Hepatitis B Core Ab, IgM |
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· | To detect acute hepatitis B infection: hepatitis B surface antigen (HBsAg), hepatitis B core antibody (anti-HBc), IgM and sometimes hepatitis B e antigen (HBeAg)
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· | To diagnose chronic HBV hepatitis: HBsAg, hepatitis B virus (HBV) DNA, and sometimes HBeAg
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· | To monitor chronic hepatitis B infection and its treatment: HBsAg, hepatitis B e antigen (HBeAg), hepatitis B surface antibody (anti-HBs) IgG, hepatitis B e antibody (anti-HBe) IgG and HBV DNA
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· | To detect previous exposure to hepatitis B, in a person who is immune compromised (when the virus can become reactivated): hepatitis B core antibody (anti-HBc) total and anti-HBs
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Test
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Description
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Use
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Hepatitis B surface antigen (HBsAG)
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Protein that is present on the surface of the virus; will be present in the blood with acute and chronic HBV infections
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Often used to screen for and detect HBV infections; earliest indicator of acute hepatitis B and frequently identifies infected people before symptoms appear; undetectable in the blood during the recovery period; it is the primary way of identifying those with chronic infections.
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Hepatitis B surface antibody (anti-HBs)
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Antibody produced in response to HBV surface antigen; levels in the blood rise during the recovery phase.
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Used to detect previous exposure to HBV; can also be acquired from successful vaccination. This test is done to determine the need for vaccination (if anti-HBs is absent) or to determine if a person has recovered from an infections and is immune (cannot get the infection again).
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Anti-hepatitis B core (anti-HBc), IgM
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IgM antibody to the hepatitis B core antigen (The hepatitis B core antigen is present only in infected liver cells; it cannot be detected in the blood.)
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First antibody produced after infection with HBV; used to detect acute infection
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Anti-hepatitis B core (anti-HBc), Total
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Both IgM and IgG antibodies to hepatitis B core antigen
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Can be used to help detect acute and chronic HBV infections; it is produced in response to the core antigen and usually persists for life.
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Hepatitis B e-antigen (HBeAG)
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Protein produced and released into the blood by actively replicating hepatitis B virus
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Unlike the surface antigen, the e-antigen is found in the blood only when the HBV virus is actively replicating. HBeAg is often used as a marker of ability to spread the virus to other people (infectivity). It may also be used to monitor the effectiveness of treatment. However, there are some types (strains) of HBV that do not make e-antigen; these are especially common in the Middle East and Asia. In areas where these strains of HBV are common, testing for HBeAg is not very useful.
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Anti-hepatitis Be antibody (Anti-HBe)
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Antibody produced in response to the hepatitis Be antigen
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In those who have recovered from acute hepatitis B infection, anti-HBe will be present along with anti-HBc and anti-HBs. In those with chronic hepatitis B, anti-HBe can be used to monitor the infection and treatment.
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Hepatitis B DNA (HBV DNA)
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Detects hepatitis B viral genetic material
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Can detect an active HBV infection; its primary use is to monitor antiviral therapy in patients with chronic HBV infections.
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· | Fever
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· | Fatigue
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· | Loss of appetite
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· | Nausea, vomiting
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· | Abdominal pain
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· | Dark urine
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· | Pale stools
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· | Joint pain
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· | Jaundice
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· | People who are possible source of infection through accidental cuts, needlesticks, etc. in health care workers
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· | People born in areas of the world that have a greater than 2% prevalence of HbsAg (for example, much of Asia and Africa)
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· | People born in the US but were not vaccinated and whose parents are from an area with greater than 8% prevalence of HbsAg
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· | Men who have sex with men
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· | People who have elevated liver enzymes (ALT and AST) with no known cause
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· | People with certain medical conditions that require that their immune system be suppressed
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· | Pregnant women
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· | People who are in close contact with someone infected with HBV
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· | Those infected with HIV
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Hep B surface antigen (HBsAg)
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Hep B surface antibody (Anti-HBs)
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Hep B core antibody (Anti-HBc IgM)
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Hep B core antibody Total (Anti-HBc IgG+IgM)
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Hep B e antigen (HBeAg)*See note
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Hep B e antibody (Anti-HBe)
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Interpretation / Stage of Infection
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Negative
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Negative
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Negative
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No active or prior infection; not immune may be good candidate for vaccine; possibly in the incubation stage
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Positive
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Negative
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Negative
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Negative
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Positive
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Negative
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Early acute infection
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Positive
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Negative
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Positive or Negative
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Positive or Negative
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Positive
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Negative
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Acute infection, usually with symptoms; contagious
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Positive
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Negative
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Positive
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Positive
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Negative*
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Positive
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Late in the acute stage of infection (seroconversion)
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Negative
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Negative
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Positive
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Positive
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Negative*
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Positive
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Acute infection is resolving (convalescent)
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Positive
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Negative
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Negative
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Positive
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Positive
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Negative
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Usually indicates an active chronic infection (liver damage likely)
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Positive
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Negative
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Negative
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Positive
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Negative*
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Positive
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Chronic infection but low risk of liver damage carrier state
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Negative
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Positive
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Negative
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Positive
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Negative*
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Positive
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Infection resolved (recovery); immunity due to natural infection
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Negative
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Positive
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Negative
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Immunity due to vaccination
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