Can anyone help me with my results

Hello, thank you for allowing me to be part of this community.

My name is Uwe, I live in Germany, I am 35 years old and a father of two children.
About 5 months ago, I had sexual contact with a dental assistant and have been more or less sick since then. It wasn’t really sex, more like petting and kissing with tongue.
The next day, a burning sensation on my tongue started, and a few days later I experienced muscle pain and fatigue.
I have been to several doctors since then, but no one really knew what it could be.
The first test was done by my general practitioner 2 weeks later, and everything was fine. Two months later, I developed a rash on my face, arms, and redness on my neck.
These rednesses were more like an allergic rash with small dots or pimples.
An ear, nose, and throat doctor then diagnosed me with haemophilus influenzae through a throat swab. I was vaccinated against type B as a child.
I was prescribed antibiotics for 3 days of azithromycin and 5 days of Cefpodoxime, and one day of Ampho-Moronal for oral thrush allegedly caused by the antibiotics.
After that, the muscle pain was less and I felt somewhat better.
At that time, I also got tested for HIV, syphilis, and hepatitis, 6 weeks later, and everything was fine, but the HBCab value was not tested.
After that, I didn’t think about it anymore, I thought it was due to the above-mentioned throat infection.
I hugged and cuddled with my children but never kissed them, as I still wanted to be sure.
3 months later, I went to a dermatologist to clarify the redness, and he couldn’t see anything and asked if I had been tested for syphilis and hepatitis, I said yes.
He wanted to do another test, so I agreed.
The results:

Everything was negative, only the HBCab value was slightly elevated, and the HBSab value was 3.10, still waiting for the results of HBV DNA.
I was fully vaccinated as a baby and received a single dose 8 years ago. There should have been 3 injections, but I didn’t go after the last one.

The following symptoms have persisted: some fatigue, but not as much as at the beginning, occasional muscle pain in the thighs towards the knees, one-sided redness on the neck and cheeks (under the eyes), a kind of burning mouth syndrome, burning in the throat, palate, and tongue. The tongue is sometimes red on the sides, itching in the neck area and on the sides of the stomach, but rarely.

What does all this mean for me? I have not been able to sleep for 4 days and have difficulty breathing. I am terrified and have even searched for palliative care facilities on Google. My mind is not in the right place.I have also read that slightly elevated HBsAg levels can be nonspecific and could have other underlying causes, such as my infection or a correct/incorrect diagnosis.

I hope someone can help me with my results. I have read 400-500 pages but am not getting any clearer because the values can constantly change, and there are special cases.

First test after 6 weeks:


Second test, after 5 Months:




Ps:
(I am a divorced, since 4 years)

I apologize for the long text.
I wish you all a nice weekend.

Dear @General_Shao,

Thanks for sharing your story and sorry that you are experiencing such anxiety over the lab results. Indeed they can be confusing!

The lab results are consistent with a previous exposure to HBV (as your anti-HBc is positive) but no current infection (HBsAg is negative). Anti-HBs antibodies are relatively low, which may be explained by the exposure being very long ago (antibody levels can decline over time). For peace of mind, it may be worth getting an additional booster vaccination for HBV so that you stimulate the antibody levels to a protective level (>10mIU/mL)

Hope this helps,
Thomas

Hey Thomas,

thank you for the response.
I’m sorry if I have to ask again briefly, but what does it mean for me that I had contact with the virus? Am I a carrier, recovered, or chronically, immune? If I carry the virus, does the booster shot not help? With these values, am I a danger to my family?

Thank you very much.

Hi @General_Shao,

These lab results are consistent with someone who has recovered from HBV infection. The vaccine would boost your antibody levels so that you are sure to be protected if in future you are exposed again. Your risk of transmitting to your family through normal contact is essentially nil with these values.

Thomas

Thank you very much!!

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Hello Colleagues,

Can someone help me understand my results. Do I need to be put on treatment?

Regards,


Hi @Mic,

Consistently raised ALTs is an indication for treatment, but these results alone cannot tell you if treatment is required. You would need a HBV DNA PCR test to see if you have a high viral load and show if treatment would be helpful for you in this case. Also a fibroscan would show if you have significant liver damage that would also be an indicator for treatment.

Thomas






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Here are my additional medical results. Kindly help interpret on whether I need to start medication. My doctor gave me TDF and I started this month

Hi @Mic,
Thanks for sharing your results. So your tests relating to your HBV only shows one liver enzyme being very high. Even though the ALT is high, it is just a little over the normal range which is between 0-45 ul. GGT is similar to the AST/ALT, in that they are in other parts of the body but mostly in the liver. It is released when there is a sign of liver damage. Some link it to liver cirrhosis and your number is on the higher side (normal range is 0-55). Your HBV/DNA is low as well. Two test results shows evidence of liver damage or abnormality. The rest looks good.
Your imaging shows a lesion and evidence of liver cirrhosis, but I am surprised that your alpha fetoprotein is actually low. That seem a bit odd, my understanding is that people with liver cirrhosis will have a higher alpha fetoprotein value.

On the advice whether to take your medicine or not, I don’t think any of us would like to second guess your doctor and his/her decision and judgement. I will encourage you to follow whatever his/her orders/recommendations are for your care. He knows your HBV journey better than any of us . Taking the treatment can help stop and even reverse some of the damage caused by the cirrhosis. Best, Bansah1.

Hi @Mic,

My understanding is that any form of significant liver disease (e.g. cirrhosis) should be an indication to begin treatment in most HBV guidelines.

Thomas

Thank you @ThomasTu

My last question: Is TDF the right treatment for Hep B?

Regards,

Yes, TDF is the recommended first line treatment for Hep B.

Thomas