These results describe a case of inactive HBV (also referred to as partial cure). This is diagnosed by HBV DNA < 2000 IU/mL with normal ALT in the absence of therapy. These patients are usually also HBeAg negative.
Liver function tests (fibroscan, BIL, ALB, AFP and PLAT) are all normal (consistent with partial cure).
Although HBV infection with liver disease can be associated with elevated ferritin levels, no liver disease is apparent a the current time. Elevated ferritin could be residual effect following recent establishment of partial cure and resolution of liver disease but this is unlikely as serum ferritin has a half life of 12 hours in the blood. It is more likely unrelated to HBV infection. This should be discussed with the physician in charge.
Functional cure means in the absence of antiviral therapy, you have no detectable evidence of viral activity in your liver (HBV and HBsAg are not detectable) and your liver function (ALT) is normal. In this case, latent viral genetic material still remains in your liver. In this case, immune function has recovered so that people with functional cure never reactivate their infection and they have a low risk of developing liver cancer. HBV reactivation can happen even from functional cure but this is very rare and only happens when individuals become severely immunosuppressed (i.e. when taking immunosuppressive medication).
Partial cure also means immune control but only partial (hence the term “partial cure”). Here your immune system controls most but not all of the infection in your liver. So HBV DNA is very low and liver function is normal in the absence of therapy. In these patients HBsAg remains detectable; most likely because of a special form of viral genetic material called integrated HBV DNA. This form cannot make virus but can still produce HBsAg. Because of this, reactivation from this “inactive” state is more likely but still not so common. Patients with partial cure do not frequently transition to functional cure but it can happen. The risk of liver cancer with partial cure is also lower but not as good as with functional cure.
I am a little bit concerned about my HBSAG quantitative increased by 220… a yr ago, it was 1442 and this month results showed 1661. … I was expecting this number to go down slightly since I am taking NUC almost a yr!! What’s your thoughts
Thank you and all of you happy new yr!!
Nas
This is the normal wobble in HBsAg levels seen in patients on NUC therapy. Most patients do not experience any additional HBsAg decline from the small initial declines typically observed in the first year of therapy. Of course it would be nice to see continued decline but the very small changes you have on hand (1442 vs 1661) do not indicate anything troubling - its just the limitation of NUC therapy.
Hoping some one can let me what they think about these results. I donated blood in august 2023 that had a false poisitive result on HBsag. then I donated in October with no positive results. Then in December I got another false positive and I am concerned I have hepatitis or alcoholic hepatitis? The 2 positive results were for
HbsAg by EIA positive
HDsAg by confirmatory negative
Anti-HBc by EIA (IgG plus IgM negative
HBV NAT for hepatitis B negative.
Welcome to the forum and thanks for sharing your story.
I’m sorry to hear about your experiences. It’s not clear what is causing the false positives, but it is not likely at all that having another sort of hepatitis (e.g. alcoholic hepatitis) would make you test positive for HBsAg. I have heard anecdotally that having a vaccination series can make you test positive for HBsAg (because this is what the HBV vaccine is composed of), but does not at all denote that you are infected or have any liver issues.
To know if you have a liver disease of some sort, it would be useful to know your liver function test results.
Liver blood tests all where green with only Globulin being 2.0 being the only outlier. I did also take a hep C test that came out negative and just took a Hep B surface ab immunity which was low- les than 5mIU/mL. interesting thing is in 2019-2020 i took the 3 part Hep A/B vaccination at walmart… guess that did not work.
People with low HBsAg (even after a vaccine course) are usually recommended to get boosters to get their anti-HBs to protective levels. Perhaps this is something that you can do and have the peace of mind that you would be protected from HBV in the future.
This does not provide much data on your Hep B status, but it does show that you have have high cholesterol and your amylase levels (a marker of pancreatic injury) are quite elevated. This is generally not caused by Hepatitis B, so it is a bit outside the expertise of this forum. It is best that you get information from your doctor to determine what could be causing this elevation and what the next steps are.
These test results are consistent with someone with chronic HBV infection in the HBeAg-negative phase (which is generally linked with low levels of HBV in the blood).
Good every one my name is jay I just did a full blood test and I was diagnosed of hep b chronic I’m so scared right now I don’t know what to do I live in Ireland but the have giving an appointment to see a specialist on the 5th of march I’m scared right now and my family is back in Nigeria I’m scared of them as well because I feel I have also exposure my wife and son to this I planned a beautiful family but this now as taken away my joy I don’t know what do I glad I found this platform I need advice because I’m scared of my family losing them and even my self anytime I see my son picture I just want to end my life this my test result below can some one explain this to me I’m so tired
HBsAg(Architect) positive
Anti-HCV(Architect) negative
T.pallidum Total (Architect) negative
HCV Ag(Architect) negative
Anti-HBe(Architect) positive
HBeAg(Architect) negative
Anti-HBc lgM (Architect) negative
Anti-Hbc total positive
Anti-HDV total (liaison)negative
Please can some explain this to me my heart is so heavy I feel my life counting by the day
Welcome to the forum and thanks for sharing your story with us. I’m sorry to hear that it has been so hard on you, but rest assured that you are not alone and many people on this forum have been through the same situation.
As others have mentioned, there is no need to wear the guilt of this. Most people with Hep B have had it for their entire lives without knowing. The good thing is that you know about it and can do something proactive about it. I understand that this diagnosis is hard on you at the moment, but it does get better over time.
Regarding your lab results, these are consistent with a chronic hep B infection. HBeAg-negative and anti-HBe positive are indicators of low risk of transmission and generally line up with lower disease progression.
To be completely sure, you will need some follow-up tests including a liver function test (which will check your ALT levels, a marker of current liver inflammation); fibroscan (which is a painless abdominal test and measures any damage to your liver built up from the past); and HBV DNA test (a measure of how much virus is in your blood and will help determine if you need treatment as well as your risk of onward transmission).
