Hepatitis B Virus (HBV) tests

Nurse Lilia is busy scanning the patient’s chart. It’s her first time to handle this patient, since her patient yesterday transferred out of the ICU. So okay, what to do today? First on the list is to check to patient’s chart, which is what she is doing now. She checks for doctors’ orders, medications due, IV fluids to follow up, and other procedures to be done.

CT scan and Chest Xray PA view, done; plates and official results seen by the attending physician. CBC, urinalysis, Lipid profile tests all done and results in. What more should she follow up? She digs in deeper in the chart to check for other orders. Okay, so this patient is due for HBSag test. Wait, what? HBSag?! You mean this patient has hepatitis B? Oh my.. I should take precaution. What should I do? I’m panicking already.

Chill, nurses. Yes, most of us are afraid of acquiring a Hep B infection, and yes we should take precaution. But an order of an HBSag test to be conducted doesn’t necessarily mean that the patient has Hepa B.

Hepatitis B Virus (HBV) tests

Hepatitis B virus (HBV) tests are tests done to check for substances in the blood that show whether a hepatitis B infection is active or has occurred in the past. This looks for antigens (made by bacteria or viruses in the body); antibodies (presence of Hep B antibodies indicates that you have been exposed to hepa B virus at some time); and DNA of the hepatitis B virus which shows that the virus is in the body. The amount of this DNA may be of great help in determining how severe the infection is and how easily the HBV infection can be spread. All three are markers or signs of infection.

Different types of HBV test:

  • Hepatitis B surface antigen (HBsAg)

This one is the earliest sign of an active hepatitis B infection and may be present before symptoms of an HBV infection are present. If this antigen is present for more than 6 months, then the patient probably has a chronic (long-term) HBV infection and can spread HBV to others throughout that patient’s life.

  • Hepatitis B surface antibody (HBsAb)

This usually appears about 4 weeks after HBsAg disappears. Its presence means that the infection is at the end of its active stage and the patient is no longer contagious. It also protects the patient from getting HBV again in the future. Usually, the test is done to determine the need for vaccination since the antibody will be present after receiving the HBV vaccine series, showing that the patient has protection (immunity) from the virus. This test may also show that a person has both the HBsAb antibodies and HBsAg antigen, which means that you are still contagious.

  • Hepatitis B e-antigen (HBeAg)

This one’s an HBV protein that is only present during an active HBV infection. With this test, you will be able to determine how contagious a person is and monitor the effectiveness of treatment for HBV.

  • HBV DNA testing

This checks for DNA from the hepatitis B virus and measures how much genetic material is present. A high level of HBV DNA means that the virus is multiplying in the body and that the patient is very contagious. If a patient has a chronic HBV infection, an elevated viral DNA level means he/she is at an increased risk for liver damage and may want to consider treatment with antiviral medicine. This test may also be used to check the effectiveness of treatment for long-term (chronic) HBV infection and is a more sensitive test than HBeAg in detecting HBV in the blood.

This HBV may easily spread through infected body fluids including blood, semen, and vaginal fluids. As nurses, it is important for us to identify which type of HBV is causing the infection to prevent its spread and choose the proper treatment for it.

Sources:

Liane Clores, RN MAN

Currently an Intensive Care Unit nurse, pursuing a degree in Master of Arts in Nursing Major in Nursing Service Administration. Has been a contributor of Student Nurses Quarterly, Vox Populi, The Hillside Echo and the Voice of Nightingale publications. Other experience include: Medical-Surgical, Pediatric, Obstetric, Emergency and Recovery Room Nursing.

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