Alberta Precision Laboratories

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Organization:

Alberta Precision Laboratories

Test Name/Synonym:

Hepatitis B Virus (HBV)

Clinical Indications:

Acute Hepatitis B: Request HBsAg
Chronic Hepatitis B carrier status: Request HBsAg
Previous exposure to Hepatitis B Virus: Request anti-HBc total, HBsAg and anti-HBs
Assessment of Immunity to Hepatitis B: Request anti-HBs

IgM antibody to core (HBc IgM) is helpful in assessing (1) An acute infection, (2) If the patient is in the “window period” when HBsAg is absent and anti-HBs is not yet detectable, or (3) Reactivation of IgM in chronic carriers.

HBV e antigen (HBeAg) and anti-HBe are helpful in the evaluation of a chronically infected patient for treatment or monitoring.

Test Includes:

Tests that can be ordered include:

Antibody Testing

Hepatitis B Virus Surface Antibody - LAB472
Hepatitis B Virus Surface Antibody - 3rd Party - LAB10472
Hepatitis B Virus Core Antibody, Total - LAB1242
Hepatitis B Virus Core Antibody, Total - 3rd Party - LAB101242
Hepatitis B Virus Core Antibody, IgM - LAB549
Hepatitis B Virus Core Antibody, IgM - 3rd Party - LAB10549
Hepatitis B Virus E Antibody Serology - LAB796

Antigen Testing

Hepatitis B Virus Surface Antigen - LAB471
Hepatitis B Virus Surface Antigen - 3rd Party - LAB10471
Hepatitis B Virus E Antigen Serology - LAB908
Hepatitis B Virus Surface Antigen - Quantitative - LAB6016
- can only be ordered by approved ID physicians or hepatologists for patients on HBV treatment

NAT or PCR (also referred to as HBV Quantitative PCR, HBV Viral Load, HBV nucleic acid test (NAT))

Hepatitis B Virus (HBV) NAT - LAB951

Ordering Alert:

3rd party testing is available for approved APL 3rd party clients only (Hepatitis B Virus Surface Antibody - 3rd Party LAB10472, Hepatitis B Virus Core Antibody, Total - 3rd Party LAB101242, Hepatitis B Virus Core Antibody, IgM - 3rd Party LAB10549, Hepatitis B Virus Surface Antigen - 3rd Party LAB10471)

Specimen Collection Requirements:

Antibody and Antigen Testing

Adult: 5 mL GOLD SST
Pediatric: 2 mL RED

NAT or PCR:

Adult: One full DEDICATED 4 mL LAVENDER EDTA
Pediatric: One full DEDICATED 2 mL LAVENDER EDTA

For remote areas (when specimen delivery is > 6 hours to Provincial Lab):
Adult: One full DEDICATED 5 mL PPT (Plasma Preparation Tube)
Pediatric: One DEDICATED PPT tube with 2 mL of blood in it

For suspected congenital HBV infection:
See: Congenital Infections

Test Resources:

Serology and Molecular Testing Requisition
https://www.albertahealthservices.ca/frm-20676.pdf

NOTE: Clinical information must be provided.
For serology: Please specify which tests are required.

Transportation:

Antibody and Antigen Testing

Transport on ice or cold packs
DO NOT freeze

NAT or PCR Testing

Transport on ice or cold packs if expected transportation time > 6 hours

Ship according to Transportation of Dangerous Goods (TDG) guidelines:

Refer to https://tc.canada.ca/en/corporate-services/acts-regulations/list-regulations/transportation-dangerous-goods-regulations
APL personnel refer to HSM14 Transport of Dangerous Goods (TDG) Program

Routine Turn Around Time:

Hepatitis B Virus Surface Antibody – 2 days
Hepatitis B Virus Surface Antibody - 3rd Party - 2 days
Hepatitis B Virus Core Antibody, Total – 2 days
Hepatitis B Virus Core Antibody, Total - 3rd Party - 2 days
Hepatitis B Virus Core Antibody, IgM – 2 days
Hepatitis B Virus Core Antibody, IgM - 3rd Party - 2 days
Hepatitis B Virus E Antibody Serology – 4 days

Hepatitis B Virus Surface Antigen – 2 days
Hepatitis B Virus Surface Antigen - 3rd Party - 2 days
Hepatitis B Virus E Antigen Serology – 4 days
Hepatitis B Virus Surface Antigen – Quantitative – 7 days

NAT or PCR: 7 days

Testing Area:

Virology

Performing Site:

Provincial Laboratory for Public Health (Calgary and Edmonton)

Additional Test Information:

Samples submitted for NAT or PCR must be DEDICATED specimens to avoid contamination or degradation of the viral nucleic acids.

Ordering of the quantitative HBV surface antigen test can only be ordered by a select list of specialist hepatologist/ID physicians that manage chronic HBV infections on a regular basis. Such patients will already be on treatment with interferon or nucleos(t)ide analogues, for whom this test (in conjunction with the HBV VL test) will be helpful in managing their antiviral therapy.

The HBV viral load assay is a measure of viral replication and the main indication is for monitoring patients who are on treatment, or are being evaluated for treatment. For other indications, please consult with the Public Health Lab (ProvLab) Microbiologist On-Call

Last Updated On:

Tuesday, April 1, 2025

Date of Last Review:

Mar 19 2025 12:00AM