Hi @Thomas
I had my results repeated and they are as follows
Hepatitis B Surface antigen [HBsAg] Not Detected
Hepatitis B Surface antibody [HBsAb] < 10 IU/L
Hepatitis B Core antibody (Total) [HBcT] DETECTED
So the doctor suspects that l may have been exposed to hep B in my childhood and have been asked to do the viral load test. My question is since HBsAg is negative is it possible l may have chronic hep B?
Hello again I had a question about recent blood work I’ve had done. My globulin and protein were high. I’m wondering if this could be a sign of reactivation? But I’m also not sure if it could be a Crohn’s flare for the reasoning if that could cause the elevation? Rest of blood work is normal. I have a follow up with GI and a CT scan this week. I’m just curious if there’s any chance I should expect to see a reactivation in hep b?
Hi @Bae,
If you are HBsAg-negative, then you do not have a current HBV infection.
It’s not common that you are previously exposed and you are both HBsAg and anti-HBs negative. It might be worth repeating to see if the anti-HBc test was a false positive. In any case, you could consider getting a booster so that your antibody levels are at protective levels.
Hi @Michaelmike223, the only way to check for reactivation is testing of HBV markers. Increase globulin and protein levels are not indicators of reactivation.
Thomas
Hello, I recently diagnosed whir hep b functional cure, please I need to know the risks of debellop hcc or transmiting the viruz during pregnancy. Please help my
Dear @Tathy,
Congratulations on your functional cure. If you do not have any existing cirrhosis, the risk of HCC is minimal after HBsAg loss.
If you are HBV DNA undetectable, then your risk of passing it on to baby is negligible (i.e., there has been no documented case ever of this happening). Birth dose vaccination for Hep B may also give you peace of mind.
Hope this helps,
Thomas
@ThomasTu
Thank you so much for your answer, it gives me peace of mind, I really thank you for your labor, te time you take to answer our questions, i wish you and your team success in all your investigations.
Thanks for your kind words, @tathy! Good luck with everything and wish you all the best. Please keep us up to date with how you’re going.
Thomas
Hi everyone. I am trying to understand my lab results and make sense of my diagnosis and appreciate everyone who is contributing to this community.
Two weeks ago, I tested positive for hep B surface antigen. It was routine testing for work. In 2017 I had immunity (hep B surface antibody) and then in 2018 my immunity level read “equivocal” at that time.
I asked to get the Hep B vaccine again two weeks ago since the last time I was tested my immunity was equivocal. I got the vaccine and then 30-40 minutes later they collected my blood for the Hep B surface antigen.
I have a few questions if anyone knows the answer:
1- if I was just vaccinated for Hep B 30 minutes before they drew my blood for the Hep B surface antigen, is it possible that it altered the test?
2- I was told if you are ever immune for Hep B you are considered immune for life. Wouldn’t it be very unlikely that I am infected with Hep B?
Thank you in advance. This information has been causing me a lot of anxiety and I would love to hear what other people think of my situation
Hi @Wexersville,
Welcome to the community and thanks for your questions. First, I don’t think the vaccine is going to impact your HBsAg test. The vaccination would not even impact your antibodies, since that will develop over weeks after vaccination.
For, the second question your results being equivocal means it could neither be interpreted as positive or negative. Do you have the value for your HBsAb test? It is possible to have HBV because for work screenings they only do tests for HBsAb at least in the US. They do not screen for HBsAg. In my case because I did not have immunity I was vaccinated. But all that while I already have HBV but because a surface antigen test was not part of the work panel tests ordered I received the shots for my work. I did find out some years later when a surface antigen test was done that I had the virus all those years.
You are correct, for most people (90% or more) immunity lasts for life, but for a small group they will need a booster from time to time when their protection wanes down.
So it is possible that you had the virus already and was still vaccinated which in this case will not lead to immunity or production of antibodies. Or there may be some false positives or negative tests here. I empathize with you regarding having anxiety. Take it easy, one day at a time. You will untangle this mess of results. Bansah1
Thank you for your reply. I appreciate you sharing your experience. This is the first time I have ever been tested for Hep B surface antigen. I agree that usually the testing that is done is only for immunity not infection. I am a health care worker so I am, of course, worried that this could be related to a workplace exposure that I wasn’t aware of.
I have been doing some of my own research and have found a few sources that say that Hep B antigen should not be drawn within 4 weeks of vaccination. (Immunize .org) I have been trying to get a clear answer from a doctor about this and I have not been successful.
I saw a lot of really smart discussion on this page and thought I would try to see if anyone here has any information about this. I’m waiting to get an appointment with another doctor for more tests. I had been weeks since my reactive antigen test and I’m not closer to getting any answers.
You are welcome and thanks for reaching out. I know you don’t do antibody test right after vaccination because it will be too early for the body to develop or produce antibodies then. I am not sure why they think vaccine could affect the antigen test.
I hope other experts can chime in on this. Sorry you have to go through this web of confusing results. Keep us posted. Bansah1
Dear @Wexersville,
Welcome to the forum and thanks for the great question. It correct that false-positive HBsAg results can occur after vaccination, particularly when blood is taken soon after getting your vaccination (as happened in your case). Several cases have been described in the literature:
If indeed you were anti-HBs positive to protective levels in 2017 (>10mIU/mL), then it is more likely that this represents a false positive. It is worth following up these blood tests at least a couple of weeks after your booster vaccination with the whole panel of HBV markers (anti-HBs, HBsAg, and anti-HBc).
Hope this helps,
Thomas
Yes that helps a lot, thank you.
I have a doctors appointment next week and am going to ask for more labs to follow up. The hardest part has been that the doctor who ordered these tests at my work place delivered the Hep B diagnosis and has not helped me get any further testing. I’ve been asking questions and been told they can’t help me any further, which has been so frustrating. Thank you for sharing your knowledge with me. I have felt so alone in this processes so just being listened to here has made me feel much better.
I was able to get some follow up testing 13 days after I was vaccinated for hep B:
My Hep B surface antigen was reactive again.
Hep B surface antibody was positive >1000 for immunity.
Hep B core antibody was negative.
If the core antibody is negative, is that indicative that I do not have Hep B and the positive antigen is due to recent vaccination?
Thanks for your help
Hi @Wexersville,
Thanks for keeping us all up to date with your results.
While in many cases HBsAg does go away a couple of weeks after vaccination, there have been reports of HBsAg being detectable for up to 38 days after vaccination (Transient Hepatitis B Surface Antigenemia Following Immunization with Heplisav-B - PMC).
Given your high levels of anti-HBs and negative anti-HBc result, it would be pretty likely that this represents a false-positive result for your HBsAg. However, to be sure, you should repeat the test in a few weeks to check and consult with your physician.
Hope this helps,
Thomas
