Do my signs suggest that I am in a clearance stage? The 6 months timeframe doesn't make sense

General Discussion Lab results
1

Hello, I’m new here and I’m Nigerian, somebody should please respond, my blood pressure has gone up due to the deep fear, anxiety and worry, I feel like just committing suicide and ending it all.

I believe I was infected with acute herpetitise B on the 7th of September 2023, on the 25th of January 2024 to 27th of February 2024 (5weeks symptoms duration) I had all the symptoms associated with acute hepatitis B, all of them.

All through the time I had the symptoms my doctor placed me on ulcer medications. After taking the medication for a while I got fed up since there was no improvement and traveled to another location to see another doctor.

I saw a gastroenterologist on the 26th of February 2024, by that time my symptoms has already started to clear, that same day I did an HBsAg test which came out positive and a liver function tests that showed.

Total Bilirubin 62 (<21 umol/L)

Conj Bilirubin 31 (<5 umol/L)

AST (SGOT) 831 (<35 IU/L)

ALT (SGOT) 932 (<45 IU/L)

ALK Phosphate 305

YGT 508 (<49 IU/L)

Total Protein 63 (66 - 83 g/L)

Albumin 31 (35 - 52 g/L)

On the 29th of February 2024 I went back to the doctor with the test result and he immediately prescribed an antiviral medication for me (which I haven’t taken till today) and asked me to do a viral marker and a DNA test, I did the test that same day and here was the result

HBsAg positive,
HBsAb negative,
HBeAg negative,
HBeAb positive,
HBcAb positive,

Alpha feto protein 5.3 (0-20)ng/mL,
Viral load 183IU/ml.

On the 2nd of march 2024 the symptoms have completely cleared without taking any medication and I haven’t experienced any symptoms till date.

Yesterday 19th of April 2024 I did an HBsAg test and it still came back positive.

HERE ARE MY QUESTIONS

Question 1:
What is the likelihood that my immune system will clear the virus and develop immunity to it and that I won’t need to take medication for the rest of my life?

Question 2:
Did I make a mistake by not taking the medication when prescribed? I didn’t take it because at the time the doctor prescribed it the symptoms were almost all gone so it didn’t make much sense to start medication at that time.

Question 3:
For those who show symptoms, the 6 months timeframe is it from the date of infection or from the date when the symptoms appeared? Because if it’s from the date of infection then what if someone start to show symptoms by the 5th or 6th month, what time does the person has before consider chronic. Shouldn’t 6-12 months be a reasonable time?
@mantana
@Caraline
@john.tavis

2

Hello and welcome I’m mot an health expert but I have had a similar journey.
I was diagnosed with acute Hepatitis B in June/july 2023 with very strong symptoms that lasted few months.
I started to take antiviral in October because of high viral load and ALT/AST
In January 2024 my viral load was down to 2000. ALT 76 AST 124
HBSag positive and HBSab negative. HbeAg positive
I’m due for a blood check end of April
To see if anything has changed . Technically I’m chronic since 6 months have passed without seroconversion!
I have been told by my hepatologist that it can happen even after the six months threshold.
In your case your viral load is going down without antivirals and you are Hbeab positive. I think you are in recovery and on the path of clearing it!
Stay positive I think you are on the right track to gain HBSab and clear it.

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I’m sure some health expert @availlant or @ThomasTu can explains better

4

Thanks for the reply, that 6 months thing really doesn’t make sense, I feel like the timeframe is too short and I don’t fully trust all these medications, some part of me feels like these medications might kind of weaken the immune system.

5

Hi David,

Please do not think of suicide, you’re probably on the recovery path. Stay positive and reduce or eliminate junk food then increase your fruits and vegetables intake. This too shall pass. I’m Nigerian too if this helps and a survivor.

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6

Wow, can you please share your story? I’ll like to know what you did to defeat the virus, did you take any medication? If yes which one. Please share your story, I’m begging you please. Don’t miss any details. I’ve already started eating fruits and raw bitter leaf. Started immediately I found out I was positive because I do not see myself Living with this, the stigmatisation here in Nigeria is too much.

7

Hi @Ossaidavid,
Welcome to the community. I do empathize with your situation but please don’t think about committing suicide, that definitely is not the answer here. Remain upbeat and stay positive.

The majority of patients who get infected as adults have a 90% chance of clearing the virus. Therefore you being infected as an adult have a 90% chance of clearing it.

Regarding medication, in some patients sometimes that is the case to help them clear the virus if their immune system seem overwhelmed by the amount of virus or they are responding slowly. Usually, they take the medicine for a short period of time when they clear the virus. The immune system can fight it but in some people they will need this extra help.

HBsAg negative should happen 6 months after your initial diagnosis. So I think you count from the day you got diagnosed. Usually, when someone is exposed it takes between 45-180 days (the incubation period: time of exposure to period of showing first symptoms) to start showing symptoms. This might affect your calculations. The 6 months clearance period is the observed and evidence based timeframe when this happens. Anything longer than 6 months becomes chronic. Do you have any other tests done after February 29th besides surface antigen test? Such as ALT, AST, Viral load etc? You had one on 26th of February.

I hope this helps answer some of your questions. Bansah1

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8

Thanks for the kind words, that 90% is a bit hard to believe, I’ve gone through this forum and read about a lot of adults who were originally acute but transitioned to chronic, I’m just wondering if that statistic is true.

I just hope the 6 months truly starts from the first time the person was diagnosed or when symptoms show, because unlike most people I knew when I was infected, this is what scares me, this makes me feel like my 6 months time is up. I hope it’s not.

Apart from the viral load and the marker test written in my topic I haven’t done any other test.

