Hi everyone, I’m so glad that I found you accidentally and I hope we can help and support each other.
My story is the following:
I’m Zhivko, 37 yo, raised and born in Greece but the last 7 years I live and work in the UK. Three months ago I had an unprotected sex with a girl and few weeks after the act I started feeling an unusual fatigue which made me worry. I decided to do a STD blood test as my biggest fear was that I might have caught Hiv. On 16th of November I got my results and I was told that I am hepatitis B positive. The doctor took another blood sample to examine further my infection, and a week later I they sent me an email with my new results. The annoying thing is that they didn’t give me much explanation on my results, they just said that I should see an hepatologist from now on; when I asked them if my infection is acute or chronic they said “we can’t comment on the chronicity of the infection due to lack of previous blood samples.” I will attach the second blood results that I got and maybe you can help me understand in what phase is my Hep B, is it bad, good, acute, chronic? I got so little information by the sex health clinic where I did the blood test, that makes me more confused.
A week after I was diagnosed with Hep B, started feeling a dull pain in the right abdomen which has become more intense the last days. It can be related to the Hep B or maybe it’s just psychosomatic syomtoms, I don’t know. Due to the pain I mentioned before I visited my GP today and she was nearly offensive when she said that I should just take an ibuprofen and not worry about it. I told her that I think that I MUST be referred to a hepatologist to check how is my liver and to do further tests since a) I am diagnosed with Hep B and b) I feel that constant pain in the right abdomen area. She said that she’ll send a letter to the local hospital and to wait for response.
As for me, I have a relatively healthy lifestyle, I avoid sugar and junk food, I don’t drink alcohol at all, but I do smoke-I guess I will quit in the near future. Mentally, I panicked at first, it was obviously a huge shock for me since I am very careful with my health. I had unprotected sex only with two partners in my whole life, the first time some 16 years ago, and second time few months ago. Between these years I always used condoms except few times during oral (I dont know if Hep B can be transmitted through oral sex). I hope I get an appointment with an hepatologist soon so all my questions be answered. Because living in oblivion is even worst than the desease itself I think.
Thank you for your patience whoever read my post and, please, if you can help me interpret my lab results I will be very grateful.
Thank you again and I hope one day Hep B is just a minor infection that can be 100 % cured.
Hi @Javer,
Welcome to the community and feel free to read around. For your results: HBeAg positive means you are still infectious and have an active replication going on in your liver cells. This also means you have high levels of virus in your blood.
HBsAg positive means you are infected or have hepatitis B. HBcAb positive indicates that you either have a current infection going on or you have had a past exposure. HBeAb negative, this is made in response to HBeAg when someone is exposed. Your test means you have lost this and does not mean you have any protection.
HBV DNA detected: meaning you still have the virus at this time. If you clear it you will lose this and it won’t be detected.
Your viral load of 412 is high but not very high. Is this the highest you have tested or the lowest. Because if it is getting lower that could mean your body is fighting and clearing the virus. Your ALT of 28 is also normal.
From all this results, my guess is that there is a possibility you still have an acute infection. 0-6 months is acute, when is longer than 6 months with no clearance then it becomes chronic. Since you mentioned its been 3 months makes me believe this is an acute infection and you have a 90% of clearing it.
I read from others that getting the virus as an adult can make you very sick at the beginning. Someone recently shared that they got so sick that they were in the hospital for 5 days. Having an abdominal pain can be a sign of your body fighting the virus or something else going on. I hope you get to see a hepatologist soon to investigate further on your pain. I hope this is helpful and keep us posted. Best, Bansah1.
Thank you very much for your response, I really appreciate it. Just a little correction, HBeAb is positive (not negative as you commented in your post) and HBeAg is negative, I don’t know if that change anything though, just wanted to mention it. I am still waiting for a letter appointment, although the pain in the abdomen area has become more intense and I could feel I slight burning sensation at some point today . I might go to the Emergency tomorrow and see if they can get me faster through the needed examination. I’ll let you updated.
Also, to add something that I found today on Internet.
