87340 Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative, multiple-step method; hepatitis B surface antigen

Name of the Procedure:

Infectious agent antigen detection by immunoassay technique, commonly referred to as:

• Enzyme Immunoassay (EIA)
• Enzyme-Linked Immunosorbent Assay (ELISA)
• Immunochemiluminometric Assay (IMCA)
• Hepatitis B Surface Antigen Test

Summary

This procedure is a lab test used to identify the presence of the hepatitis B surface antigen (HBsAg) in a blood sample. It utilizes immunoassay techniques to detect the viral antigen, indicating an active hepatitis B infection.

Purpose

Medical Condition:

• Hepatitis B Virus (HBV) Infection

Goals:

• To detect active HBV infection
• To help diagnose acute or chronic hepatitis B
• To identify carriers of hepatitis B

Indications

• Symptoms of hepatitis (e.g., jaundice, fatigue, abdominal pain)
• Elevated liver enzymes (AST/ALT)
• Routine screening in high-risk populations (e.g., healthcare workers, pregnant women)
• Monitoring status of known HBV carriers
• Blood donors and organ transplant candidates

Preparation

• No special preparation is typically required.
• Inform the healthcare provider about any medications or underlying health conditions.

Procedure Description

1. Sample Collection: A healthcare professional will draw a blood sample from a vein, usually in the arm.

2. Laboratory Processing:

   • The blood sample is sent to a laboratory.
   • Immunoassay techniques (EIA, ELISA, or IMCA) are used to detect the HBsAg in the blood sample.
   • Specific antibodies that bind to the HBsAg are utilized.
   • Multiple steps involve binding, washing, and detection stages to ensure specificity and accuracy.

   Tools Used:

   • Needles and syringes for blood collection
   • Laboratory assay kits specific for HBsAg detection

Anesthesia or Sedation:

• None

Duration

• Blood sample collection: 5-10 minutes.
• Laboratory processing: Several hours to a few days, depending on the lab.

Setting

• Typically done in outpatient clinics, hospitals, or specialized diagnostic labs.

Personnel

• Phlebotomists or trained healthcare providers for blood collection
• Laboratory technicians or medical technologists for sample analysis

Risks and Complications

• Common: Minor discomfort or bruising at the site of blood draw
• Rare: Infection at the puncture site, fainting or dizziness

Benefits

• Accurate identification of active hepatitis B infection
• Facilitates timely medical treatment and management
• Helps prevent the spread of HBV through early detection

Recovery

• Patients can usually return to normal activities immediately.
• Post-procedure: Simple care for the puncture site, such as keeping it clean and covered if needed.
• Results discussion with the healthcare provider typically follows once the analysis is complete.

Alternatives

• HBV DNA PCR Test: Measures viral load, more detailed but typically used for ongoing monitoring rather than initial diagnosis.
• Total anti-HBc Test: Detects previous or current HBV infection but does not differentiate between acute and chronic infection.

Pros and Cons of Alternatives:

• HBV DNA PCR is more precise but more expensive and complex.
• Total anti-HBc is broader but not specific for active infection.

Patient Experience

• During the Procedure: Brief discomfort during blood draw.
• After the Procedure: Minimal to no discomfort.
• Pain Management: Not typically needed; over-the-counter pain relievers can be used if necessary.
• Comfort Measures: Relaxation techniques during the blood draw, such as deep breathing.

This comprehensive guide should help patients understand the test for hepatitis B surface antigen detection by immunoassay technique and what to expect before, during, and after the procedure.