EXPLAINER: Lab results and their interpretation

Oh, okay. Thanks for the correction. That is bad that the other doctor never mentioned this to you. How are you feeling? Angry, disappointed, shocked, lost of words, feeling alone and guilty, etc. These are all normal reactions. I hope you’re will be able to follow up with the doctor and understand where things stand for you. Keep us posted. Bansah1

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Can you explain that a bit more? I’ve always been confused by those statistics. The say that if someone doesn’t have the vaccine and are an adult, after exposure only about 5% will go on to develop chronic HBV. Isn’t that the same stats as the vaccine? Or is it that the 5% that would normally develop chronic HBV, that only 5% of them will develop it if they are vaccinated?

I also struggle with the idea that HBV doesn’t spread casually, yet it spreads within households easily enough it seems. Isn’t that contradictory? Thx.

Hi @Stargazer6138,
Welcome to the community. I am not sure I understand your question especially about the vaccine. The majority of people who get the vaccine develop immunity, I am not sure where you are getting the 5% from. There are a few instances where someone will get vaccinated and not develop immunity, such as if they have HIV, already infected with HBV, immune suppressed due to cancer or medications that suppress the immune system. With the infection from acute to chronic in adulthood, about 90% do not develop chronic infection. But there are about 5-10% of people who will develop chronic infection for some other reasons. The opposite is true for children where 5-10% don’t develop chronic infection but 90% do.

HBV is not known to spread casually. I have lived with a roommate for 8 years, we share the kitchen, knives, utensils, etc. but he does not have HBV. The spread in households is commonly through birth and other means rather than casually. I have 4 other siblings who are infected from my family and we all got it through birth. This point is not contradictory, because it does not spread casually. I hope this helps clarify things for you. Best, Bansah1

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Thanks for the reply.

" HB vaccine is 95% to 100% effective pre-exposure"

When you look at vaccine stats, it always says 95 - 100%. So the 5% comes from there.

Is your roommate vaccinated? Then I can see it not spreading casually. I’m considering the scenario where the roommate isn’t vaccinated though. Because when you read research papers, it seems to spread within households eventually. Where I am from, living with someone with Hep B is considered “high risk” which is why I’m confused.

Thanks!

Sure, I mentioned some instances where some people might not develop immunity, but the majority of people do. Plus when it comes to vaccine, I doubt we have any that is 100%. A range of 95-100% is better.

Living with someone with hepatitis B is not risky if you understand how the virus spreads and protect yourself. I don’t do anything that could expose others. HBV patients are smart and do everything to protect others. If you are not vaccinated, please do so. Some communities out of lack of knowledge about HBV and how it’s spread, creates situations that are not backed by any science. The scientific evidence shows HBV does not spread casually like a common cold or flu or even a cough. One has to come into contact with an infected blood. And I don’t think people walk around daily in our households with blood on their bodies, or do they?

The chances of someone vaccinated getting HBV is almost 0. The reason we encourage people to get vaccinated. That is the best prevention method.

If the infected roommate doesn’t leave blood anywhere or is not a sexual partner, the unvaccinated individual has a less chance of getting infected. There has to be a blood exchange or contact. Could someone be careless, sure off course but that is not the norm. My roommate got vaccinated later on when I found out about my status. But we lived many years without me being aware I had it. I have lived with other roommates in the past and I wasn’t aware about my status at those times either. If it spreads casually all these people I have lived with should be infected, but none is because there was no blood contact and they were not my sexual partners either. I hope this provides more context. Please get vaccinated if you have not done so already, the 5% should not be the reason why you should not get vaccinated.
Best, Bansah1.

Thanks. I actually was vaccinated in 2004, but I’m confused because I think I just tested positive. I say “I think” because I live in a place where positive STI results aren’t visible, but negative ones are. So I can see all the things I’m negative for, but for Hepatitis B, only my surface antibodies are showing and not the other ones (like surface Antigen), which leads me to believe it was a positive test.

I donated blood from 2015-2017, and those were all accepted, so I don’t think it’s possible I had hep b then. My last sexual encounter was six years ago. I tested negative in December, and again in February, but in June this one looks like it’s positive, so I don’t understand. Did my vaccine fail, or is my immune system suppressed or something? Need to see my doctor I guess.

Thanks for your information though, very helpful.

What is the result for your surface antibody test? False positive results are possible too. I empathize with you.

In February (two tests) it varied from 0.5 to 1.5. On this last test in June (which I think is positive), it was around 3.1. Both are under the threshold of 10. Which is odd because I had two twin-rex vaccines and followed it by a recombinex or whatever it was called, back in 2004/2005.

Thank you.

So, your surface antigen test is not accurate. You do have antibiotics but not very high. You might want to consider a new test for surface antigen, viral load and if those are negative then get a boaster. It’s been 20 years since your last one and antibodies can wane over the years. Please get a new test done and a boaster could be the solution here if everything else remains negative. Thank you, Bright.

Sorry, what do you mean ‘not accurate’. These are three different tests, so they seem like they are accurate (valid tests). Are they low because I have hep B and they are being used to fight it maybe?

I am referring to the surface antigen result that you are guessing might have become positive. False positive and negative do happen. Plus you do have some antibodies not high enough. So it doesn’t add up. Maybe a new surface antigen test with confirmation is needed plus a viral load test, should help clarify this problem. I hope this makes sense now. Sorry about the confusion

Yah I’ll try and get new tests. Here are the ones I had though.

Dec 2023
HBsAg Qualitative (0.46, cutoff was 1.0 s/co so negative)
HBcAb IgG (0.1, cutoff was 1.0 s/co so negative)
HbsAb - not measured

February 2024
HBsAg Qualitative - Negative
HBcAb Qualitiative - Negative
HbsAb - 1.15 (< 10 is no immunity)

June 2024
HbsAg - can’t see
HbcAb - can’t see
HbsAb - 3.1m[iU]/ml (< 10 is no immunity)

So yah, at this point I don’t know. Seems like I have no immunity and may have tested positive for June (you only can’t see them if you’re positive for some weird reason here. someone should have called me, but nobody did).

I can empathize with you. It’s crazy having all these different results. Talk to your doctor and see what they think is going on here with this mixed results. Keep us posted. Bansah1

Hi @Stargazer6138,

You’re right that a lot of the terminology is confusing. As I see it, these are separate issues:

  1. If you get the vaccination course, 95% of people will raise anti-HBs antibodies that completely protect against hepatitis B.
  2. If you’re unvaccinated, exposure to Hep B when you are an adult will lead to chronic infection 5% of the time and acute infection 95% of the time. The vaccine will improve this rate dramatically.

In many cases, this is mother to child transmission during birth and not during usual casual contact.

I agree with @Bansah1 and it is best to get the newest results directly to see them and get some clarity.

Thomas