It says that if the HBeAg becomes undetectable and the HBeAB is positive, it does mean recovery from an acute infection. Does it mean that my infection is actually acute and I’m recovering. Because my HBeAg is negative and the HBeAB positive in my results and I don’t know if I understood well.
Sorry I got the positive and negative messed up. HBeAg negative means you have low virus in your blood therefore you will be considered to be less infectious.
HBeAb positive, means you have gained antibody or protection. Indicating that you are on the way to clearing it. Yes, that is what your results indicate. That you had an acute infection and you are on your way to clearing it. I encourage you to continue your monitoring until you are 100% cleared. Hepatitis B virus is a complex one and can change without warning.
It’s a good idea to visit the emergency room if you are still having intense abdominal pains. I hope this is helpful. Bansah1
I am in the same boat. After waiting a week for my results, my doctor just called and told me I have chronic Hep B. I am in complete shock. Had she not ordered a complete STD panel, I never would’ve known. I have an appointment with a hepatology specialist in a few weeks. I’m beyond distressed and trying to find resources in the meantime.
I’m (maybe naively) hoping it’s an acute infection or even a false positive. I’m in complete disbelief since I was vaccinated as a child.
Here are my results if anyone can shed some light before I can get in to see a hepatologist.
That’s quite encouraging, but I won’t keep my hopes up until I know for sure that I’ve cleared it. It makes sense though because I had an unrpotected sex only once few months ago, I never ever felt discomfort or fatique until now. Also to mention that from the usual symptoms of hep b I had only the tiredness, no jaundice, no vomiting, nothing. Cross fingers that everything will be fine.
Sorry to hear about your situation, I can feel 100% what you’re going through, the shock too big to comprehend. A very good advice would be to stay away from Internet because too much information only can make you panic more, but from my experience I know that it’s hard to resist. When I was first diagnosed few weeks ago, I searched a lot on Internet about hepatitis B and I got dishearted, I was ready to make my will and say goodbye to my close people, lol. In addition, the fact that the doctors said very little to me regarding my results and what they actually mean made it worst, basically they said just “you have a hepatitis B, you go and see a hepatologist, period.” The reason I am here though is, because it looks that people here actually know and understand a lot about hep B and they are very supportive.
I wish you wholeheartedly the best and I hope we all come stronger out from this mess.
I have been going through the exact same thing as you @Javer. I received oral sex from someone at the start of September. 2 months later I met this person again and received oral sex again, only this time I noticed a box of medication (tenofovir) which is used for the treatment of chronic hepatitis b in their room. They tried telling me it was for PREP but a few days later at the start of November I then started to develop symptoms like nausea, pale stools, rash and abdominal discomfort. The nausea and pale stools are now gone but the abdominal discomfort is persisting and is now accompanied with back pain sometimes and weird smelling urine. This is making me worry that I am more likely going to progress to chronic.
@Javer how long has your abdominal discomfort been going on for, has it been more than a month?
Also, due to your background I think things look good for you. Studies have shown that Greeks show the lowest tendency to progress to chronic. Perhaps this is due to the Mediterranean diet.
@availlant , do you think the fact that my abdominal discomfort is persisting for longer than a month is an indicator that I am progressing to chronic infection. Thank you.
@ThomasTu also, if you could provide some insight into this it would be much appreciated. Thank you.
Welcome to the forum! We are very sorry to hear about your recent diagnosis but we are here to help you with information and encouragement.
It is important that you communicate your test results accurately so that we can know how best to advise you.
I assume by “Hep B Antigen” you mean HBeAg or HBV e-antigen.
I assume by “Hep B Antibody” you mean HBeAb or HBV e-antigen antibodies.
Based on the other results, it appears as if you have been infected with HBV and that is has not resolved (your HBcAg IgM is no longer detectable yet you are HBcAg total Ig positive and have HBsAg and no HBsAb). Additionally, your infection has likely been around for some time since you have cleared HBeAg and developed HBeAb. This event usually takes several years to appear in the absence of therapy. Important tests to follow as soon as possible will be your viral load (HBV DNA) as well as liver function tests (including ALT). These should be performed by your hepatologist (as well as confirmatory tests for the other results) at your first visit.
