Flowchart for HBV screening and confirmation (accessible version)
Updated 4 December 2025
Applies to England
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For reporting please use the results table and reporting comments for hepatitis B.
1. Perform hepatitis B surface antigen (HBsAg) assay: is HBsAg detected?
If no, report as hepatitis B surface antigen not detected. End of laboratory pathway.
If yes, go to step 2.
2. Perform neutralisation or alternative HBsAg assay: is HBsAg detected?
If no, go to step 3.
If yes, go to step 4.
3. Test hepatitis B core antibody (anti-HBc) (total): is anti-HBc detected?
If no, go to step 5.
If yes, go to step 4.
4. Test other serology markers and review all results
Go to step 5.