Lab Test: Hepatitis B Surface Antibody Level
of hepatitis B surface antibody (anti-HBs) in serum for the evaluation of
infection or immunity for hepatitis B infection
- Confirmation of immunity following hepatitis B vaccination - hepatitis B surface antibody (anti-HBs) is the only hepatitis B (HBV) antibody marker present following HBV vaccination. Titers fall, often rapidly, following the completion of the HBV vaccination series. The highest anti-HBs titers generally occur 1 month after a booster vaccination, with a sharp decline over the next 12 months and a slow decline thereafter. The generally accepted titer level associated with the minimal level of protection against HBV is 10 International Units/L, although this is debatable. A titer level between 10 and 100 International Units/L may be an indication for revaccination of immunocompromised patients. The anti-HBs level may be elevated with 4 days of administration of the booster immunization.
- A positive anti-HBs titer combined with a negative hepatitis B surface antigen (HBsAg) titer at 12 to 15 months of age indicates effective treatment for infants born to HBsAg-positive mothers and treated with hepatitis B immunoglobulin (HBIG) and HBV vaccination.
- Suspected hepatitis B exposure from sexual assault - HBV testing should be performed at the time of the initial sexual assault examination to determine the need for HBV immunization. HBV tests should be repeated in 6 weeks.
- Suspected hepatitis B infection - Hepatitis B surface antibody is generated during the resolution phase of acute hepatitis B and is usually a marker for recovery and immunity. A positive hepatitis B surface antibody may also indicate a chronic HBV infection. In chronic HBV, the anti-HBs level can remain positive for decades, and some patients may have detectable levels of both HBsAg and anti-HBs.
- Elgouhari HM, et al. Hepatitis B: a strategy for evaluation and management. Cleve Clin J Med 2009;76:19-35.
- Kuo A et al. Chronic hepatitis B infection. Clin Liver Dis 2012;16:347-369.
- LaGow B et al., eds. PDR Lab Advisor. A Comprehensive Point-of-Care Guide for Over 600 Lab Tests. First ed. Montvale, NJ: Thomson PDR; 2007.
- World Health Organization website. Hepatitis B.
Indications & Uses
MESH Terms & Keywords