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HBsAg (-) Negative HBsAb (-) Negative HBcAb (-) Negative

Initial Hepatitis B Screening: Simplified Diagnostic Test Flow Guide. Initial Test Results. Action Required. Interpretation. HBsAg (-) Negative HBsAb (-) Negative HBcAb (-) Negative. Vaccination Needed. Infection Risk/Not Immune. HBsAg (-) Negative HBsAg (+) Positive

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HBsAg (-) Negative HBsAb (-) Negative HBcAb (-) Negative

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  1. Initial Hepatitis B Screening: Simplified Diagnostic Test Flow Guide Initial Test Results Action Required Interpretation HBsAg (-) Negative HBsAb (-) Negative HBcAb (-) Negative Vaccination Needed Infection Risk/Not Immune HBsAg (-) Negative HBsAg (+) Positive HBcAb (-/+) Negative or Positive Immune due to natural infection (HBcAb positive) Immune due to Hepatitis B vaccination (HBcAb negative) No Action Needed HBsAg (+) Positive HBsAb (-) Negative HBcAb (+) Positive IgM anti-HBc (+) Positive Monitor Patient and Schedule Six Month Follow-up Acute HBV Infection Present Additional Testing Needed: 1. HBV DNA by PCR 2. Serology (HBeAg) 3. Liver Function Tests (ALT) 4. Screen for HCC (AFP/Ultrasound) 5. Liver Biopsy (if appropriate) Consult a Specialist HBsAg (+) Positive HBsAb (-) Negative HBcAb (+) Positive IgM anti-HBc (-) Negative Chronic HBV Infection Present

  2. Initial Hepatitis B Screening: Simplified Glossary of Terms and Information Initial Screening Labs HBsAg: Serological marker for Hepatitis B Virus indicating infection HBsAb: Serological marker showing immune clearance against Hepatitis B Virus HBcAb: Serological marker for prior or ongoing Hepatitis B Virus infection IgM anti-HBc: Serological marker elevated in Acute Hepatitis B Infection HBeAg: Serological marker for active Hepatitis B viral replication Viral Testing HBV DNA by PCR: Quantifies the amount of Hepatitis B Virus in the serum. This test is needed if the patient is HBsAg positive for greater than 6 months. Patients that are HBsAg positive for greater than 6 months but have low levels of detectable HBV DNA should have periodical (6 months to 1 year) monitoring and testing as determined by a physician. • General Types of Hepatitis B • Chronic E Antigen Positive Disease (also referred to as “wild-type” Hepatitis B) • Chronic E Antigen Negative Disease (also referred to as Precore Mutant or Core Promoter Mutant Chronic Hepatitis B) • Acute Hepatitis B (characterized by the presence of HBsAg and IgM antibody) • Signs and Symptoms of Hepatitis B • Fatigue, Abdominal Pain, Joint pain, Jaundice, Loss of Appetite, Nausea • Only about 30% of Hepatitis B infected persons have any physical signs or symptoms Other Baseline Evaluations Liver Function Tests (ALT): ALT and AST are enzymes released from liver cells upon injury and indicates potential liver damage AFP: Hepatocellular Carcinoma (HCC) tumor marker that is elevated in patients with HCC Ultrasound of the liver and CT Scan: Diagnostic evaluation tools for Hepatocellular Carcinoma (HCC) Liver Biopsy: Useful in assessing current liver damage or inflammation caused by chronic hepatitis B infections For more information, please visit http://www._______

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