Hi @Bunny,
Thanks for your question and welcome to the forum. If your HBs antibodies are low, then it is worthwhile getting a booster with the HBV vaccine to get them up to protective levels. If you were exposed to HBV early in your life (as shown by the positive HBcAb test), then clear it, it may be possible the HBsAb levels wane over time.
Hope this helps.
Thomas
Dear @alicia_b9298,
My understanding is that this is a follow up HBsAg test to your initial HBsAg screen. These initial HBsAg screening tests can give false positives, and so the confirmation tests are to show whether it really is positive. A negative HBsAg result is consistent with all of your other results, so it is more probable that this is correct compared to your initial HBsAg screening result.
Do you think this interpretation is right @MarkDouglas?
Thomas
@ThomasTu @availlant
Respected all,
I have a question regarding the lab results as well. I have posted separated question regarding myself and my status.
This is concerning my mother who is HBV positive.
HBV DNA quantitative test : POSITIVE (2.11 x 10^2 IU/ml)
HBSAg POSITIVE (45,2784)
I would like to know the following:
Hi @Layla_mac,
Thanks for your questions:
Hope this helps,
Thomas
Hi @Layla_mac
A small clarification here:
HBsAg is not a marker for virus in the liver but for the levels of subviral particles circulating in the blood. These subviral particles are produced by a mechanism distinct from viral replication.
Subviral particles are not infectious (or defective virus) and outnumber virus by a factor of 10,000 - 100,000 to one in the blood and function to inhibit immune control of HBV infection.
The average HBsAg level in individuals with chronic HBV infection is ~10,000 IU/mL.
Your mothers case is somewhat unusual in that her viral load (HBV DNA) is very low but her HBsAg levels are high. However, it seems that she has achieved some measure of immune control since her viral replication (and risk for liver disease) is low. As Thomas indicated, this is likely the reason why her doctor did not place her on antiviral medication.
She should still continue to be monitored every 6 months.
Best regards,
Thank you for sharing your knowledge and expertise. I would like to hear your opinion on another question I had posted a while ago.
Regarding myself
I am HbsAg negative, antiHbc Positive, and antiHbs > 1000.00
My question was do I need a booster vaccine with this immunity level? And also, is this immunity level enough to protect me in case of having an unprotected intercourse with my partner (since at some point we will be thinking about expanding our family), he is inactive HBV carrier since birth, with low viral load ( <500)?
Thank you for sharing your expertise.
I am very grateful for answering my other question. I will check the link you have posted on my other question. Thank you 
Hi @Layla_mac,
You do not need additional vaccination.
Since your partner has inactive HBV, vaccination will not help improve his immunity. His circulating HBsAg will prevent an effective vaccination response.
If you are planning to start a family, you should plan for the eventual birth of your child as an infected mother. Even though you have functional cure and the risk for transmission to your child is very low, you should discuss birth vaccination with your doctor as soon as possible after your child is born (within hours if possible).
Good luck!
Thank you so much.
As I understood, even with my HbsAg non reactive, antiHbc positive (3.07), and antiHbs >1000.00 I can still transmit infection to my future baby ? Or this is only the case if my partner has CHBV ? What in case if my partner doesnt have HBV, and me gaining natural immunity, would it still be the case ?
Also, what about my immunity level being >1000.00, is it enough to protect me from getting infected with hep b in case of for example direct contact with infected blood, or unprotected sexual intercourse with infected partner ?
I am suspected to being infected with the virus sometime in the past, and the body naturally fought off the virus and created antibodies. I just wanna make sure I dont get infected again, I am very much scared and nervous going through this again.
Ps. Sorry if my grammar is bad, English is not my mother tongue, so myb sometimes I do not express myself right.
Yes, quite correct. Iāve now edited the original post to clarify this point a bit more.
As I understand it, with such a high antibody level, the risk of transmission of any virus to your newborn is miniscule. According to the WHO, there has been no observed transmission of mother to child with a viral load less than 200,000 IU/mL, even without anti-HBs antibodies.
Yes, this level is very high and is considered protective.
I am not aware of any studies showing re-infection is possible. The more likely scenario (but still very very rare) is reactivation of the infection if you are severely immunocompromised under special circumstances (e.g., organ transplant). This can easily be managed by antivirals and is so rare that this shouldnāt worry you in your everyday life.
Hope this helps,
Thomas
Thank you Thomas. You have been very helpful.
Dear colleagues,
This is my lab test of today.
AFP is said to be 6.9 down from 18. what could be the cause?
Doctor says all the pain in my abdomen and back pain and fatigue is due to Multiple Renal Gravels at both kidneys.
Total billiribin is always higher than normal 1.1 instead of 0.2 to 1. Is this related to Renal Gravel or Liver from your experience?
