Good evening
I have been diagnosed with chronic infection since 2022. I usually do DNA levels, this time my doctor ordered HbSAg quantitative. It came back as 65 IU/ml and undetectable DNA as usual. Now sure why they tested for HbSAg.
Please can someone explain?
Hi @Huanparebi,
There is a quantitative test for HBsAg that is useful for monitoring how close you are to clearing surface antigen altogether (functional cure). Studies on new therapeutics in development have shown that quantitative surface antigen is crucial in determining who is a good candidate for such therapies. Luckily for you, 65 IU/mL is actually very low, and you would have a good chance of becoming functionally cured with new drugs in development. I wish you the best of luck with your journey!
Hi @Huanparebi,
The HBsAg quantitative test checks whether someone has cleared the surface antigen and achieved a functional cure. It’s mostly used when someone is on treatment, and the provider wants to see if they have cleared the surface antigen or where things stand. So, it is not a routine test for all patients. 65 IU/ml is very low, which is great because it gives you a good chance of achieving a functional cure. I hope this helps. Best Bansah1
@Bansah1 It’s interesting, because quantitative HBsAg is performed much more often in other countries, but is less common in the US. I had to fight the lab to get it done, because they kept just giving me the standard qualitative one. I used to have it done in Canada all the time though. I think it’s very useful data to have because it shows how well your immune system is controlling the virus.
That is true. HBsAg quantitative is not something I get tested for every time. Once a year or so, we will check it. I guess it is not routine in the US given the lower rates of functional cure on the current antivirals. I am unsure about the costs either. However, getting tested once in every few years could be useful in one’s care.
Thank you for letting me know. This is useful information to know. My lab also had difficulty finding the test so I found the code for them. Quest code is 94333 for quantitative test. My hepatologist told me that information since labs usually put the wrong test. I’m in US. Hope this information can help for your future test. Best of luck!
Thank you for your reply. This gave me some useful insight. Best of luck!
I just wanted to chime in because I just asked my hepatologist to order the quantitative test and he said he would do it, but needed to look up the CPT code. I went to the lab to complete the blood draw 2 weeks later, which included me getting other tests done for my PCP, and when all my results came in, I only saw the qualitative HBsAg rand the quantitative surface anitbody results. So I messaged my hepatologist to ask if the quantitative HBsAg was still outstanding and he said he still needed to figure out how to send the test out since it’s not peformed in-house. I guess he doesn’t request it often enough to place the order! Very frustrating, but I’m hopefully he’ll figure it out and i can get it done the next time I go to the lab for testing.
@Huanparebi, congrats on your low HBsAG results!
What lab did you go to? In house? Or Labcorp or Quest if in US?
@Rebecca the same thing happened to me. More than once actually. Very frustrating! The worst part is that we still have to pay for the test, even when it was the lab that messed up and ran the wrong one.
I go to a large academic University hospital here in the U.S. So most labs are performed by the Medical labs at the hospital but they send out the more uncommon tests to outside facilities.
Yes. It’s not a routine test Dr would order. I mentioned about this at recent Dr. appointment and the test result would benefit if you were on some functional cure therapy to track the progress other than that the Dr would need justification to order it and it will cost the patient additional cost for test that may not benefit at the time. I suppose if you are not on a functional cure therapy, it suffice to know you cleared HBsAG or not along with other test results. I believe this test costs more than the qualitative test.
HBsAg Qualitative test typically costs between $45 and $60 out-of-pocket in the U.S. In contrast, an HBsAg Quantitative test is much more expensive, generally ranging from $215 to $740 in the U.S. Insurance always do the cheaper option first before giving in to doing it the expensive option.
Thank you for this information! This certainly provides some insight into why the quantitative test is not regularly performed, at least not in the U.S. Luckily for me, due to the cost of Vemlidy, I meet my deductible early in the year and try to get all my visits completed after this time so the costs are not as high as they could be. I think it’s worthwhile for me to get the test done at least once, especially now in light of the latest promising clinical trial results.
Are you currently on antiviral medication?
Yes I’m on antivirals.
Does anyone know that we need to test for HBD if we have HBV? Also, does anyone know the lab code for quantitative HBsAg at Lab Corp?
Hi, yes, it’s useful information for your physician to know your HBD status, just in case. Quantitative Hbsag at Labcorp is Labcorp Test 007130.
Good luck, Ace
I am assuming by HBD you mean hepatitis delta.
Yes I meant Hep Delta :))
@lnguyen Yes, I personally am of the opinion that everyone who is HBsAg-positive should be tested for Delta. Some guidelines still suggest risk-based screening, but this has been largely ineffective.