Hepatitis B Core Antibody

Message

Performed in the Chemistry Laboratory x5820.
10.2018

Test Code

HBCOR

CPT Codes
86704

Preferred Specimen

Plasma from a green top (PST) tube

Minimum Volume

1 mL

Transport Container

Green Top (PST) tube

Transport Temperature

Room temperature

Specimen Stability

2 - 8 ^oC: 7 days

Methodology
Chemiluminescent Microparticle Immunoassay (Abbott Architect)

Setup Schedule

This assay is performed Monday through Friday

Reference Range

Results are reported as "REACTIVE" ,"EQUIVOCAL" , or "NON-REACTIVE".

Clinical Significance

Antibodies against the hepatitis B virus core antigen of all heavy chain types (measured as total Anti-HBc) are marker of prior contact with hepatitis B virus. In recent infection, the majority of the total Anti-HBc are IgM, which are gradually replaced by IgG. A separate test can specifically determine if IgM antibodies against the hepatitis B virus core antigen (Anti-HBc IgM (HBCM)) are present and can help to interpret clinical situations in which total Anti-HBc are reactive. Total Anti-HBc are reactive in recent infection (Anti-HBc IgM (HBCM) reactive) or remote infection (Anti-HBc IgM (HBCM) non-reactive). Remote infections (i.e. total Anti-HBc (HBCOR) reactive AND Anti-HBc IgM (HBCM) non-reactive) need to be distinguished by a separate test for the hepatitis B virus surface antigen (HBsAg (HBSAG)) into remote cleared infections (HBsAg (HBSAG) non-reactive) and chronic active infections (HBsAg (HBSAG) confirmed positive).

Total anti-HBc are not induced by vaccination and do not convey immunity against infection. Use a separate test for antibodies against hepatitis B virus surface antigen (Anti-HBsAg (HBSAB)) to determine successful vaccination.

Typical patterns of Hepatitis B Virus related serum markers

Marker	No exposure *	Acute infection	Chronic infection **	Resolved infection	Vaccination
HBsAg (HBSAG)	NON-REACTIVE	CONFIRMED POSITIVE	CONFIRMED POSITIVE	NON-REACTIVE	NON-REACTIVE
Anti-HBs (HBSAB)	NON-REACTIVE	NON-REACTIVE	NON-REACTIVE	REACTIVE	REACTIVE
Anti-HBc IgM (HBCM)	NON-REACTIVE	REACTIVE	NON-REACTIVE	NON-REACTIVE	NON-REACTIVE
total Anti-HBc (HBCOR)	NON-REACTIVE	REACTIVE	REACTIVE	REACTIVE	NON-REACTIVE

* consider recent exposure
** in chronic Infection HBs Ag levels may wane and Anti-HBc IgM may recur in flares

The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.