EXPLAINER: Lab results and their interpretation

We all know that it’s important to have blood tests to know your current Hep B status or to know if you’re protected against it. There are a lot of different tests in a panel for Hep B and these can be confusing. Here are short explanations for some of the common ones:

  • Hepatitis B core antibody (or anti-HBc)
    Measures past Hep B infection. If this is positive, you have been exposed to Hep B, but this won’t tell whether you still have the virus or not.

  • Hepatitis B surface antigen (or HBsAg)
    Measures current Hep B infection. If this is positive, you currently have a Hep B infection. If you are positive for more than 6 months, it is defined as a chronic infection.

  • Hepatitis B surface antibody (or anti-HBs)
    Measures protection against Hep B infection. If this is over 100 units, you are protected from both Hep B and Hepatitis delta infection. Protection can be due to vaccination or recovery from a past infection.

  • Hepatitis B DNA
    Measures how much virus is in your blood. This will go down if you are on treatment and it works. As long as this is detectable, there is some chance that you can pass it on.
    Hep B DNA does not measure liver damage! Lots of people can have very high virus, but not much liver damage: the immune response against the virus causes liver damage not the actual virus.

  • Alanine Aminotransferase (ALT)
    Measures current immune response against the virus. ALT level goes high when the immune system starts attacking the infected liver cells.

  • Fibroscan or ultrasound
    Measures the current liver damage. Over time, repeated damage to the liver causes scars (this is called fibrosis, or cirrhosis when it gets very bad). This scarring can be seen on ultrasound or fibroscan. Too much scarring will stop the liver from working properly. Ultrasound can also be used to find any liver tumours that are forming.

  • Alpha-fetoprotein (AFP)
    Measures liver cancer risk. If this is high, it indicates there is a risk you have liver cancer. This has to be confirmed by other methods (like ultrasound) because there may be other reasons why AFP levels are high.

  • Hepatitis B e antigen and e antibody (HBeAg and anti-HBe)
    Used to determine what stage of chronic infection you are in. This will let your doctor know whether treatment is recommended for you or not.

Use this thread to get help if you don’t understand your results.

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Hello sir.
Please what’s hepatitis b report says: (indeterminate) my wife tested recently and her result says indeterminate…what does this result mean please.she was diagnosed since 2015

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Dear Everich,

Thanks for your question. Could you give a little more information about what you mean? What is the actual test (see the post above) that gave the result as “indeterminate”?

Thomas

My wife went for a blood test because she was diagnosed with hepatitis b but I myself is negative…now we wanna have kids so she went to do another test last week and the results came out as: indeterminate…so we don’t know if it’s Reative or non reactive…

Please have anyone here gotten a blood test and it says indeterminate…so my wife hepatitis b result is (indeterminate)

Hi Everich,

You need to be a bit more specific about what the exact test was. What is all the information you have about the test? We cannot answer your question without that information.

Thomas

Hi Everich, there are basically 3 blood tests that are required for a new vs. a chronic hepatitis B infection. Below is a simple summary of these tests. If you could let us know which blood test was “indeterminate” that would be very helpful.

(1) Hepatitis B surface antigen (HBsAg) - If [+] or [reactive] means the hep b virus is present. This could mean a “new” infection or a “chronic” infection (meaning the virus tests + for more than 6 months). If this test is [-] or [non-reactive], then the hep b virus is not present in the blood.

(2) Hepatitis B surface antibody (HBsAb or anti-HBs) - this tests for a protective antibody against the hep b virus. This can occur through getting the hep b vaccine or recovery from an exposure to the virus. If [+] or [reactive], then it means a person has been protected against the hep b virus either through vaccination or recovery from an infection. Generally, the above test (Hepatitis B surface antigen or HBsAg) will be [-] or [non-reactive].

(3) Hepatitis B core antibody (HBcAb or anti-HBc) - this tests for an exposure to the hep b virus. If it is [+] then a person has been exposed the hep b virus. If it is [-] then the person has not been exposed to the virus.

