Hep B Titer - More Information

The hepatitis B titer, sometimes known as an HBsAb test and an anti-HBs titer, measures the hepatitis B surface antibody level in the blood to check for immunity to Hepatitis B.

Hepatitis B is a viral infection caused by one of five hepatitis viruses - the Hepatitis B virus (HBV). Hepatitis B infections can be both short-term (acute) and long-term (chronic) and affect an organ in the right upper part of the abdomen known as the liver. Hepatitis B infections are more commonly transmitted by blood and other body fluids during sexual activity, intravenous drug use (IVDA) and inadvertent infected blood or fluid exposure while working in a healthcare environment. Rarely, one can get hepatitis B from getting a tattoo or acupuncture from a contaminated needle and also dialysis for kidney failure.

If one is exposed to and gets a Hepatitis B infection, symptoms can range from nothing to flu-like symptoms like fatigue and headache. Additionally, hepatitis B can result in stomach pain, jaundice (yellow skin) from liver abnormalities, and nausea and vomiting which lasts for 14-21 days. In some cases, symptoms won't begin until six months after the initial exposure.

Because so many people have received the Hepatitis B vaccine as part of their routine vaccines, checking the Hepatitis B titer has become common practice to assess one's immunity to hepatitis B. The hep B titer is technically known as a Hepatitis B surface antibody test, or HBsAb titer test. This hepatitis B vaccine titer is practically used to demonstrate immunity to hepatitis B in people who will be working or studying in healthcare organizations or schools. When ordered in this capacity, the hep b titer is frequently ordered with the MMR titer and varicella titer, all of which are included in the immunization titer panel. Additionally, some people also need to present a negative TB blood test when going through the clearance process for a new school or job. Sometimes, the Hep B surface antibody test is ordered for other reasons. For example, people sometimes get the blood test to check for immunity when engaging in activities that might lead to an inadvertent exposure to Hepatitis B (e.g. traveling, getting a tattoo) instead of getting revaccinated unnecessarily.

Hepatitis B Titer - Process & Results

Getting a hepatitis B titer near you is not difficult if there is a Quest Diagnostics' lab near you. This blood titer test requires fairly standard lab equipment which every lab has available. On the day of your HBsAb test, you will get a small amount of blood drawn. No fasting is required before the hep B titer and your results will come back relatively quickly. Given that the hepatitis B vaccine series is thought to provide lifetime immunity as measurable via antibody levels, it makes sense to start with a hepatitis B titer before getting revaccinated to confirm your immunity status. Most people will have received the hepatitis B vaccine series if they received routine vaccines while growing up even if they cannot find their HBV immunization records.

Interpreting hepatitis B titer lab results is not overly complex. In reviewing the sample hepatitis B lab report above, one can see the hepatitis B surface antibody level reported under the results column in mIU/mL units. Quant indicates that this hep B titer will report an actual quantitative, or numerical, result as opposed to a qualitative Hep B titer which just reports a positive (reactive) or negative (nonreactive) result. Quantitative hepatitis B IgG titer levels are considered the gold standard for proving hepatitis B immunity.

On the hep B lab sample result above, one can see the text that says that, based on the antibody level, the patient has immunity to hepatitis B virus. As a result, this person will not need to be revaccinated with the hepatitis B virus series. In contrast, if the lab result reported that the patient is not immune to hepatitis B, then revaccination with the hepatitis B vaccine series would be recommended.

It is important to note that this lab test is not useful for checking for an actual hepatitis B infection as the hepatitis B surface antibodies check for immunity, not an infection. The hepatitis B surface antigen test is more helpful for looking for a hep B infection, particularly early on after an exposure. Typically, if someone with Hep B immunity takes both the HbSAg test and this anti-HBs (surface antibody) test, the HbSAg test result will be negative while this hepatitis B titer will demonstrate adequate antibody levels for immunity. The length with which hepatitis B titers persist after longer periods of time seems to depend on the strength of the initial titer response. Hepatitis B titer levels may also naturally wane with time and will vary from person to person.

Routine immunization with the hepatitis B vaccine is the reason that the hepatitis B titer is even utilized as a measure of hep B immunity. The hepatitis B vaccine was developed in the 1960s and approved in the 1980s. The HBV vaccine has become a regular part of routine childhood and adult vaccinations. The full HBV immunization series typically consists of 3 separate doses and the first dose is often given one day after birth. Injected into the muscle, the Hepatitis B vaccine is not a live vaccine. The Nobel Prize was awarded to the doctors who developed the hep B Vaccine. In most people, after getting the HBV vaccine series, the immune system learns what a hepatitis B infection looks like and can generate special proteins called antibodies that will protect the body if a Hep B infection attempts to invade the body in the future.

This hepatitis B surface antibody test is a useful test for anyone who is looking to find out if they are considered immune to hepatitis B or not. For most people, hep B titer testing will eliminate the need for revaccination when hep B immunity is needed for school, work or personal reasons.

Hepatitis B Titer - Additional Information

CDC Hep B Testing