Hepatitis B Screening Panel (HBsAg, Core Antibody & Surface Antibody)

Three hepatitis B markers measured on one blood sample: hepatitis B surface antigen (HBsAg, current infection; reactive results are automatically confirmed), total hepatitis B core antibody (anti-HBc, any past or current infection, never caused by the vaccine) and quantitative hepatitis B surface antibody (anti-HBs, immunity; 10 mIU/mL or more is considered protective).

Every adult 18 or over who has never had a hepatitis B triple-panel screen, as the CDC recommends. It is especially relevant for people born in regions where hepatitis B is common, people whose parents were born in high-prevalence regions and who were not vaccinated as infants, people with HIV or current or past hepatitis C, men who have sex with men, people with a current or past STI or multiple sex partners, people who inject or have injected drugs, people who have been incarcerated, household or sexual contacts of someone with hepatitis B, people on dialysis, people with unexplained raised liver enzymes, and anyone about to start immune-suppressing treatment. You do not need to share a reason to test.

Once in adulthood for everyone, ideally before or alongside hepatitis B vaccination (vaccination should not be delayed while waiting for results). People who are not immune and have ongoing risk, such as new sexual partners, injection drug use or a household member with hepatitis B, should repeat testing periodically at an interval agreed with a clinician. After a specific exposure, markers can take up to about 11-12 weeks to appear, so a negative result in the first three months may need repeating. No fasting is needed.

Read the three results together. Immune from vaccination: surface antibody positive (10 mIU/mL or more), surface antigen and core antibody negative. You are protected; if your vaccine series was incomplete, finish it. Immune from past infection: surface antibody and core antibody positive, surface antigen negative. The infection has resolved; tell any clinician planning chemotherapy or other immune-suppressing treatment, because it can reactivate. Current infection: surface antigen positive (confirmed) with core antibody positive and surface antibody negative. This can be a new or chronic infection (chronic means still positive after six months); see a clinician for HBV DNA, liver tests and follow-up, and contacts should be offered testing and vaccination. Susceptible: all three negative. You have never been infected and are not protected; hepatitis B vaccination is recommended. Isolated core antibody: core antibody positive, the other two negative. This can be an old infection with faded surface antibody, a hidden low-level infection or a false positive; a clinician will usually repeat testing or check HBV DNA. Results are informational; please review them with a clinician.