeFevre ML, US Preventive Services Task Force: Screening for hepatitis B virus infection in nonpregnant adolescents and adults: US Preventive Services Task Force recommendation statement. Ann Intern Med. 2014 Jul 1;161(1):58-66. doi:10.7326/M14-1018
6. Jackson K, Locarnini S, Gish R: Diagnostics of hepatitis B virus: Standard of care and investigational. Clin Liver Dis. 2018 Aug 22;12(1):5-11. doi: 10.1002/cld.729
7. Coffin CS, Zhou K, Terrault NA: New and old biomarkers for diagnosis and management of chronic hepatitis B virus infection. Gastroenterology. 2019 Jan;156(2):355-368. doi: 10.1053/j.gastro.2018.11.037
9. Division of Viral Hepatitis, National Center for HIV, Viral Hepatitis, STD, and TB Prevention: Testing and public health management of persons with chronic hepatitis B virus infection. Centers for Disease Control and Prevention. Updated March 28, 2022. Accessed September 9, 2022. Available at www.cdc.gov/hepatitis/hbv/testingchronic.htm
The VITROS hepatitis B surface antibody (anti-HBs) quantitative assay is performed using an immunometric technique in which the anti-HBs present in the clinical serum sample reacts with hepatitis B surface antigen (HBsAg) (ad and ay subtypes) coated onto the assay reaction wells. A horseradish peroxidase (HRP)-labeled HBsAg conjugate (ad and ay subtypes) then complexes with the bound anti-HBs forming an "antigen sandwich." Unbound materials are removed by washing.
A reagent containing luminogenic substrates (a luminol derivative and a peracid salt) and an electron transfer agent are added to the wells. HRP in the bound conjugate catalyzes the oxidation of the luminol derivative to produce light. The electron transfer agent increases the level and duration of the light produced. The light signals are detected by the system. The amount of HRP conjugate bound is directly proportional to the concentration of anti-HBs antibody present.(Package insert: VITROS Anti-HBs Quantitative Assay, no. GEM1208_US_EN. Ortho-Clinical Diagnostics; Version 14.0, 04/08/2020)
Monday through Saturday
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.
86317
Test Id | Test Order Name | Order LOINC Value |
---|---|---|
HBABT | HBs Ab Monitor, Post-transplant, S | 5193-8 |
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.
|
---|---|---|
HBABT | HBs Ab Monitor, Post-transplant, S | 5193-8 |