EXPLAINER: Lab results and their interpretation

Hi Gongo,

Your ALT is normal normal but this blood test result alone is not sufficient to exclude liver-related issues (including increased HBV activity) which may be causing your elevated liver stiffness. I urge you to press your doctor on this point at your next visit: this should not go on without some sort of diagnosis / intervention.

Good luck!
Best regards,

Thank Availlant
As many here said most of the doctors are not very competent in making follow up for patients with HBV.Its my self pushed the Dr to make the fibro scan and CT scan. When I was telling the Dr that I am feeling abdominal discomfort he was just giving me ulcers medication for six months until I said no we need to concentrate on my hbv issues then we did a CT scan and fibro scan. The CT scan was ok buy the fibro scan results give 12.2kPa beyond normal.
I will make sure before my next visit(sixt months) I will another Dr to do more labs details.
Thank you once again and appreciated

how much improvement on 72 weeks

Suresh I believe its something in the rage of an additional 5% but also restricted to genotype A.

how do i know my genotype

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Hi Suresh,

This test is expensive and requires your HBV DNA to be at least 1000 IU/mL (and preferably higher). It is available but not every lab does it.

Check out this paper to help you understand global genotype distribution.

Best regards,

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thanks, how about guess based on country

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Thank you Thomas for pointing me to the correct thread. I recently did a blood work and the doctor said it didn’t look too bad. But he wanted sent me to get Fibrosis and ultrasound done, and later called me to advise me that he needed to put me on some type of medication. I don’t have that medication yet as I am still waiting for him to reach back out to me. Here are my results.

HEPATITIS B SURFACE ANTIBODY, QUANTITATIVE
Hep B S Ab
Your Value
15.0 mIU/mL
Standard Range
Immunity>9 mIU/mL

Hepatitis B surface antigen
Hepatitis B Surface Ag
Your Value
Positive
Standard Range
Negative
Flag
A

Hep B E Ab.
Your Value
Positive
Standard Range
Negative
Flag
A

Hep B E Ag
Your Value
Negative
Standard Range
Negative

|Hepatitis B Surface Ab, Qual|Your ValueReactive|||
|Non Reactive: Inconsistent with immunity,
less than 10 mIU/mL
Reactive: Consistent with immunity,
greater than 9.9 mIU/mL|

HEPATITIS B DNA QUANTITATIVE, PCR
|HBV IU/mL|
Your Value8,630 IU/mL|
Standard RangeIU/mL||

|log10 HBV IU/mL|
Your Value3.936 log10 IU/mL|
Standard Rangelog10 IU/mL||

Fibroscan
|Controlled Attenuation Parameter (CAP)|
Your Value197 dB/m|
Standard Range100 - 200 dB/m||

|Liver Stiffness (E)|
Your Value8.7 kPa|
Standard Range1.47 - 7 kPa|
FlagH|

Ultrasound abdomen complete - Details

Study Result

Narrative

Abdominal sonogram.

INDICATION: Chronic hepatitis B virus infection

TECHNIQUE: An 8 MHz transducer was used along with color-flow for evaluation.

FINDINGS: Liver span is 16.7 cm. Echotexture is normal. There is no biliary dilatation or mass.

The gallbladder wall thickness is normal. There is no stone or sludge demonstrated.

The common duct measures 0.5 cm.

The head and body of the pancreas are normal. The tail is not seen.

The spleen measures 9.2 cm.

The right kidney measures 10.9 cm and the left 11.3 cm. The kidneys are unremarkable without hydronephrosis, stone, mass, cyst or abnormal
echotexture.

There is normal appearance of the inferior vena cava. The aorta is only partially seen.

There is no ascites or effusion.

IMPRESSION: The liver and gallbladder are normal. There is no evidence of biliary obstruction.

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Dear @Poseidon,

Thanks for sharing your results. It is a fairly uncommon state to have both anti-HBs antibodies and HBsAg at the same time, but I don’t think there is evidence that this is either good or bad in itself.

Your tests suggest moderate levels of virus replication (HBV DNA) which would be lowered by the treatment suggested by your doctor. This may reduce the mild liver injury suggested by the elevated fibroscan values. Otherwise your liver health looks OK via the ultrasound, though it would also be good to get liver function tests done.

Thomas

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Dear @ThomasTu

Thank you for going over the results for me. There’s just so much information on these things that it sometimes confuses me. I guess I’ll keep doing what I’m doing, trying to eat right and exercise often and see what happens. Hopefully the medication helps. Is it possible that a person on medication can possibly beat the virus in the future?