Everich, do any of these tests appear on your wife’s results? Can you ask the doctor’s office for a copy of her blood test results if you don’t have them? Thanks and we all look forward to helping answer your important question. Always, Joan

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Ok thank you for your response.but my wife went for hbv viral load by real time PCR…

Her report says HBV VIRAL LOAD <34. IU/ml

Comments
*******KINDLY NOTE:THE HBV DNA IS NOT DETECTED.

Please I think some input on this this recent report.
Thank you.

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Dear Everich,

This means your wife has very low levels of virus in the blood. This means the risk of her infecting you or your children is very low.

Thomas

Am I in a danger zone or do I still have a chance to fight this? If you any knowledge is this please give me an updated.

Dear Mercy,

Your results show that you have low levels of virus in the blood. This means you are fairly unlikely to pass it on to other people.

However, what this does not show is how your liver is functioning. This requires an ultrasound or a fibroscan test. To see if you should have this test, you should contact a liver specialist and discuss with them.

Thomas

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Thank you so much. Those are results from my pregnancy which was two years ago but I was too ashamed and embarrassed to ask my Doctor and she never explained much besides writing notes on my chart “complications with hepatitis b”. Thank you so much, I feel better and even motivated to take throw diseases seriously. I will definitely find another specialist on Monday. Thank you.

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I just did liver function test and this my results as follow. Please I need interpretation

Dear Sirbay, thank you for joining the hepbcommunity.org and sharing your question. The lab tests look normal, which appears to indicate that your liver is in good health. The 5 test results above are related to the normal functioning and health of your liver.

The only question I have is whether you have been diagnosed with hep b or not? Did your doctor order the above tests as part of your evaluation for hep b? And have you discussed the above test results with your doctor? We look forward to hearing more from you so that we can be most helpful. Thank you again for question. Always, Joan

I was diagnosed positive on 24
the of November and haven’t been on any drugs yet. My doctor ordered me to do the test and told me it’s normal results. And also said I have to wait for 6 months to be considered either acute or chronic and also repeated hepatitis b test again yesterday which is still hbsag positive no change in my results yet

Hi Sirbay, thanks for the clarification of your posted liver blood test results. So according to what you wrote above, your doctor wants to tests you again for hep b in 6 months - probably May of this year - to determine whether you still test positive for hep b. A “chronic” infection is diagnosed if a person tests positive for the hep b virus (hepatitis B surface antigen or HBsAg+) for 6 months. If you test negative at 6 months for the hep b virus, then you would have had an “acute” (or new) infection and recovered. Please keep us posted on your test results if possible. And thanks so much for joining our conversations. Always, Joan

Hello Joan,
Thanks for sharing your experience and expertise.
I joined this community late last year when my husband was diagnosed with Hep B. Unfortunately, he developed Hepatocellular carcinoma which progressed rapidly and he died on Feb 20th.
I was asked by his Hepatologist to do the Hep B tests and below are the values. I will appreciate if you or anyone here can help interprete the results. My appointment with him is next Thursday by I’m apprehensive.

Hep B Test results

HEPATITIS B cAb - Positive

CORE VALUE - 4.52 S/CO

HEP ‘B’ CORE IgM (HBcIgM) - Negative

CORE M VALUE - 0.08 S/CO

HEP B SURFACE antigen - Negative ELI

HEPATITIS B SAb - Immune

HEP ‘B’ surface Ab value - 29.57 mIU/mL

Thank you,

Dear @174,

I’m so saddened to hear about your loss. My condolences on behalf of everyone from HepBCommunity. I hope you are getting the support you need through this time.

Regarding your lab results, they indicate that you are protected from Hep B (your HEP ‘B’ surface Ab levels are above 10, which is the common threshold for protection). They also show that you have been exposed to the virus before (as your HEPATITIS B cAb is positive) but you had cleared the virus infection.

I hope this helps.

Yours sincerely,
Thomas

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