Need help to understand my test

What do my lab results mean?
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Continuing the discussion from IMPORTANT: Best practice for posting lab results:

Hello everyone greetings of the day
I need little help I got to knw last 2 months before that I have hepatitis b i went for job medical test I was got shok that I have Bt I need help for you guys to tell me I have acute or chronic infection here’s the my lab results pls help me to get over this situation Bz I lost my job bz of this
The all lab test are between April 14 to 26 n now I am takeing TDF tablet everyday pls help me to understand I have acute or chronic Hepatits b

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Hi @datta_chavan,
Welcome to the community and thanks for your question. It is difficult to tell from the test results you have shared. There is not a lot to glean from to say whether you have an acute or chronic infection. Two tests that might be helpful are Anti-HBc IgM if positive then you have an acute infection. The other test is Anti-HBc IgG positive indicates a chronic infection.
Thanks, Bansah1

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Hi @ datta_chavan
Based on your HBV profiles and liver function tests that you provided, we can’t differentiate between acute and chronic HBV infection due to overlapping of the laboratory findings.
Like @ Bansah , anti HBc IgM that occurs during acute infection may help in diagnosis. In cases of acute hepatitis B, patients may have history of blood or body fluids exposure about one to two months before symptoms occur, additionally, patients may have clinical symptoms and signs of hepatitis like anorexia , nausea, vomiting and jaundice with elevation of AST/ ALT over 5-10 times of upper normal limit. You can follow up HBsAg for 6 months, if HBsAg is negative, it means that your immune system can clear the virus and control it and you are recovered from acute HBV infection.If HBsAg remain positive , it is considered chronic hepatitis B infection with phase 1 (Immune tolerance phase)
I hope this may help you .
chul_chan
Chulapong Chanta MD. Pediatrics.

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Your viral load is pretty high and if it stays high your AST/ALT would have gone high eventually indicating your liver is irritated and damaging your liver. Best to take the antiviral your doctor prescribed to help your body stop replicating the virus. I think at this point it’s more important to control the virus replicating and worry about if its chronic or acute. With or without the IGG or IGM test you will know for yourself it is chronic or acute after 6 months or so and retake the HBsAg, HBsAB,HBcAB,HBeAb, HBeAg, HBA DNA viral load test to see where you are .
Sorry to hear that you lost your job over this. Yeah, it’s devastating to learn that you got HepB. It’s truly a silent disease.

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Hi, @TomPsu Nice to meet you.
I knew that I was affected by Hepb when I was 16 years old. Its mom-child transform.
I’m 31 years old now. I’ve been using entecavir for 7 years as i was suggested to take it by a doctor. I did a blood test 3 weeks ago, here is the result. Can you please review the summary? Any insights from other folks here would be so appreciated! Many thanks!

Test Results Overview:
Alpha-Fetoprotein (AFP):

Result: 2.32 ng/mL
Reference Range: 0.0-7 ng/mL
Interpretation: Normal

Hepatitis B Virus Surface Antigen (HBsAg):

Result: >250.0 IU/mL
Reference Range: 0-0.05 IU/mL
Interpretation: Positive

Hepatitis B Virus Surface Antibody (anti-HBs):

Result: <2.0 mIU/mL
Reference Range: 0-9.99 mIU/mL
Interpretation: Negative

Hepatitis B Virus Core Antibody (anti-HBc):

Result: 28.37 S/CO
Reference Range: 0-0.99 S/CO
Interpretation: Positive

Hepatitis B Virus DNA Quantification (PCR Test):

Result: Target Not Detected
Detection Limit: 1.0E+01 IU/mL
Interpretation: No active viral replication detected

Liver Enzymes and Other Markers:
Alanine Aminotransferase (ALT):

Result: 22.4 U/L
Reference Range: <50 U/L
Interpretation: Normal

Aspartate Aminotransferase (AST):

Result: 21.0 U/L
Reference Range: <40 U/L
Interpretation: Normal

Alkaline Phosphatase (ALP):

Result: 65 U/L
Reference Range: 40-129 U/L
Interpretation: Normal

γ-Glutamyl Transferase (GGT):

Result: 23 U/L
Reference Range: <60 U/L
Interpretation: Normal

Total Protein:

Result: 76.7 g/L
Reference Range: 63-82 g/L
Interpretation: Normal

Albumin:

Result: 52.3 g/L
Reference Range: 35-50 g/L
Interpretation: Slightly Elevated

Total Bilirubin:

Result: 5.2 µmol/L
Reference Range: 3-22 µmol/L
Interpretation: Normal

Direct Bilirubin:

Result: 2.1 µmol/L
Reference Range: 0-16 µmol/L
Interpretation: Normal

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Hi John29. Sorry to hear that you got it at birth. It can be tough. I am not a MD so best to consult with a doctor or someone from this forum with a medical background to give you best advice than I can provide.

But based on what I know, your DNA vital load is very very low and undetectable but still active chronic HepB since your HBsAg is positive and your HBsAb is still negative (your body doesn’t have or have not enough to fight the HepB virus.). Note that your viral load can fluctuate. The antiviral is doing its job by stopping the HepB replication. Your ALT/AST looks good so your liver is not irritated. Perhaps over time with luck you will achieve serocoversion naturally or by functional cure drug when it is available.

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Thank you for all your help
I just Did test last week can you pls tell me what my test is looking like it’s viral load is getting low or I am clearing the virus sorry for my week English

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Hi @datta_chavan,
Your anti-HBc IgM being negative means your infection is not acute. Your HBV DNA and viral load were both detected and measured as shown by the test results. This makes you infection lean highly towards a chronic infection given that your anti-HBc IgM is negative. Thanks, Bansah1

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Hi @John29,

Your tests are all consistent with chronic HBV infection and that the drugs are working as expected, limiting both viral replication and liver damage. Continued treatment and monitoring are the general recommendations, and there doesn’t seem to be anything to worry about from these results.

Hi @datta_chavan,

From these results, it is unclear whether it is an acute infection or chronic. Viral load is still relatively high. The only way to confirm chronic vs. acute infection is to check 6 months after the initial diagnosis and see if HBsAg is still present.

Hope this helps,
Thomas

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Hi, @ThomasTu Thank you so much for your reply.

Yes, I’m keeping to take the entecavir.
You guys here are doing very awesome job for people. Thanks.

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