9

Wow, can you please share your story? I’ll like to know what you did to defeat the virus, did you take any medication? If yes which one. Please share your story, I’m begging you please. Don’t miss any details. I’ve already started eating fruits and raw bitter leaf. Started immediately I found out I was positive because I do not see myself Living with this, the stigmatisation here in Nigeria is too much

10

Thanks for the kind words, that 90% is a bit hard to believe, I’ve gone through this forum and read about a lot of adults who were originally acute but transitioned to chronic, I’m just wondering if that statistic is true.

I just hope the 6 months truly starts from the first time the person was diagnosed or when symptoms show, because unlike most people I knew when I was infected, this is what scares me, this makes me feel like my 6 months time is up. I hope it’s not.

Apart from the viral load and the marker test written in my topic I haven’t done any other test.

12

I understand your concern. We have people on here who had acute infections and cleared it as well. If you have a 90% of clearing something, why feel so disappointed?
Yes, there is the fact that about 5-10% of adults exposed will develop chronic infection that is 1 out of 10 compared to children exposed which is 9 out of 10 develop chronic infection. So overall, you have a better chance than majority of hepatitis B patients did since we were exposed at childhood and had less chance. You might doubt the science or the statistics, but that is what the research/studies show.

Clearing the virus is a slow process that happens over a period of time. Much patience is required when you are going through it as it might not happen as quickly as one will want it to. Try and see if you can get your viral load and liver function tests (AST and ALT) done again. We can compare that results to the one you did in February (the 26th) to see whether there are any changes especially with your ALT/AST. Do not lose hope, I understand it is hard and a frustrating period. Thanks, Bansah1

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13

Hi @Ossaidavid,
I forgot to add this:

“Given the availability of safe and effective vaccines, a major global public health goal is the prevention of the spread of this virus (5). Unfortunately, the estimated 350 million chronically infected people remain an ongoing source of infection, and the spread of this virus will only be stopped after several generations of targeted vaccination (6). Vaccination programs have focused on eliminating perinatal transmission to neonates, where the risk of developing chronic infection is 70% to 95%, and to young infants (toddlers), where the risk of developing chronic infection is estimated at 30%. Sexual transmission and injection drug use are major risk factors for acquiring infection in young adults and a major cause of incident infections in North America (5) (Table ​(Table1).1). Although fewer than 5% of acutely infected young adults develop chronic infection, virtually all infections can be completely prevented by vaccination ([1]”(The laboratory diagnosis of hepatitis B virus - PMC),5).
You are able to click on the link and read more on the subject. Best, Bansah1

14

Dear @Ossaidavid,

Welcome to the forum and sorry to hear about your experiences. Please know that you’re not alone and there is a whole community here who know what you are going through. Please trust us that it gets easier over time and it is greatly possible to live a long and fulfilling life even with Hepatitis B.

As mentioned by others, 90% of people exposed to HBV as adults clear the infection. However, it is also possible that you were infected earlier (e.g. during childhood) and have had an asymptomatic infection for a long period of time. Symptoms can be sporadic over the course of a chronic infection.

As mentioned in another thread, we can’t really tell whether you should or should not take medications without physically examining you, having your medical history, and taking into account your circumstances (e.g., your access to the drugs, how much they cost, coverage by health insurance, etc.)

This has been answered in your other thread.

There isn’t any evidence that medications weaken the immune system. These medications have been shown to prevent liver cancer and progression of liver disease.

Many of the people with acute infections never know about it, because they have no symptoms or brief symptoms so they never get tested. The majority also don’t come on this forum to talk about it, so this is a bit of a biased sample.

Hope this helps contextualise it a little,
Thomas

1 Like
15

It’s really hard, when I sleep it’s peaceful but immediately I wake up it feels like I’ve been thrown back to hell. My major fear is the 6 months time that I’m not sure about. I keep seeing different online sources say the 6 months start counting from the day of infection.

16

But is it true that those who get infected with acute hepatitis and show symptoms have a weaker immune system than those who do not show symptoms during the acute stage?

Also is marker result favourable?
HBeAg positive
HBeAg negative
HBeAb positive

I did this test after the resolution of symptoms.

17

I understand. The worrying, the anxiety and fear of the unknown, the guilt of making a mistake, the had I done this or that etc is normal human reactions. But remember to take anything you read on the internet with a grain of salt. Hepatitis B infection can be complex and different for each patient. You might have much better luck than someone else so try not to compare cases. It will only make things well. You need a healthy and robust immune system to fight and clear this virus. Remain hopeful and don’t relent. Thanks, Bansah1.

1 Like
18

Thanks, you’ve been really helpful, one of my major confusion now is if I should still take medication

19

Sure, try and have a conversation with your provider for a advice or recommendation on this matter. He or she will be the better person to guide you here. Thanks, Bansah1

20

I agree with @ThomasTu comments.

If this was acute infection then you have already cleared HBeAg which is a good sign.

However it is possible you have had hepatitis B for many years and have only now been diagnosed. People with chronic hepatitis B can develop flares along the way, particularly when they are clearing HBeAg. This could be what has happened to you.

In any case it looks like things are settling down and you are well, so I agree fully with others about the need to stay positive and follow up with your doctor to ensure you are getting the correct treatment. There is no rush for antiviral treatment at this stage and I do not think you have done any harm by not taking it recently.

Suicide is never the answer so if you are still having these thoughts it is really important that you go to see your doctor, a psychologist, counsellor or someone else you can talk to straight away.

Keep strong and stay positive!

best wishes,
Mark
Infectious Diseases Specialist

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21

@MarkDouglas

It’s Acute because I know the person who infected me, sometime around September of last year.

Question 1
What do you think about the 6 months timeframe? Is it from the date of infection or from the date of diagnostic or from the onset of symptoms (for symptomatic patients).

Question 2
Do I have a weak immune system? I mean since I was symptomatic because I read that most adults do not develop symptoms.