Hepatitis B testing can show whether you have a current or past HBV infection and whether you have antibodies from a hepatitis B vaccine.

Hepatitis B is a viral infection caused by the hepatitis B virus (HBV). It can cause liver inflammation (hepatitis), leading to signs and symptoms that can range from mild illness to severe liver damage. Early screening is important because HBV often doesn’t cause symptoms until it has already harmed your liver.

Understanding your test results can be challenging, but with a little guidance it becomes much clearer. Let’s delve into how to interpret your HBV test results.

When reading your hepatitis B panel, look for the specific markers or antibodies mentioned in the results, as these indicate different things. We’ll break it down by positive and negative results.

Positive result meaning

A positive result on a hepatitis B test can indicate a current or past HBV infection, or it may show antibodies from a hepatitis B vaccine.

Here’s a general guide:

  • Hepatitis B surface antigen (HBsAg): This appears early in a new acute infection and indicates an active HBV infection. It typically disappears within 15 weeks in those who recover.
  • Hepatitis B surface antibody (anti-HBs): This appears after HBsAg disappears and indicates recovery and immunity from future HBV infections.
  • Hepatitis B core antibody (HBcAb): This remains positive indefinitely after HBV exposure, indicating past infection.
  • Hepatitis B e-antigen (HBeAg): This is present in new acute infections and indicates higher viral levels and ability to transmit the virus.
  • IgM anti-HBc: The presence of immunoglobulin M antibody indicates a new acute infection. This antibody typically declines within 6 to 9 months.
  • IgG anti-HBc: Immunoglobulin G remains positive indefinitely after HBV exposure, indicating past infection or immunity.
  • Hepatitis B core antigen (HBcAg): This antigen is found on the core of the virus, and its presence means that the virus is actively replicating in your liver.

Negative result meaning

A negative result on a hepatitis B test generally indicates that the specific marker being tested for is not present in the blood sample.

Here’s what negative results typically mean for each marker:

  • HBsAg: A negative result indicates that you do not currently have an HBV infection.
  • Anti-HBs: A negative result indicates that you are not immune to HBV as a result of either past infection or vaccination.
  • HBcAb: A negative result indicates that you have not contracted HBV in the past.
  • HBeAg: A negative result indicates low viral replication and lower likelihood of transmitting the virus.
  • IgM anti-HBc: A negative result indicates that there is no acute or recent HBV infection.
  • IgG anti-HBc: A negative result indicates that there is no past HBV infection.
  • HBcAg: A negative result indicates that HBV is not actively replicating in your body.

Hep B core antibody vs. surface antibody

The hepatitis B core antibody (HBcAb) and hepatitis B surface antibody (HBsAb) are different markers used in hepatitis B testing:

  • HBcAb: This antibody indicates a past or ongoing hepatitis B infection. It appears during or after acute infection and typically remains detectable for life.
  • HBsAb: This antibody indicates immunity to hepatitis B. It appears after recovery from acute infection or after hepatitis B vaccination, providing protection against future infection.
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HBcAg positivity indicates an active HBV infection. Treatment for HBcAg positivity focuses on suppressing HBV replication and reducing liver inflammation to prevent liver damage and the progression to cirrhosis or liver cancer.

The primary treatment for chronic hepatitis B includes antiviral medications such as the following:

Nucleos(t)ide analogues (NAs)

These pills work by stopping the virus from making copies of itself, which lowers the amount of virus in your blood. Entecavir and tenofovir are examples of common NAs.

According to a 2020 research review, treatment with NAs can reduce disease progression and the risk of hepatocellular carcinoma, a type of liver cancer.

Pegylated interferon-alpha

Research shows that these drugs, which are taken as an injection under your skin, can help your body fight the virus and potentially lead to long-term remission.

However, some people find them hard to tolerate, so doctors often prefer to use other medications that are taken by mouth.

Hepatitis B treatments are typically covered by insurance, including Medicare, but coverage can vary based on your treatment and your insurance plan.

To look up whether your treatments are covered, you’ll need the ICD-10 information. You can ask your doctor’s office for this, but common ICD-10-CM codes for HBV infections include:

  • B18.0 (chronic viral hepatitis B with delta agent)
  • B18.1 (chronic viral hepatitis B without delta agent)
  • B19.1 (unspecified viral hepatitis B)
  • Z11.59 (screening for viral diseases other than HIV)

Get vaccinated for hepatitis B!

Vaccines are an important part of public health, and the hepatitis B vaccine is no exception. The CDC recommends the vaccine for all infants, anyone younger than 19 years old who has not yet received it, all adults ages 19 through 59 years old, and adults more than 60 years old who have risk factors for HBV.

Most people receive a hepatitis B vaccine during childhood, but if you have any questions about your vaccination record, make sure to discuss them with your doctor.

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Getting tested for hepatitis B is necessary for early detection and treatment, which can help prevent the virus from spreading and reduce the risk of liver damage.

If you believe you’ve been exposed to HBV, don’t hesitate to seek medical advice. Effective treatment can help manage the virus, improve your quality of life, and reduce the risk of complications.