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Hepatitis B surface antigen (HBsAg) may be detected in the presence of acute or chronic hepatitis B virus (HBV) infection [ 281 ]; it indicates that the person is infectious. In acute infection, its appearance predates clinical symptoms by 4 weeks and it remains detectable for 1–6 weeks. The tests for detecting hepatitis B and D disease are primarily serologic and molecular ( Table 62 ). Care providers should check with the laboratory on the minimum volumes of blood needed, as some molecular platforms require more blood than others.

Table 62.

Laboratory Diagnosis of Hepatitis B and D Viruses

Abbreviations: EDTA, ethylenediaminetetraacetic acid; IgG, immunoglobulin G; IgM, immunoglobulin M; NAAT, nucleic acid amplification test; PPT, plasma preparation tube; RT, room temperature; SST, serum separator tube.

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Table 62.

Laboratory Diagnosis of Hepatitis B and D Viruses

Abbreviations: EDTA, ethylenediaminetetraacetic acid; IgG, immunoglobulin G; IgM, immunoglobulin M; NAAT, nucleic acid amplification test; PPT, plasma preparation tube; RT, room temperature; SST, serum separator tube.

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The presence of hepatitis B surface antibody (HBsAb) indicates recovery from and immunity to HBV infection, as a result of either natural infection or vaccination. In most patients with self-limited acute HBV infection, HBsAg and HBsAb are not detectable simultaneously in serum or plasma.

Hepatitis B core (HBc) IgM antibody appears during acute or recent HBV infection and remains detectable for about 6 months. A serologic “window” occurs when HBsAg disappears and HBsAb is undetectable. During this “window” period, infection can be diagnosed by detecting HBc IgM antibody.

HBc total antibodies appear at the onset of symptoms of acute hepatitis B infection and persist for life. Their presence indicates acute (positive HBc IgM antibodies), recent (both HBc IgM and HBc total antibodies), or previous (positive HBc total antibodies but negative HBc IgM antibody) HBV infection. There is currently no commercially available test for HBc IgG antibody in serum or plasma.

A chronic HBV carrier state is defined by persistence of HBsAg for at least 6 months. In patients with chronic hepatitis B, the presence of hepatitis B e antigen (HBeAg) in serum or plasma is a marker of high viral replication levels in the liver. Loss of HBeAg and emergence of antibody to HBeAg (ie, HBe antibody) is usually associated with improvement of underlying hepatitis and a reduction in the risk of hepatocellular carcinoma and cirrhosis. Alternatively, disappearance of HBeAg may denote the emergence of a precore mutant virus; high concentrations of HBsAg and HBV DNA, in the absence of HBeAg and presence of HBe antibody, suggest the presence of a HBV precore mutant virus. Hepatitis B viral DNA is present in serum or plasma in acute and chronic hepatitis B infection [ 282 ]. Quantification of HBV DNA in serum or plasma may be included in the initial evaluation and management of chronic hepatitis B infection, especially when the serologic test results are inconclusive or when deciding treatment initiation and monitoring a patient’s response to therapy. Other molecular laboratory tests used in the diagnosis and management of chronic hepatitis B infection have been reviewed and include assays for determining viral genotype, detection of genotypic drug resistance mutations, and core promoter/precore mutations [ 282 ].

Email
[email protected]
Phone
(310) 962-6000
Address
830 Traction Ave. #3a
Los Angeles, CA 90013
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Los Angeles County’s juvenile justice system is the largest in the nation with nearly 16,000 youth under the jurisdiction of the Probation Department, including more than 1,800 held in detention facilities.

“I learned that I am capable of doing anything if I put my mind to it. I thought the art project was real great work.”

AIYN provides multi-discipline, high-impact arts across SIXTEEN Probation-run facilities in Los Angeles County.


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About Us

The Arts for Incarcerated Youth Network (AIYN) is an interdisciplinary collaborative that provides exceptional arts programming in order to build resiliency and wellness, eliminate recidivism, and transform the juvenile justice system.

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830 Traction Ave. #3a Los Angeles, CA 90013 310-962-6000 [email protected]

AIYN is a 501(c)3

AIYN has identified four areas of focus and shared purpose among membership. These areas are:

integrated into detention facilities as a core healing-informed strategy for addressing trauma, redirecting lives, and as a foundational strategy for successful reentry, including developing to 21st Century job skills (creativity, communication, collaboration, and critical thinking) and connecting young people to the creative economy.

as an effective model to increase capacity, efficiency, and partnership. Includes community-building events among AIYN members, partners, advocates, and alum.

on transforming systems to recognize and prioritize arts integration in youth wellbeing. Includes resources on similar efforts, and emerging resources on the impact of arts in detention, and youth.

providing hands-on experiential training as professional development, or corporate team-building in an effort to support change in institutional cultures.

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AIYN is a network of peers. As such, our norms, guidelines, and expectations of each other are driven by our members. We are an open network in that we are always open to new members who share our collectively articulated values, approach, and principles. New members are brought in through a standardized series of peer interviews, site visit, and exploratory partnership. All members have their own curriculum, disciplines, and pedagogy, while also supporting each others growth and the growth of the field. Membership has no fee, but does come with expectations of behavior in alignment with the following articulated principles:

University of Utah Health

50 N. Medical Drive SLC, UT 84132 801-581-2121

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Site Links

Site Information

All clinical services and programs are part of University of Utah Health Hospitals and Clinics.

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