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PHESP
9021
products (ie, blood transfusion, sharing of needles by drug addicts). The virus is found in virtually every
type of human body fluid and also is spread through oral and genital contact. HBV can be transmitted
from mother to child during delivery through contact with blood and vaginal secretions, but it is not
commonly transmitted transplacentally. Infection of the infant can occur if the mother is a chronic
hepatitis B surface antigen carrier or has an acute HBV infection at the time of delivery. Transmission is
rare if an acute infection occurs in either the first or second trimester of pregnancy.
Useful For: Screening pregnant women for chronic hepatitis B virus (HBV) infection Determining the
level of infectivity in pregnant women with chronic HBV infection
Interpretation: Hepatitis B surface antigen (HBsAg) is the first serologic marker appearing in the
serum 6 to 16 weeks following hepatitis B virus (HBV) infection. A positive result for HBsAg is
diagnostic of acute or chronic HBV infection. In acute cases, HBsAg usually disappears 1 to 2 months
after the onset of symptoms. Persistence of HBsAg for more than 6 months indicates development of
either a chronic carrier state or chronic liver disease. Hepatitis B surface antibody (anti-HBs) appears with
the resolution of HBV infection after the disappearance of HBsAg. Hepatitis B envelope antigen (HBeAg)
appears at approximately the same time as HBsAg and indicates that the virus is replicating and the
individual is infectious. Appearance of hepatitis Be antibody (anti-HBe) after the disappearance of
HBsAg and HBeAg usually indicates recovery and loss of infectivity. If HBsAg is positive and the
patient's condition warrants, consider testing for hepatitis B core antigen (anti-HBc) IgM, HBV-DNA, and
anti-hepatitis delta virus (HDV) to evaluate viral replication and infectivity.
Reference Values:
Negative
See Viral Hepatitis Serologic Profiles in Special Instructions.
Clinical References: Vranckx R, Alisjahbana A, Meheus A: Hepatitis B virus vaccination and
antenatal transmission of HBV markers to neonates. J Viral Hepat 1999;6:135-139
Previous Hepatitis Exposure Profile
Clinical Information: Hepatitis A Hepatitis A virus (HAV) is an RNA virus (enterovirus) that
accounts for 20% to 25% of the viral hepatitis in United States adults. HAV infection is spread by the
oral/fecal route and produces acute hepatitis that follows a benign, self-limited course. Spread of the
disease is usually associated with contaminated food or water caused by poor sanitary conditions.
Outbreaks frequently occur in overcrowded situations and in institutions or high density centers such as
prisons and health care centers. Epidemics may occur following floods or other disaster situations.
Chronic carriers of HAV have never been observed. Hepatitis B Hepatitis B virus (HBV) is a DNA virus
that is endemic throughout the world. The infection is spread primarily through percutaneous contact with
infected blood products (eg, blood transfusion, sharing of needles by drug addicts). The virus is also found
in virtually every type of human body fluid and is known to be spread through oral and genital contact.
HBV can be transmitted from mother to child during delivery through contact with blood and vaginal
secretions; it is not commonly transmitted transplacentally. After a course of acute illness, HBV persists
in approximately 10% of patients; some of these chronic carriers are asymptomatic. Hepatitis C Hepatitis
C virus (HCV) is an RNA virus that is a significant cause of morbidity and mortality worldwide. HCV is
transmitted through contaminated blood or blood products or through other close, personal contacts. It is
recognized as the cause of most cases of post transfusion hepatitis. HCV shows a high rate of progression
(>50%) to chronic disease. In the United States, HCV infection is quite common, with an estimated 3.5 to
4 million chronic HCV carriers. Cirrhosis and hepatocellular carcinoma are sequelae of chronic HCV.
Publications: -Advances in the Laboratory Diagnosis of Hepatitis C (2002) The following algorithms are
available in Special Instructions: -HBV Infection-Diagnostic Approach and Management Algorithm
-Recommended Approach to the Diagnosis of Hepatitis C -Alternative Approaches to the Diagnosis of
Hepatitis C
Useful For: Determining if an individual has been infected following exposure to an unknown type of
hepatitis Obtaining baseline serologic markers of an individual exposed to a source with an unknown type
of hepatitis Determining immunity to hepatitis A and B viral infections
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