Are people around me safe?

General Discussion
1

Hi everybody, I’m Julia :slight_smile:

I’ve been lurking here for a little while now and have learned a lot thanks to experts and community. Really appreciate it.

I am a 50 year old woman, recently diagnosed with chronic hep b. It was discovered by accident. I was supposed to be checked for vaccination status before a minor cosmetic surgery but, by mistake, my doctor ordered more test.

My results were:
HBsAg - positive
HBcAb - positive
HBeAg - negative
HBeAb - positive
HBsAb - negative

Blood test was repeated to exclude lab error and a viral load was checked. Came back at 33 iu/ml.

I was vaccinated with 3 doses in teenage years, so I believe I must had been infected before that.

15 years ago I went through pregnancy oblivious of my hep b status. I wasn’t tested and my child didn’t get any special treatment at birth, other than being vaccinated with the first dose the day after.

Here are her results:
HBsAg - negative
HBcAb - negative
HBsAb - positive

Are we out of the woods? Does she need more tests or monitoring in the future?

Luckily, all my husband’s results came out negative and he’s just got his first dose of vaccine.

How well do HBs antibodies protect against the virus? I don’t mean vaccine efficacy but actual antibodies being over 10 mIU/ml.

I was refused treatment because of low viral load. Shouldn’t we all with detectable virus be treated, so we don’t spread the disease? I know the risk is low but still, why not lower it even more and, maybe, avoid possible spikes in viral load?

I’m really anxious about passing the virus to someone.

Sorry if that’s too many questions. I have a doctors appointment in February and I’m too anxious to wait for answers.

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Dear @JuliaB ,

Welcome to the HBV community forum and we are glad you shared your concerns.

You likely have inactive chronic HBV (sometimes referred to as partial cure). In this stage of HBV infection, viral activity is low and the risk of liver disease progression is also very low. Under these conditions, most physicians would follow current treatment guidelines (in NA and EU) and not start antiviral therapy. You are correct regarding the timeline of infection: prior to your childhood vaccination.

Regular 6 month follow-up visits with your doctor are important to monitor the status of your infection.

Birthdose vaccination is the best way to prevent the development of chronic HBV hepatitis from infection during pregnancy. Assuming the results you provided from your child are recent (within the last year or two), there is no evidence of viral transmission or infection and normally in this scenario your child will not develop disease.

We actually measure vaccine efficacy in HBV by looking for titers of anti-HBs >10 mIU/mL. These levels of anti-HBs are considered highly protective against the development of disease.

The question of whether to treat patients with a low viral load like yours is currently a topic of debate in the field. The reason for this is that early adoption of antiviral therapy may help reduce the risk of liver cancer. In persons like you with very low viral load this is very unlikely but in China, treatment guidelines have been recently revised to indicate the initiation of therapy in any patient who has detectable HBV DNA.

Transmission of HBV can only occur by sharing needles for IV injection, unprotected sex or exposure of infected blood to an open wound. Otherwise transmission is very difficult (including touching and kissing etc). Additionally, with such a low viral load, the chances of you transmitting infection even under the high risk scenarios I mentioned above is low. Vaccinating your husband is the best possible safeguard within your family group. You should not feel anxious about transmitting HBV infection to someone else.

Hope these comments help!

Best regards,

Andrew

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Thank you so much for your answer. That’s a huge relief.

I do have disturbing thoughts about infecting others by leaving a tiny amount of blood somewhere, for example from paper cut I haven’t noticed.
I’ll just have to learn to live with that and try my best to not put people in danger.

Thank you again. It is so kind of you to use your private time to help other people. :heart:

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Hey, Julia.
Don’t know if you’re still on here but I read your story. Lurking seems to be an apt term for what many people seem to have done when they find this valuable (in my opinion) site. Many anonymous people, too. I DO get it…all part of the shame and stigma attached to this disease.
I hope your mind found respite here. I know that for myself, it has been as helpful as AA must be for an alcoholic. Just wish we didn’t feel so stigmatized that we can’t really feel free enough to open up more to each other.
Anyway, take care. I hope things turned out better for you than before you joined.

Denny

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