Chari A. Cohen, Hepatitis Test Expert

Chari A. Cohen is currently the associate director of public health for the Hepatitis B Foundation. Ms. Cohen has a BS in biology, an MPH in community health education and a DrPH(c) in community health and prevention. She has 10 years of experience developing interventions to reduce the morbidity and mortality associated with chronic hepatitis B and liver cancer.

What initially made you interested in working for the Hepatitis B Foundation?
I had a strong interest in both infectious disease and cancer, and with HBV you get both. Chronic hepatitis B is the leading cause of liver cancer worldwide.

How is hepatitis B transmitted?
HBV is transmitted through direct contact with infected blood and bodily fluids, including sexual fluids. It can be passed on through re-using needles, having unprotected sexual contact and from a mother to her child during the childbirth process. It is not transmitted through casual contact.

Who should be tested for hepatitis B?

Anyone who falls into a high risk category should be tested: individuals who have received blood or organs before 1992, individuals who receive blood products routinely, people who come from areas of the world with high hepatitis B prevalence (Asia, Pacific Islands, Africa), men who have sex with men, and people who live with someone who is infected (or sexual partners of infected individuals).

How does a hepatitis B test work?
It is a blood test. One vial of blood is needed. The test is a 3-part panel:
1) Hepatitis B surface Antigen (HBsAg) - this tests directly for the presence of the hepatitis B virus. It should be negative if there is NO virus present.

2) Hepatitis B surface Antibody (HBsAb or anti-HBs) - this tests for the production of protective antibodies against the hepatitis b virus. This blood test should be positive if the protective antibodies are produced in response to vaccination or recovery from a natural infection.

3) Hepatitis B core Antibody (HBcAb or anti-HBc) - this antibody does not provide any protection, but only refers to a piece of the virus itself. A positive result may indicate that a person has been exposed to the hepatitis B virus. This test must be interpreted in relation to the above two test results.

If you have been exposed to the virus and recovered, you should have developed the hepatitis B surface Antibody (HBsAb+). This test result would indicate that you have recovered and cannot infect anyone else. 90% of healthy adults who are exposed to the hepatitis B virus recover on their own and develop the protective surface antibody. However, 10% of infected adults are unable to get rid of the virus and develop chronic infections. These people need further evaluation by a liver specialist or doctor knowledgeable about hepatitis B.

What type of certification or training is needed to administer a hepatitis B test?
It needs to be ordered by a physician. A person who is trained and certified to draw blood is needed to collect the sample.

What is the most significant piece of advice you can offer to people who wish to get tested for Hepatitis B?
Call their local department of health to see if there is a clinic where they can get tested. Ask their doctor to test them. Go to a family planning or STD clinic.

Do you have any additional advice or suggestions regarding Hepatitis B testing?
It is so important for people to know their HBV status. There are two million people in the U.S. with chronic HBV, and up to 25% of them will die prematurely from the consequences. Unfortunately, over 50% of infected people do not know that they have HBV. These deaths can be prevented if people get diagnosed and into appropriate care.

To learn more about hepatitis testing, read our Hepatitis Test Guide.

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