The presence of HBcAb Ig and lack of detectable HBsAb is indicative either of not being vaccinated and infected, being infected prior to vaccination or losing all immunological response from your vaccination followed by infection. The last one of the these possibilities is least likely.
This must be extremely discouraging for you. However, there are excellent treatment options out there to effectively suppress viral replication and prevent liver disease. There are many people on this forum (and worldwide) who live healthy productive lives with chronic HBV infection.
Thanks for the support. I have an appointment with a hepatologist next week to determine next steps. It’s been a whirlwind of emotions, but I am happy I found this group and have an outlet.
@availlant Good morning, I hope you are well. Can you please have a look at my lab results, if it’s convenient and tell me your opinion on them? Thank you… @Johnjoe123 Hi mate, I am sorry to hear about your experience, it seems similar to mine indeed with the difference that the girl that I had sex with claimed that she didn’t know that she has Hep B, which of course can be true.
Now, regarding my symptoms, as I’ve mentioned earlier on my post, a couple of weeks after I was exposed, I started feeling a very unusual fatique, all wanted to do is to lay in bed and rest, didn’t have much energy for anything. In that period a couple of times I asl9 had very greenish stools and I never had them again since then. As for the abdomen pain, I started feeling it only three weeks ago, when I was diagnosed, and since then it hadn’t dissappeared. The first week after I was diagnosed, the pain in my right upper abdomen was just dull, I could barely feel it. Later, it became more intense and spread to the lower abdomen as well and sometimes at my back as well, especially when I walk and lift things. Last Tuesday I went to my GP and she just told me to take an ibuprofen and wait to receive a letter from NHS for appointment with an hepatologist. To mention, I didn’t feel any nausea, didn’t have fever and neither vomited. The only symptoms I have is fatigue and the abdominal pain.
Update on my visit to emergency today. A doctor-not gastroenterologist - saw me, she touched the abdomen areas where I feel the pain and said that the liver doesn’t seem to be inflamed or abnormal anyway. She checked my last test results and said that my ALT is quite low which means that the liver is in good condition. Also, said that since I don’t have jaundice, diarrhea and I don’t vomit, my case is not considered urgent, therefore I should wait on the waiting list to see a gastroenterologist and be scanned. Alternatively, she told me to go to my GP again on Monday, to do another blood test and if my viral load is higher, then I might be seen earlier by hepatologist or gastroenterologist. Lastly, she gave me Buscopan for the pain and sent me home.
I won’t lie that I’m quite frustrated, I feel like I’m not taken seriously by the doctors. Either I’m right or I’m overreacting.
Based on the information you provided in your current posts, it is hard to tell when you actually became infected with HBV. It could have been recently from unprotected sex (have you informed your partner?) and therefore acute and potentially on its way to resolution or you could have become infected prior to this event.
There is a blood test called hepatitis B core antigen IgM which helps diagnose if your infection is acute or not. It is not clear if the Hepatitis core antibody test you reported is IgM or total (IgM + IgG). IgM and IgG are the two forms of antibodies your body makes in its initial response to infection. IgM only appears early in infection so its absence is correlated with chronic infection.
Your abdominal pain and green stools (accompanied by your normal liver function test results and your report of the ER physicans’ evaluation) suggest that you have a gastrointestinal issue which may be separate from your HBV infection. Additionally your viral load is quite low and acute HBV infection with liver complications is typically accompanied by very high viral loads. As your ER physician suggested, seeing a gastroenterologist to have some imaging studies performed is a good idea.
Please keep that appointment with the hepatologist when you get it, it will be important to follow-up on how your infection is doing.
Your level of stress must be high and this is very understandable. It also might be contributing to your abdominal symptoms so please do what you can to try to relax a bit. You will find out how to proceed and in the meantime, your liver is clearly ok from the information you provided (this makes sense given your very low viral load). Please be sure to discuss all of these issues with your hepatologist.
