Can COVID cause HBV to become reactive?

After being sick since I tested positive for COVID in Sept 2023 my dr tested me for Hepatitis B and below are my results. Now here is the back story. I got COVID in Feb 2021 and was hospitalized and later diagnosed with long covid bc the symptoms lingered for months similar to the same symptoms I’m experiencing now. Each time I’ve got COVID I got blisters on the palms of my hands and bottoms of my feet (pictures of hands below) After doing my internet research which I know is not good but I couldn’t resist, I’ve learned that HBV could also cause palmee erythema which looks similar to what my hands look like. My questions is, is it possible that I have had HBV for years even before the first time I got COVID and if I’ve had it for years will it always show up in my DNA or does it only show up in your DNA when it’s active? My appointment with my dr isn’t until 3/21 so he hasn’t went over my results with me yet. I logged into quest and got them myself.

Hi @BriGirl,

To answer your question about your test results, you have markers for hepatitis B infection based on your lab results posted. What it cannot confirm if it’s nearing the end stage (viral clearance) of an acute infection or a chronic infection. For that you must consult with your doctor and do follow-up lab work after 6 more months to see if the results have changed. Please see below for my intrepretation of your test results.

Hepatitis Core AB - Reactive: Clinical marker for past or present HBV infection.

Hepatitis Surface Antibody - Non-Reactive: Not enough free floating HBV surface antigen antibodies detected in the sample, either not enough is being produced or all antibodies produced are already attached to HBV antigen in the blood.

Hepatitis B Virus DNA: Measures the amount of HBV DNA contained in the
blood in IU/ml. 19900 IU/ml shows some immune control as the viral load is low.

Hepatitis B Surface Antigen - Reactive: Shows that there are HBV surface antigen present in the sample, therefore confirming the HBV infection.

Will it always show up in my DNA or does it only show up in your DNA when it’s active?

Viral DNA PCR tests are very sensitive, and will pick up even the slightest amounts of DNA of the Hepatitis B virus. It will always show reactive even if there are so little virus that the quantity cannot be defined; possibly even in people who have cleared an acute HBV infection.

@A7xImpulse .

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Thank you for your response. Any idea as to my hands and feet getting the blisters? I have printed out pictures to take with me to the Dr next week so that he can see them. When I had my last Dr appointment it was on the day AT&T was out so I couldnt pull up the pictures on my phone but he made it clear that he wanted to see what my hands and feet look like when the blisters come.

Dear @BriGirl ,

This kind of blistering can occur with a variety of viral infections and there are some case reports of this occurring with SARS CoV2 infection so your experience is not unique. However, this should be discussed with your doctor to be sure if these sores are not an indication of something else going on.

As with any infection, your body spends energy to fight it and if this fight becomes prolonged, you can become immunosuppressed. This can lead to reactivation or exacerbation of chronic HBV infection.

Your HBV virology tests indicate that you have active HBV infection but it is not possible to know if this is reactivation or exacerbation without knowing your previous test results for HBV. It is possible that you have been infected with HBV for many years and not been aware.

Moving forward, your doctor should evaluate your liver function and if you have any evidence of liver disease. These will be important in deciding if you should start treatment for your HBV infection.