Acute Hep B then hbsag negative

Dear Group

Hii, im new here from indonesia
You can call me Yuji.

First of all i would like to say that my english is not good, my ELTS score english was very bad.

Below is short story
In feb 2020, 6 weeks after potential exposure
My hbsag was Positive, i didnt know about hep b since i didnt have any scare symtompts, only fever for a week, then gone. so at that time i ignore and forgot it

then in Jan 2023, i met with my wife and plan to marriage,
before marriage i have searched so many sources that hep b is very danger that make me stressfull,

i come to many clinics and ask them to take HBSAG test,
8 times test also different clinic , and everything are NEGATIVE, so my hbsag negative

then i have just read that, “you have to take anti hbs to make sure you are immune”*

but i havent taken any anti hbs to check my immune, OR HBC
since my hbsag negative 8 times , please your advice :

  1. is it possible that my anti hbs have not developed for 3 years ? with 8 times hbsag negative. i afraid to go to clinic to take anti hbs (trauma /OCD after googling hep b) When does anti hbs appear after hbsag gone ?

  2. if i have cured from acute hep b , can i still spread the virus to my wife ?

  3. am i fine ? please

thank you for this community @ThomasTu

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HI Yujie,

You went form HBsAg positive to HBsAg negative over a relatively short time. This indicates you almost certainly cleared the infection. “Clearing the infection” means that your body won the war with the virus and killed it off.

Anti-HBs is antibodies your body makes against the HBs (also called HBsAg) protein. They protect you for life from further infection with HBV. Clearing HBV is almost always accompanied by appearance of anti-HBs, so you can confirm that you cleared the infection with a simple anti-HBs blood test. Your doctor will know how to do this.

If you are HBs negative and anti-HBs positive, then your health risks over your lifetime will be very similar to someone who never caught HBV. In other words, you would be fine!

Finally, I recommend your wife be tested for HBs. If she is negative, she should be vaccinated against HBV. The vaccine is extremely effective and safe, and will protect her from getting HBV.

I wish you the best!



Dear mr john tavis @john.tavis

Thank your for your explanation

I will take my wife to get vaccine

As you said i won from war and kill it off

Please advice

“For condition won from war and kill it off, can i still pass/spread hepatitis b to my wife, beacuse she has not been vaccined yet ? “

Second question
“How long usually anti hbs develop after hbsag gone ?

Thnk you, you are expert !!

Dear scientist,

Please kindly your answer regarding my question

Thank you

@john.tavis @ThomasTu

I replied last night, but it does not appear in this message chain.

If you are HBs negative and anti-HBs positive, you will not be able to pass HBV to anyone.

anti-HBs usually develops at the same time as HBs is lost.



Dear Mr John tavis

Thank for your insight
But i still doubt

You said “ anti-HBs usually develops at the same time as HBs is lost “

Do you mean word “HBS is lost” is same as hbsag gone ?


Yes. You are interpreting my reply correctly.


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Dear Mr John Travis

Ok thank you
So if hbsag gone , means that i will have anti hbs

Is possible after recovery and lost hbsag but not develop anti hbs ? Is that common ?

Apologize for too many questions


Dear @Ngurah_Yuda,

You seem to be concerned about the potential for transmission to someone else unless you have anti-HBs.

It is important to understand that achieving HBsAg negativity is a sign that you have already developed strong immune control of the virus (without even knowing what your anti-HBs value is). With this strong immune control of your infection in place, you are not at risk of transmitting the virus to someone else.

We are more concerned about anti-HBs when we are assessing the ability of vaccination to provide protection for someone who has not been infected with HBV. In this case, we look for anti-HBs levels > 10 mIU/mL as an indicator of effective protection from developing chronic HBV infection.

As John has mentioned, your transition from HBsAg positive to negative was relatively quick so it is almost certain that you have developed anti-HBsAg antibodies. If it gives you more of a sense of comfort to have a positive test for anti-HBs than I encourage you to have this done (as John has mentioned this is a simple and relatively inexpensive test) but again your HBsAg negativity is a sign that you are not infectious.


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Dear DR Availlant

thank you for your great explanation, i can calm now,
cause i am in isolate island where i cant find any anti hbs test
i will go to city in next two weeks

another question

if someone has resolved their HBV ( acute infection ), then why we cannot donate our blood ?