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Hello there Thomas and Team,

Thank you so much for creating this site. You and your group been very helpful to patients like us…
Me and my siblings are HebB positive all our life and now we’re adults become more aware of this infection.

We had tests yesterday and these are the initial report we got. Can you help interpret?

Thanks a lot in advance…

Brother1
Currently not on medication.
ALT NORMAL
AST NORMAL
Anti-HAV IgG NONREACTIVE 0.14
Anti-HCV
Anti-HBc Total REACTIVE 10.00
Anti-HBc IgM NONREACTIVE 0.09
HBeAg NONREACTIVE 0.53
Anti-HBe REACTIVE 0.03
HBsAg w Titer REACTIVE 4679.35
Anti-HBs NONREACTIVE 0.00
HBV VIRAL LOAD. 2815 IU/ml , 14,655 copies/ml

Brother2
Currently not on medication.
ALT NORMAL
AST NORMAL
Anti-HAV IgG NONREACTIVE 0.26
Anti-HCV
Anti-HBc Total REACTIVE 6.90
Anti-HBc IgM NONREACTIVE 0.08
HBeAg NONREACTIVE 0.38
Anti-HBe REACTIVE 0.01
HBsAg w Titer GRAYZONE 1.01
Anti-HBs NONREACTIVE 2.04

Me:
On TAF medication for 2 years. This is my first blood test since lockdown in 2020.
I had very high ALT and AST in 2019 and my HepB tests were alarming.

Today I got these:
ALT NORMAL
AST NORMAL
ALP NORMAL
HBeAG 0.47 NONREACTIVE (used to be reactive)
Anti-HCV 0.05 NONREACTIVE
Anti-HBc IgM 0.16 NONREACTIVE
Anti-HBe. 0.08 REACTIVE (used to be non reactive)
HBV VIRAL LOAD -HBV DNA NOT DETECTED (used to be in millions)
I am improved right?

All the best,
LiverLover

Dear @liverlover,

Welcome to the community and thanks for your kind words. I’m not sure what specifically you would like to know about these results, but these are my impressions:

Brother1: This is consistent with the immune control phase, with moderate/low viral loads.
Brother2: Possibly in the process of HBsAg seroconversion/clearance of the infection.
You: successful suppression of the virus and normalisation of liver function tests. This would suggest good improvements compared to your previous results.

Hope this helps,
Thomas

2 Likes

Hello there Thomas.
Thank you for this feedback.
Yes you answered what I need in summary. I only need a quick interpretation for now. As im the only one taking medications in the family, I want to assure my brothers things are alright before meeting their doctors…

Thank you so much and all the best to you. May more people find this site and become more open to discuss HepB.
:heart:

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Hi liverlover
I must congratulate you on the courage you and your siblings are fighting the infection. This explains why all of you are doing wonders.

Kinoti

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Great. It would be worthwhile also getting a fibroscan to determine your liver health. The ALTs will only provide information on active liver damage occurring now, but will not pick up if liver damage had occurred in the past and current fibrosis levels.

Cheers,
Thomas

Hi.

Thank you creating this site. I recently found out that I have Hepatitis B. Here are my test results:

  1. HBsAg - 2.11 (Postitive)

  2. Anti HBC -IgM - 0.75 ( Negative)

  3. HBeAg - 0.62 (Negative)

  4. HBV DNA Quantitative - Not detected

I am currently not on any medication.

Is this low level chronic HepB?
What are the chances I pass this onto others?

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Welcome to our community VJim!

Following your acute HBV infection, you have developed a very good control of your infection (HBV DNA not detected) with some residual production of HBsAg (which is almost certainly from non-infectious subviral particles). The chance of you passing your infection onto others is very very low, especially with causal contact. However, I would still advise the use of condoms or dental dams in the case of more intimate contact.

Its always useful to also give us your liver function test results (particularly ALT) to help us advise you properly. Also with your HBsAg test, is this a quantitative result (IU/mL) or a qualitative result (S/Co)?

Best regards,

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Hi @availlant,

Thank you for your response.

My ALT is normal (within the range, exactly at the midpoint). All the other parameters on the Liver Function Test are normal as well.

The HBsAg test was a qualitative result (S/co).

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VJim, with these additional test results and assuming you are not currently on any antiviral therapy, your HBV infection status meets the criteria for partial cure (partial immune control) which indicates a very good long term prognosis for your liver (low risk of liver disease or HCC). Transmission risk is still there for intimate contact however.

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Thank you, @availlant !

What can I do to reduce transmission risk during intimate contact? Would starting an anti-viral treatment be beneficial? I ask because I want to start a family.

FYI, I am a Male, 30 years old.