We have reviewed Hepatitis B serology requesting at Pathlab. Due to the range of serological assays that can be requested for this infection, this can be a potentially confusing area for both requestors and the laboratory receiving the requests.
With this in mind, we have put together some brief guidance, as detailed below:
In an immunocompetent patient, please request HBsAg (Hepatitis B surface antigen) when looking for evidence of Hepatitis B infection.
In an immunosuppressed patient, or a patient who will be undergoing immunosuppression, please request HBsAg and anti-HBc (Hepatitis B core antibody) when looking for evidence of Hepatitis B infection.
Any non-specific requests such as “Hepatitis B serology”, Hepatitis B status”, “Hepatitis B screen”, etc. will receive HBsAg testing only, unless other tests are specified.
Hepatitis B Immunity testing (anti-HBs, Hepatitis B surface antibody) is not publicly funded, except in cases of clear known or potential exposure (e.g. BBFEs, incarceration, household contact).
In order to practice effective diagnostic stewardship, we would be grateful if you could adhere to the recommendations above.