Thank you so much
@availlant ,
CC : @ThomasTu , @john.tavis

Dear @Ngurah_Yuda ,

You cannot donate blood after clearing HBV because in many patients (we don’t know the exact proportion), there is a tiny amount of HBV left in the liver that is under very good control by the immune system. It does not cause disease unless the person becomes immunosuppressed, and it cannot be transmitted by the normal routes HBV uses. However, blood transfusion moves a very large amount of blood from one person to another, a situation that does not occur during natural infections. Consequently, the prohibition on donating if you’ve cleared HBV after an acute infection is a very conservative decision to remove a very small risk of transmission to someone who has not been vaccinated.


Dear Dr john tavis

I see,

But this sentence confusing me

“ However, blood transfusion moves a very large amount of blood from one person to another, a situation that does not occur during natural infections. ”

Here is the situation

My finger was torn due to a cut by a knife, and my wife sucked on my finger to stop bleeding

Will she get infected?"


Normal transmission of HBV involves volumes of blood much smaller than a single drop, so transfusion of ~500 mL of blood is a vastly larger volume.

We’ve already discussed that you are almost certainly no longer HBV infected based on the information you have provided, so if the knife cut occurred after you cleared the virus, then there is no risk of transmission.


Hi John,

Do you happen to have any insight into the below results? I posted my own thread in hopes of getting some insight into my HepB readings but had not gotten any replies. Results are below. Does this indicate active or inactive carrier status? We were wondering if there should be any concern regarding the fact that there is the word “High” behind under the reactive results for the Hep B readings (full lab results are in another post). Thanks!

  1. Hepatitis B Core AG IgM: non-reactive
  2. Hepatitis B Surface Antigen II: Reactive (High)
  3. Hepatitis B Core Total: Reactive (High)

Hi @Anon2023,

I try to stay away from anything more than the most basic interpretation of lab results as I am not a physician, and consequently am not licensed nor qualified to go beyond the most basic interpretations.

These results indicate to me that you most likely have a chronic HBV infection. You have 2 markers of HBV being present in your body (HBs and HBc), and anti-HBc IgM is negative. IgMs are the first antibodies made by the immune system when it initially encounters an antigen (ie, part of something foreign that needs to be responded to, in this case HBc). They then “class switch” to other types, with IgG being the most important for non-mucosal pathogens such as HBV. As you are anti-HBc IgM negative, it has been more than a month or so since your immune system first saw HBV. The formal definition of chronic HBV is being positive for HBV markers (here HBc and HBs) for longer than 6 months.

I urge you to speak with your physician about these results as s/he knows your full medical context and can give you a more detailed answer.

I wish you the very best.


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Hi - appreciate the insight! OK thanks - and a chronic infection indicates an inactive status, correct? Or is that not necessarily the case?

I saw online that generally something referred to as an envelope reading (or something like that) indicates whether or not the Hep B is inactive. But I noticed it’s not anywhere on my most recent blood work so I was wondering if maybe the mix of my reactive / nonreactive results helped to indicate if it was active or inactive.

And yes, that’s the plan - I need to make time to visit my doc with my partner, but it might be a bit before that happens - we’re long distance so hoping to bring her along for her ease of mind. These results here are from August of 2023, and tbh I don’t recall the doc I got these results with saying anything, so idk if it was that there’s nothing concerning, or maybe just negligence (not necessarily just on the docs side, but mine too for not following up). I’m hoping to go to a specialist rather than just a normal primary care physician

Dear scientist Dr John Tavis, @john.tavis

Please kindly clear my doubt

Because the cut was on the vein of the index finger, about 2 tablespoons of blood may come out, not just a drop, and then it was sucked by my wife

I know it will not 500 ml but,
Is 2 tablespoon of blood from someone who has recovered from HBV enough to transmit the virus?

Assuming 1 spoon = 15 ml, then 2 spoons equal 30 ml.

I am truly grateful to be able to speak directly to the scientists in this community. Thank you so much

@john.tavis @availlant @ThomasTu

Hi @Anon2023,

“Active” vs. “inactive” generally is taken to mean whether there is liver inflammation happening or not. Either can occur during a chronic infection.

Dear @Ngurah_Yuda,

Sucking on a wound is not a very efficient way of transmission. The risk in this context is quite low. To prevent any worry in future, it is best that your wife be vaccinated so that she is protected.


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Dear Dr Thomas,

again thank you for your suggestion, i will take my wife to have vaccine in next 2 weeks

also i need another opinion from profesor @john.tavis for my previous question regarding 2 tablespoon blood,

thank you so much

CC : @john.tavis

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I second Thomas’ comment. The risk is essentially zero based on your test results being HBs negative and likely anti-HBs positive. If you cleared the virus as we have discussed, then there is no virus in your blood to transmit. This should wrap up this line of questions, and if you need more assurance, get tested for anti-HBs as has been suggested.


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