Instance of false positive

What do my lab results mean?
1

*lab results attached in order. March 2013, April 2013, March 2024.

Hi everyone! I joined this group because back in the beginning of 2013 I had read about hepatitis B. I was paranoid about all sorts of germs & infections being a new healthcare worker at a hospital. I decided to test on my own at an independent lab. My results came back with surface antibodies just below immunity levels (8.2 mIU/ml), positive total core and negative antigen. 12 days later I follows up with my primary doctor and she ordered the same labs plus Core Igm. Came back the same with my surface antibodies being 4.5 mIU/ml. Positive total core, negative antigen and negative core Igm.

Given these results I was told I most likely had an acute infection that I cleared over 6 months prior. I was not offered and did not receive another vaccine. I completed my vaccine series in 2002 as a teen.

I was so stressed out at the time. I thought I had always been so careful. I grew up with my dad having hep c so being careful with blood was pounded in my head from a young age. I had a few sexual partners since I had last donated blood (2008, no flags) so I let them know I may have been infected with them at some point. No one shared their results with me. But given their professions/age I’m sure all had been vaccinated. My boyfriend at the time (now husband) tested negative. I’ve felt bad I haven’t been able donate blood or plasma knowing I had a positive total core test.

Fast forward to this last month I started a new healthcare job after being a stay at home mom awhile. One question was do you want a hep b vaccine? I said no. Then I started looking online and seeing where total core does not provide immunity like my doc said back then. And that I should base immunity off my surface antibodies. Curiosity got me and I went in for a test yesterday. This time it came back negative antibodies (undectable), NEG total core & NEG core Igm. Didn’t do antigen.

So what could be the deal here? Everything I’ve read says total core stays for life and the instance of a false positive is very little. All 3 of these tests were ran at different labs. The first 2 were only 12 days apart. But that was 11 years ago. Has technology gotten better and my positive total core was just a fluke back then? I would love to donate plasma & blood again. I guess I’m just looking for some reassurance and instances of this happening to others.

I’m happy to have a negative everything. I’m definitely going to get another hep b vaccine now. But all my late night reading about hep b had me convinced false positives don’t happen with total core. I’m going to share the lab results of each place. I blacked out sensitive info.

IMG_2670
IMG_26701170×607 137 KB

IMG_2673
IMG_26731170×2013 323 KB

IMG_2675
IMG_26751170×2017 341 KB

IMG_2676
IMG_26761170×2013 267 KB

IMG_2672
IMG_26721170×795 142 KB

2

Hi @johnna88,

Thanks for sharing your story and for the great questions. And it’s great that you’re going to get the vaccine to get your protective antibodies up.

Regarding the anti-HBc tests, yes the current thinking is that everyone who has been previously exposed maintains anti-HBc. But it’s not clear why this is: likely it’s due to underlying HBV infected cells still present in the liver at very low levels and all the virus produced by them is being neutralised by anti-HBs antibodies.

Indeed this could be a rare case of false positivity. Alternatively I guess, theoretically, it may be possible to clear all HBV infected cells and therefore any anti-HBc antibodies wane completely over time, but this is really not understood. Indeed, as you mention anti-HBc is not protective, you are only protected by anti-HBs antibodies.

Hope this helps,
Thomas

3

Thanks Thomas! My primary doctor put in a referral to my GI doc who is also a heptologist (I’ve seen for different things). I requested this so I can see what his thoughts on this may be, and if it would be safe for me to donate blood/blood products. I will update this thread after I see him. Hopefully in next couple months :slight_smile:

1 Like
4

Great! I’m sure many here (including myself) would love to hear the update when it comes.

All the best,
Thomas

5

IMG_5926
IMG_59261170×2532 197 KB

So here’s the update! Went to my GI doc. He said those were likely false positives of total core in the past. So he ordered this to make me feel better. I read that false positives should be confirmed by testing 8 weeks apart. I unfortunately never got that guidance so my first 2 false positives were only 2 weeks apart and just never followed up.

1 Like
6

Dear @johnna88,

Fantastic news and I’m sure it’s great to have that peace of mind!

Thomas