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Hepatitis B Virus (HBV)

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Hepatitis B Virus (HBV)

Hepatitis B (Hep B) is a vaccine preventable disease caused by Hepatitis B Virus (HBV). The prevalence of Hep B in the general population in Ireland is estimated to be less than 0.5%.

The majority of Hep B cases occur in “at-risk” groups, defined as those with multiple sexual partners, sexual or household contacts of known cases, intravenous drug users, those born in countries with intermediate or high Hep B endemicity and from perinatal transmission from an infected mother.

Following acute infection, the risk of developing chronic infection declines with increasing age. Approximately 80-90% of infants infected at birth will develop chronic infection, compared to 30-50% of infected children and in less than 5% of adults of whom 20-30% will develop liver cirrhosis or hepatocellular carcinoma.

Blood tests can determine if you have the virus in your system and whether it is acute or chronic. Hepatitis B is a notifiable disease in Ireland.

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Clinical Details

The average incubation period for HBV is 60-90 days (range: 45-180 days). Acute HBV infection may be subclinical or range in symptoms to include anorexia, abdominal discomfort, nausea, vomiting, and may be followed by jaundice. These symptoms usually last several weeks. Approximately half of patients will no longer be infectious by 7 weeks post onset of symptoms. In individuals where HBsAg continues to be detected at 6 months, they are considered chronic carriers and remain at risk of transmitting infection.

The following is a summary of the serological markers of Hepatitis B which are available at Enfer Medical. Please note the following is a guide to interpretation and patient history and other serological markers may be required for final interpretation.

HBV Marker Clinical Details
HBsAg Hep B Surface Antigen is a protein on the surface of HBV, it is a marker of infectivity. It can be detected in high levels in serum during acute or chronic infection. Chronic HBV is defined as detectable HBsAg in serum > 6 months. 
Anti-HBs Antibody to HBsAg indicates recovery and immunity from HBV infection. It is an antibody that also develops in a person who may have been successfully vaccinated against HBV
Anti-HBc Antibody to Hep B Core Antigen that does not provide any protection or immunity against Hep B and indicates previous infection at some point in time. It is generally interpreted along with other serological markers 

Based on the WHO recommendation and as per the Irish National Immunisation Guidelines, an A-HBs concentration of >= 10mIU/mL is regarded as being protective against Hepatitis B viral infection.

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At Enfer Medical, we have integrated a cutting-edge and fully automated WASPLab® (Walk Away Specimen Processor) that has significantly enhanced our testing capabilities to ensure the highest of quality when processing patient samples.
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WASPLab® at Enfer Medical
Our entire microbiology workflow has been optimized using automation and highly sophisticated robots to ensure uninterrupted incubation for rapid bacterial growth and improved turnaround times for patients.
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Our Services

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Health & Wellness
General health and wellness testing can include a variety of tests, depending on the needs of the individual or recommendations of
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Sexual Health
Regular STI screening facilitates early treatment and reduces the long-term consequences of infection.
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Respiratory Health
Rapid early pathogen identification has important treatment and infection control implications. See our range of tests here.
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Hormonal analysis is hugely beneficial to identifying problems that can arise during the reproductive years.
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Sample Type &
Volume Required

5mL venous serum or plasma OR 0.8mL capillary serum for each HBV test required.

Enfer Medical

Tests/Assays

Enfer Medical offers the chemiluminescent microparticle immunoassay (CMIA) technology for the quantitative assay for anti-HBs, and the qualitative assays for anti-HBc and HBsAg. These three tests are CE-IVD certified.

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Patient

Request Form

For clients using the Enfer Medical Client Portal, the Enfer Medical Patient Request Form (PRF) will be generated when you have completed your “Test Request” within the portal linked below.

Enfer Medical Portal

Please note that samples suspected of containing high risk pathogens such as Mycobacterium tuberculosis should be clearly identified on the form and packed separately from other samples.

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24 hours

Results are available next working day.

7 Days a Week

These assays are available seven days a week.

Packaging

The packaging/preparation of samples for delivery to the laboratory are required to be in adherence to all national regulations for the safe transport of biological materials. HSE guidance can be reviewed HERE.
There are specific packaging instructions and labelling requirements requiring triple packaging including:

  • Primary leak-proof container – tube or vial containing the sample.
  • Secondary watertight container, with absorbent material, intended to protect the primary container.
  • Outer container protects the secondary container.
  • Patient Request forms must be placed between the secondary container and the outer shipping container.


Further information on the packaging/preparation of samples for delivery to the laboratory is contained within the Enfer Medical Laboratory User Manual which clients are provided with.

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Storage & Stability

Venous blood samples must be tested within 14 days of collection if stored at 2-8°C. Capillary blood samples must be tested within 7 days of collection.

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Transporting
Samples

In addition to the packaging of samples, the transport/delivery of clinical samples to the laboratory is required to be in adherence to all national regulations for the safe transport of biological materials. Enfer Medical provides a fully compliant logistics service, aligned with clients’ testing requirements.

Prompt transport of specimens:
To ensure prompt testing of samples and release of results within the published test turnaround times, samples should arrive to the laboratory by 18:00. Test turnaround time is measured from receipt of the sample at the laboratory until the time the authorised results are reported to users.

Acceptance/Rejection
of Samples

In rare cases specimens may not be suitable for testing on arrival to the laboratory. In that case the sample will be rejected at the receipt stage and the service user will be notified immediately and an explanation as to why the sample could not be processed will be provided. Reasons why samples cannot be processed include but are not limited to:

  • Samples received beyond the stability limits and/or not at the correct temperature indicated for each test.
  • Incorrect sample type received.
  • Leaking samples, sample not received or sample insufficient for analysis as stated below within sample requirements.
  • Non-compliant samples or request forms i.e. those missing sample date information, missing sample test request and/or missing sample site/type information.
  • Samples received without the necessary patient identifiers.
Clients will be provided with guidance on Sample Receipt Anomalies.

Our Services

Service
Health & Wellness
General health and wellness testing can include a variety of tests, depending on the needs of the individual or recommendations of
Find Out More
Service
Sexual Health
Regular STI screening facilitates early treatment and reduces the long-term consequences of infection.
Find Out More
Service
Respiratory Health
Rapid early pathogen identification has important treatment and infection control implications. See our range of tests here.
Find Out More
Service
Reproductive & Female Health
Hormonal analysis is hugely beneficial to identifying problems that can arise during the reproductive years.
Find Out More
Service
All Services
View the full suite of services at Enfer Medical here.......
Find Out More
Result Values for Anti-HBc, HBsAg & Anti-HBs
Results will be reported as:
Qualitative results for Anti-HBc and HBsAg will be reported as:
  • DETECTED
  • NOT DETECTED
  • INVALID
Quantitative results for Anti-HBs will be reported as:
  • Quantitative results for Anti-HBs will be reported with the numerical titre value. Based on the WHO recommendation an anti-HBs concentration of ≥ 10 mIU/mL is regarded as being protective against Hepatitis B viral infection.
Please note that Hepatitis B is a notifiable disease under the Infectious Diseases (Amendment) Regulations 2020 (S.I. No. 53 of 2020) February 2020.

Please refer to the Health Protection Surveillance Centre for the Case Definitions for Notifiable Diseases:

HPSC Link
Accessing

Your Results

Following receipt at the Laboratory, results should be available on the next working day and will be reported to the referring clinician via the Enfer Medical Client Portal or in a format agreed with clients.

Client Login

Established clients can login to the portal using the link above.

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