Hi @Wadani1,
Thanks for sharing this result. Your liver results looks fine to me. I think I have to agree with your doctor about the possibility of kidney stones. I have not had one personally, but I have spoken to others who have had it and they all share the same theme āpainfulā. I am sorry you are going through so much pain, I hope it can pass soon so you get some needed relief. Feel better soon. Bansah1
Hello everyone and experts, I am new here. Iād like to ask for help interpreting my lab result. I was diagnosed with HBV at the age of 21 and Iāve been taking Tenofovir 300mg for almost 4 years already.
I have several questions regarding to my lab result because the doctor didnāt seem to provide me with thorough details.
My viral load is decreasing (starting with 60,000,000 IU/ML and 7.78 for log) but my HBs Ag quantitative is still high, why is that? latest result was 1153 IU/ML (the first diagnosed was 2391 IU/ML)
My viral load was uncertain and a little fluctuate from time to time, I have the time that it was <10 IU/ML, but later it can be 30 or 14 (I checked it every 6 months) and what does Log mean?
I was wondering whether are there people who stop medication? And to what requirements that allow you to live without medication? Or do you have to take medicine for the rest of your life?
My Hbs Ag was negative and Anti Hbs was Negative what does it mean?
Is it okay if I do not take medication on time, maybe an hour late sometimes. Will there be any problem regarding to the medicine effectiveness?
With Hepatitis b, are you not allowed to drink alcohol at all? Or maybe a glass of wine/beer from time to time (once in 3 or 6 months) is allowed? I am drink alcohol - I was just curious wondering if I can do it in social situations.
I have attached my lab results accordingly from past to present, please help me. (i cannot attach photos therefore Iāll list it down).
Result 08/2020
Hepatitis B virus (HBV)Viral Load by abbott Real time PCR (Plasma)
Result 01/2021
Result 07/2021
Result 04/2022
Result 10/2022
My ALT and AST are always in normal range of 0-31 after medication.
And lastly I would love to hear all of your success story, maybe not fully recovered but going down to undetected if you experience something similar to me, Iād highly appreciated.
Sincerely,
Hopee
Hi @Hopee,
I want to welcome you to the forum, please take sometime to check out some of the discussions that have gone on or remain ongoing. I see from your results that your HBV Viral load has really gone down, that is the amazing thing about these antivirals as you can see these changes happen. I think it is possible to have all these normal markers but still have your HBsAg remain high. I have started treatment back in 2015, I reached undetectable level like within a year and half or so if I remember correctly. But my HBsAg has remained high for all these while. Some patients donāt seem to see a decline in their numbers here.
I have been undetectable since early or late 2017 and have remained there since. Those antivirals really does what it needs to do, sometimes not fast enough for some patients but they get there eventually. Alcohol can cause serious liver damage, but I do not think having a glass of wine once in a while during social events can cause such problem. I think the key here should be moderation and not doing it daily or regularly. Keep up with all that you do. An expert (s) will respond with their thoughts soon. Be patient, someone will respond to your questions. Thanks, bansah1
Dear @Wadani1,
AFP is generally quite low. As long as it stays below the normal limit, it is nothing to be worried about.
Itās unclear whether this is due to your natural bilirubin levels being high or something to do with the chronic condition.
Also, welcome to the community @Hopee, and thanks for your questions:
@Bansah1 Thank you very much for your kind welcoming and response. I am so happy to hear your story!
Dear Thomas @ThomasTu Thank you very much for very thorough information. I would like to further ask to have the āundetectableā status means to to have viral load undetectable or the HbsAg undetectable? Is it possible to have Viral load undetectable but still have HbsAg quantitative.
Thank you very much for create this safe space for everyone.
@Hopee,
You welcome, we try to make this place home and comfortable for every patient. I think being undetectable applies to the viral load, not with HBsAg. @Thomas can correct me here if I am wrong. Keep doing what you doing my friend, we shall overcome hepatitis B and its complexities. Best, bansah1.
Hi @hopee,
Thanks for your question. Your results show that your HBV DNA (viral load) is undetectable (more accurately, detectable but under quantification level) while your HBsAg is still detectable. These are expected results for someone on antiviral treatment.
Hope this helps,
Thomas
@Hopee ,
It is important to understand that oral antiviral therapies work by preventing the production of infectious virus (which is measured by the HBV DNA test). HBsAg is almost entirely produced by a separate mechanism as non-infectious āsubviral particlesā which is not affected by these oral antiviral therapies.
In your case, your antiviral therapy has efficiently suppressed the production of infectious virus (which is very good for restoring normal liver function and halting the progression of liver disease) but your liver is still producing subviral particles or HBsAg (which is the reason why oral antiviral therapy is typically life long).
This is why it is possible to have undetectable HBV DNA but detectable HBsAg.
Best regards,
Andrew
