Also Known As
Haemoglobin S
Hb S
Hgb S
Formal Name
Haemoglobin S evaluation
This article was last reviewed on
This article waslast modified on 14 October 2021.
At a Glance
Why Get Tested?

To screen for the presence of sickle cell trait or to confirm the presence of sickle cell disease

When To Get Tested?

If you are of Afro-Carribean descent to determine if you carry one or both genes for sickle cell disease and for antenatal screening. There are other ethnic minorities in whom the sickle gene is found and should be tested if index of clinical suspicion is high.

Sample Required?

A blood sample taken from a vein in the arm. In children, a blood sample from a finger-prick or heel-prick

Test Preparation Needed?

None; however, if this test is used for diagnosis, the sample should not be taken after a recent blood transfusion

On average it takes 7 working days for the blood test results to come back from the hospital, depending on the exact tests requested. Some specialist test results may take longer, if samples have to be sent to a reference (specialist) laboratory. The X-ray & scan results may take longer. If you are registered to use the online services of your local practice, you may be able to access your results online. Your GP practice will be able to provide specific details.

If the doctor wants to see you about the result(s), you will be offered an appointment. If you are concerned about your test results, you will need to arrange an appointment with your doctor so that all relevant information including age, ethnicity, health history, signs and symptoms, laboratory and other procedures (radiology, endoscopy, etc.), can be considered.

Lab Tests Online-UK is an educational website designed to provide patients and carers with information on laboratory tests used in medical care. We are not a laboratory and are unable to comment on an individual's health and treatment.

Reference ranges are dependent on many factors, including patient age, sex, sample population, and test method, and numeric test results can have different meanings in different laboratories.

For these reasons, you will not find reference ranges for the majority of tests described on this web site. The lab report containing your test results should include the relevant reference range for your test(s). Please consult your doctor or the laboratory that performed the test(s) to obtain the reference range if you do not have the lab report.

For more information on reference ranges, please read Reference Ranges and What They Mean.

What is being tested?

Blood is tested for the presence of Haemoglobin S (HbS), which is a genetic variant of the protein haemoglobin. Haemoglobin is found inside red blood cells (RBCs) and is responsible for carrying oxygen from the lungs to all of the tissues and organs of the body. Normally haemoglobin exists in various forms (Haemoglobin A, Haemoglobin A2, and Haemoglobin F) that are present in different amounts. One genetically abnormal haemoglobin is known as HbS, which causes the RBC to change shape and affects its ability to carry oxygen. In sickle cell disease, one abnormal HbS gene is inherited from each of the parents. The RBC in these individuals change shape, thus affecting the ability of the red cells to carry oxygen.

How is the sample collected for testing?

In young children a finger-prick or heel-prick is performed to obtain a few drops of blood. In adults, a blood sample is obtained from a vein.

Is any test preparation needed to ensure the quality of the sample?

No test preparation is needed; however, testing for diagnosis should not be performed after a recent blood transfusion.

Accordion Title
Common Questions
  • How is it used?

    The test is used to screen for the presence and amount of Haemoglobin S (HbS). In the screening test, a chemical is added to the patient's blood sample that reduces the amount of oxygen it carries. In those who carry the sickle cell gene (homozygous), the reduced amount of oxygen will cause crystals to form. These crystals alter the shape of the RBC, resulting in the characteristic sickle shape. To confirm and identify the amount of HbS present a test is used that separates out the different types of haemoglobin. Each type of haemoglobin will form a unique 'pattern' so that HbS can be identified and a diagnosis of sickle-cell disease made.

  • When is it requested?

    Because sickle cell disease is a genetically inherited disorder, an individual may have the trait (carry one mutated gene from one parent) or the disease (carries two mutated genes, one from each parent), thus the screening test is often performed on infants and children. If you are of African ancestry (about 25% of Africans carry at least one gene for this trait), you may wish to be tested prior to starting a family.

  • What does the test result mean?

    If the screening test is negative, it means that the gene for sickle cell trait is not present. If the screening test is positive, then further haemoglobin testing must be performed to confirm whether one mutated gene or both are present. In unaffected individuals HbS is not present. In those who have sickle cell trait, 20% to 40% of the haemoglobin is HbS. In sickle cell disease, as much as 80% to 100% of the haemoglobin may be HbS. In general, individuals who have sickle cell trait do not have any significant symptoms and live a normal life. Those individuals who carry both abnormal genes have sickle cell disease. In this condition the person may not experience any symptoms under 'normal' conditions, but may experience episodes called 'sickling crises' brought on by, for example, infection or dehydration. During such episodes symptoms can include joint pain, abdominal pain, fever and seizures. In the long-term, sufferers may experience haemolytic anaemia (breakdown of red blood cells), growth impairment, jaundice and increased risk of serious infections.

  • Is there anything else I should know?

    Because of the abnormal (sickle-cell) shape of the RBC in sickle cell disease, RBCs can become stuck in small capillary blood vessels, thereby blocking the blood supply to various organs. About 25 percent of the African population carry at least one abnormal gene although only a small proportion of these carry both genes. A sickle cell test can screen for presence of the abnormal gene.  

    The test can fail to detect haemoglobin S (sickle cell disease or trait) under the following circumstances:

    • if you have a blood transfusion within three to four months before the sickle cell test
    • if you have the red blood cell disease polycythaemia (increased red blood cell production)
    • if you test an infant less than 3 months old
    • if you are taking certain drugs, such as phenothiazines.

    Because of the severity of the disease, people of African ancestry who are planning to have children may wish to seek counselling from their doctor to ensure that neither carries the sickle cell trait.

  • What is the treatment for sickle cell disease?

    The life span of a patient with sickle cell disease has increased significantly to over 50 years of age. Common causes of death include infections, clots or blockages of blood vessels, and kidney failure. Treatment is based on the symptoms existing at the time of a 'sickling-crisis'. This may include blood transfusions, antibiotics, on-going fluid intake through intravenous (IV) solutions and/or drinking of fluids, and medication to reduce pain. Red blood cell exchange has been used in sickle cell crisis. More recently, bone marrow transplants have been shown to be effective. An allogeneic stem cell transplant has the potential to cure sickle cell disease.

  • If I have sickle cell trait, will I still need treatment?

    Patients with sickle cell trait generally do not require any long-term treatment. Under certain circumstances, those individuals with the trait who are exposed to reduced levels of oxygen (excessive exercise or high altitudes) may experience some 'crisis-like' symptoms like pain or difficulty breathing.

  • Do people who are not of African ancestry get sickle cell disease?

    The sickle cell gene is found mainly among African descendents. It is suggested that individuals who have sickle-cell trait (i.e. only one copy of the faulty gene) are naturally 'protected' against the parasite that causes malaria, which is why the gene has 'survived' to be passed down through generations.

    However, in clinical practice we see malarial infections in individuals with sickle cell trait and sickle cell anaemia. Anti malarial  prophylaxis is always recommended in these individuals when travelling to high risk areas. Testing for  malarial parasites should also be performed in the event of a febrile illness, especially after return from high risk areas. 

    The trait also appears in individuals from the Mediterranean coastal areas and may be seen in those from inter-race backgrounds.

  • Is there antenatal testing for sickle cell disease?

    Antenatal testing (i.e. testing the foetus while still in the womb) is available. Amniotic fluid may be tested at 14–16 weeks to provide a definitive answer as to whether or not the foetus has sickle-cell trait or disease. Potential parents can also be tested to see if they carry the sickle-cell gene before starting a family - genetic counselling is strongly encouraged if a positive sickle screen is obtained from one or both parents.