Pathology Handbook

Hepatitis B immunity


Hepatitis B antibody, Hepatitis B surface antibody, anti-HBs

Clinical Indications

Post vaccination check for seroconversion

Test Includes

Detection of antibodies to Hepatitis B surface antigen

Request Form

ICE request


On request during routine working hours

Specific Criteria

Please give detailed clinical information, including (1) the date of any Hepatitis B virus immunisation course; (2) the date of the incident and identity of any patient involved in a "needle-stick" incident, as relevant. Please note that tests required for employment or insurance purposes will be charged unless received via Southend University Hospital Occupational Health Department

Turnaround Time

Tests are performed weekly, usually on a Monday


Serum, red or gold top (SST) tube


5 ml


Vacutainer red top


Samples should be transported to laboratory immediately

Causes for Rejection

Unlabelled sample
Delay in sample reaching laboratory

Reference Range

An antibody level of less than 10 mIU/ml indicates no significant response or immunity; further investigations may be required if vaccination <1 year ago. A booster is indicated for patients who have been vaccinated >1 year ago; in this instance a further blood sample should be tested 1 - 2 months after the booster dose

An antibody level of 10 - 100 mIU/ml following vaccination <1 year ago indicates a low level of immunity ; a single booster dose of vaccine should be given and a further blood sample tested 1 - 2 months after this booster dose

An antibody level of 10 - 100 mIU/ml following vaccination >1 year ago indicates immunity

An antibody level of >100 mIU/ml indicates a good immune response with protective immunity

Lab Handling

Aliquot and store at 4ºC prior to testing; store at -40ºC for 3 months following testing