Discordant lab results

Hi

I’m writting because I feel depressed due to my unclear test results and I’m worried sick that I could transfer the virus to my baby during birth.
I got 3 weakly positive hbsag results within 1 year. Confirmatory tests with neutralising antibodies were also positive. All the tests were made on Abbott CMIA alinity. The last test sco was borderline 1,17 and neutralization test result was 51% (the cutoff is 50%)
Other than that I tested Hbsag negative 6 times on Roche Eclia during the same period. Hbcab total shows negative on both devices. NAT test and 4 Pcr HBV DNA tests are non reactive. I was vaccinated 20 years ago and my antibodies level is still high ( 150). I have never had any issues with the liver.Doctors say they had never seen such results where hbcab is negative. They refused to give HBIG to my newborn . The baby only received the vaccine the next day after birth.
I read about some hbv mutants and I’m really scared. I feel I haven’ t received enough support from the doctors . I don’t even know when to test my baby. I know that hbsag test cannot be taken right after the vaccine to avoid false positive result. What about HBV DNA test ,will this also show false result right after vaccine? The baby is yet to receive 2 more doses in 4th and 7th month. I m not sure how long I should wait after the vaccination and what my results mean.
I think about this problem everyday.
Could anybody here advise me? Is there anthing else I can do to verify my results.
Thanks

Dear @Natalia,

Your concern for your baby is certainly very natural, and I agree that these test results are rather unusual. If you actually are HBV+ (something I’m not sure of), then you have an extraordinarily low level of virus in your body as 4 independent PCR DNA tests were negative. Such low level infection (if the HBs results are not artifacts) is likely have very low transmissibilty. Your baby has been vaccinated, and staying on the normal vaccination schedule is the right thing to do as clinical studies have shown that that schedule yields very good protection.

Overall, I think the risk to your lovely little one is very low. However, I am a PhD scientist rather than an physician, so I’m interested to hear what the physicians think.

As always, it is OK to seek a second opinion from anther physician.

I wish you and your baby the very best, and I hope you find comfort in this Community.

John.

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Dear @Natalia

It is normal for you to be worried about passing on the virus to your baby. We all go through this and it kind of never goes away. It does get less intense the longer we live and learn about the virus and you find that there are not many ways to pass it on to others.

I had one baby without even knowing I had the virus and he never got it from me. I then went on to have two more babies and they were vaccinated at Perth. I also had a husband who was not vaccinated for a year and he never got the virus either.

Please try and relax and enjoy this precious time and know that the doctors have got this in control.

Thanks for sharing

Hi @Natalia,

The risk of mother-to-child transmission with undetectable HBV DNA and such high anti-HBs levels after appropriate birth dose vaccination is essentially negligible.

Technically, an anti-HBc antibody test would be able to verify if there has been any transmission event, but this is something you would have to discuss with your doctor.

Thomas

Thanks. How long I should wait with the hbsag testing after vaccine , what are the most recent recommendations on this?

My understanding is that testing 1-2 months after the last dose of your course is the recommended practice.

https://immunisationhandbook.health.gov.au/recommendations/people-at-risk-of-hepatitis-b-are-recommended-to-have-serological-testing-4-8-weeks-after-they-complete-the-hepatitis-b-vaccine-course

Thomas