Interpreting Hepatitis B Titer Outcomes: Understanding Their Significance and Subsequent Actions
In the battle against hepatitis B, a crucial weapon is the Hepatitis B titer panel. This blood test, consisting of three parts, offers invaluable insights into a person's infection status and immunity.
The HBsAg (Hepatitis B surface antigen) is the first component of the panel. Its presence indicates an active hepatitis B infection, either acute or chronic, as this antigen is part of the virus's outer surface.
The second part, HBsAb (Hepatitis B surface antibody), indicates immunity to hepatitis B. Quantitative titers ≥10 IU/L are considered protective, meaning the individual is immune to the virus and unlikely to transmit it.
The third part, HBcAb (Hepatitis B core antibody), detects prior or ongoing infection since it indicates exposure to the core antigen inside the virus. It is not present after vaccination alone; its presence shows natural infection.
The panel also includes HBeAg (envelope antigen) and HBeAb (envelope antibody). HBeAg reflects active viral replication and higher infectivity. A positive HBeAg means the virus is actively replicating and the person is more infectious. HBeAb, on the other hand, appears as the viral replication decreases; positivity usually signals a lower level of infectivity and a transition towards recovery.
The pattern of these markers helps clinicians determine whether a person is uninfected, currently infected, immune due to vaccination, immune due to past infection, or chronically infected with active replication. For example, HBsAg positive + HBeAg positive suggests active infection with high infectivity. HBsAb positive alone suggests immunity from vaccination. HBcAb positive with HBsAb positive suggests immunity from past natural infection.
A positive result on HBcAb requires further testing to determine the hepatitis B status. A positive result on the HBsAg test indicates that the virus can spread from the person to others. A positive result on the HBsAg test typically requires additional testing to determine if the infection is acute or chronic.
The results of the titer come back as either negative or positive on each subtest of the panel. The Immunization Action Coalition recommends the hepatitis B vaccination for all infants, certain groups of children and adolescents, sexually active people, people who risk exposure to blood, people living with HIV, individuals with chronic liver disease or hepatitis C, those who are incarcerated, and anyone who wants protection against hepatitis B.
The hepatitis B titer panel can help a doctor determine the need for treatment and decide whether a person is a good candidate for vaccination. By providing comprehensive information about a person's infection status and immunity, this panel is a vital tool in the management and control of hepatitis B.
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