If a doctor suspects that a person may have hepatitis B, they will likely order a single blood test to check for the condition. This test is called a hepatitis B titer panel, and it consists of three main parts. Positive results for each part indicate different things.
Each part of the test plays an important role in showing whether a person has hepatitis B. Testing can also help a doctor determine the need for treatment and decide whether the person is a good candidate for vaccination.
The three parts of a hepatitis B titer panel check for:
- hepatitis B surface antigens (HBsAg)
- hepatitis B surface antibodies (anti-HBs or HBsAb)
- hepatitis B core antibodies (anti-HBc or HBcAb)
This article looks at what each part of the test evaluates and what the results may mean.
The hepatitis B panel consists of three parts that look for the presence of antibodies or the virus itself. A person only needs one blood draw for a lab to run the panel.
Each of the three parts provides a doctor with information on a person’s infection status. This information helps the doctor decide on the next steps.
The next sections provide an overview of each part of the panel.
HBsAg
The HBsAg test looks for the presence of the hepatitis B virus. A person who receives a positive result on this test has an active hepatitis B infection.
When this test comes back positive, a doctor will typically order additional testing to check whether the virus is the result of an acute or a chronic infection.
A positive result on this test also indicates that the virus can spread from the person to other people.
Anti-HBs or HBsAb
This part of the test shows a doctor that the person has immune protection from the virus. They may have this as a result of receiving the hepatitis B vaccination or recovering from a hepatitis B infection.
If a person gets a positive result on this part of the panel, the virus cannot pass from them to other people.
Anti-HBc or HBcAb
This part of the test can indicate either a past or current infection with hepatitis B. However, the presence of core antibodies does not mean that a person is immune.
A doctor requires the HBsAg and HBsAb tests to make sense of this third part of the panel.
Anyone who gets a positive result on the HBcAb portion but negative results for the first two tests will likely require further testing to determine their hepatitis B status.
The titer will also likely look at IgM anti-HBc, which is a subclass of anti-HBc. Positive results for IgM anti-HBc indicate an active infection within the past 6 months.
The results of a hepatitis B titer panel can help a doctor determine a person’s hepatitis B status. The results can be confusing if a person has never been through this type of testing before, but the doctor can explain the findings.
The results for the titer come back as either negative or positive on each subtest of the panel. Positive means that the virus or antibodies showed up on the test, while negative means that they did not.
The following table outlines what positive and negative results mean on different parts of the test and the possible next steps.
The information comes from the Immunization Action Coalition:
| Test | Results | What the results mean | Vaccination recommended? |
|---|---|---|---|
| HBsAg anti-HBc anti-HBs | negative negative negative | may become infected | vaccinate as indicated based on risk factors for developing the infection |
| HBsAg anti-HBc anti-HBs | negative negative positive with >10 mlU/ml | immune due to vaccination | no |
| HBsAg anti-HBc anti-HBs IgM anti-HBc | negative positive positive negative | immune due to natural infection | no |
| HBsAg anti-HBc IgM anti-HBc anti-HBs | negative positive positive positive | presence of acute resolving infection | no |
| HBsAg anti-HBc IgM anti-HBc anti-HBs | positive positive positive negative | acute infection present | no |
| HBsAg anti-HBc IgM anti-HBc anti-HBs | positive positive negative negative | presence of chronic infection | no, but may need treatment for infection |
| HBsAg anti-HBc anti-HBs | negative positive negative | may need additional testing | possibly |
The
- all infants
- all children and adolescents under the age of 19 years who have not received the vaccination
- sexually active people
- people who risk exposure due to contact with blood
- people living with HIV
- individuals with chronic liver disease or hepatitis C
- those who are incarcerated
- anyone who wants protection against hepatitis B
The hepatitis B titer panel looks for the presence of both the virus itself and antibodies related to the virus. The combined results of the subtests can indicate whether a person currently has an active infection, has had it before, or may have had the vaccination.
The panel presents negative and positive results for the various parts of the test. Each subtest helps a doctor determine a person’s hepatitis B status and can shape their recommendations for treatment or vaccination.