@availlant Thank you very much for your evaluation, it makes things much more clear and understandable. I too tend to believe that my infection is chronic although I’m not very happy with that thought. Still, I do have hopes that even with a chronic Hep B I will be able to live a relatively normal live. As for my current pain, I really hope that it has nothing to do with my infection and it is something minor. I’ll keep you updated for sure, so other people who relate with my experience be helped in the future.
Dear @javer
if you read my posts you’ll see I’m also pretty new with this pathology. Thanks god for this forum!
it has helped me immensely to navigate the past few months and not going crazy, and understanding this illness.
I was diagnosed on June 29th 2023 with acute HEP B I have been waiting month after month for six months to clear the virus and Unfortunately so far I haven’t been able to.
My doctor/Hepatologist thinks ( given the recent blood tests) I’ve gone chronic. and I have been on antivirals ( TDF) since October 27th 2023 becauseI had very high viral load and AST ALT. ( my viral load was in the millions but has gone down to 55.000 since the antivirals, its still high, but hopefully will go down further) .
I think your situation its still unclear and you might still clear the virus.
the reason I’m answering your post is because I wanted to tell you that I had very strong symptoms (similars to yours) back in June/July.
I was advised to not take Ibuprofen or buscopan etc ( of course if you can manage and you are not in terrible pain. Drink a lot of water and eat vegetables and fruits) as it may injure the liver that is already under stress,although you have quite normal AST/ASL .
good luck Gregory
It is important to remember that Gregory’s abdominal symptoms (which were accompanied by classic acute HBV infection with high viral load and liver inflammation) likely do not have the same cause as Javer’s symptoms, where liver inflammation (and liver disease) is not evident and HBV viral replication is very low. Please be cautious in attempting to correlate the resolution or causes of these symptoms between these two cases.
In the case of liver disease, the use of ibuprofen, aspirin or naproxen are not advised as they place an additional burden on liver metabolism. Acetominophen (aka paracetamol) can be used for pain relief in patients with liver disease if daily intake is kept to 2000mg or less. There is no published contraindication regarding the use of buscopan with HBV or with liver disease in general.
In Javer’s case, there is no evidence of liver disease and he has been prescribed buscopan medication following evaluation of his liver. Buscopan is a completely different class of drugs from those above and acts as an anti spasmodic designed to relieve cramping in the smooth muscle in many parts of the gastrointestinal and urinary tract.
@Gregory, thank you for your post, I appreciate the fact that you shared your experience too. Even if we develop chronic Hep B-at least from my perspective I have accepted it already - we should not lose hope, it’s really not the end of the world. With a healthy diet and cautious lifestyle we have high chances to stay strong for really long time. @availlant The buscopan didn’t do anything by the way, I took one after dinner and couple of hours later the dull pain is still there. Can’t wait to resolve this problem with the abdominal pain soon, because I want to go back to the gym and to carry on with my life. Unfortunately, the last two months I have neglected myself and the pain makes it even harder to go back to my routine.
@availlant@ThomasTu
Could you give me some insight and tell me whether abdominal symptoms persisting for over a month and a half indicate progression to chronic disease?
Please see my previous post on this thread. Thanks.
Tenofovir (in different prodrug versions) is a component in the two approved medications for PREP (pre-exposure prophylaxis) treatment for persons as risk of contracting HIV infection. Tenofovir may have been written on the side of the box in addition to other medication (such as emtricitabine) which is also included in these drug products. So it is not clear if your partner has any infection or not (HIV or HBV). They could jsut be taking precautions.
It is not clear from your post above in this thread if you have been infected at all (or have a previous diagnosis of HBV infection).
If you feel you have contracted a viral infection, you should visit you nearest infectious disease clinic and get tested. This is an important part of understanding the basis for your gastrointestinal symptoms.
Just a little correction, HBeAb is positive (not negative as you commented in your post) and HBeAg is negative, I don’t know if that change anything though, just wanted to mention it. 
I am still waiting for a letter appointment, although the pain in the abdomen area has become more intense and I could feel I slight burning sensation at some point today . I might go to the Emergency tomorrow and see if they can get me faster through the needed examination. I’ll let you updated. 