EXPLAINER: Lab results and their interpretation

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1075

Hi @Chukwu

Functional cure means in the absence of antiviral therapy, you have no detectable evidence of viral activity in your liver (HBV and HBsAg are not detectable) and your liver function (ALT) is normal. In this case, latent viral genetic material still remains in your liver. In this case, immune function has recovered so that people with functional cure never reactivate their infection and they have a low risk of developing liver cancer. HBV reactivation can happen even from functional cure but this is very rare and only happens when individuals become severely immunosuppressed (i.e. when taking immunosuppressive medication).

Partial cure also means immune control but only partial (hence the term “partial cure”). Here your immune system controls most but not all of the infection in your liver. So HBV DNA is very low and liver function is normal in the absence of therapy. In these patients HBsAg remains detectable; most likely because of a special form of viral genetic material called integrated HBV DNA. This form cannot make virus but can still produce HBsAg. Because of this, reactivation from this “inactive” state is more likely but still not so common. Patients with partial cure do not frequently transition to functional cure but it can happen. The risk of liver cancer with partial cure is also lower but not as good as with functional cure.

Hope this helps.

@availlant

1076

Thank you. Now I understand what you mean

1 Like
1077

@availlant @ThomasTu

I am a little bit concerned about my HBSAG quantitative increased by 220… a yr ago, it was 1442 and this month results showed 1661. … I was expecting this number to go down slightly since I am taking NUC almost a yr!! What’s your thoughts
Thank you and all of you happy new yr!!
Nas

1078

Hi @Nass,

This is the normal wobble in HBsAg levels seen in patients on NUC therapy. Most patients do not experience any additional HBsAg decline from the small initial declines typically observed in the first year of therapy. Of course it would be nice to see continued decline but the very small changes you have on hand (1442 vs 1661) do not indicate anything troubling - its just the limitation of NUC therapy.

@availlant

2 Likes
1079

Thanks… I was expecting decrease since I am on NUC almost a yr…thanks always and happy new yr…

1 Like
1080

Hello:

Hoping some one can let me what they think about these results. I donated blood in august 2023 that had a false poisitive result on HBsag. then I donated in October with no positive results. Then in December I got another false positive and I am concerned I have hepatitis or alcoholic hepatitis? The 2 positive results were for

HbsAg by EIA positive
HDsAg by confirmatory negative
Anti-HBc by EIA (IgG plus IgM negative
HBV NAT for hepatitis B negative.

Same result for both positives.

What the heck is going on with this??? Help!

1081

Dear @Tommytula,

Welcome to the forum and thanks for sharing your story.

I’m sorry to hear about your experiences. It’s not clear what is causing the false positives, but it is not likely at all that having another sort of hepatitis (e.g. alcoholic hepatitis) would make you test positive for HBsAg. I have heard anecdotally that having a vaccination series can make you test positive for HBsAg (because this is what the HBV vaccine is composed of), but does not at all denote that you are infected or have any liver issues.

To know if you have a liver disease of some sort, it would be useful to know your liver function test results.

Hope this helps.
Thomas

1082

Hello,

Liver blood tests all where green with only Globulin being 2.0 being the only outlier. I did also take a hep C test that came out negative and just took a Hep B surface ab immunity which was low- les than 5mIU/mL. interesting thing is in 2019-2020 i took the 3 part Hep A/B vaccination at walmart… guess that did not work.

1083

Hi @Tommytula,

People with low HBsAg (even after a vaccine course) are usually recommended to get boosters to get their anti-HBs to protective levels. Perhaps this is something that you can do and have the peace of mind that you would be protected from HBV in the future.

Thomas

1084

With his hbsag quantification of 15,000, is it possible for him to sero-convert within six months?

1086

Did my blood test yesterday and below are my results. Kindly help and interpret and give guidance where necessary. Thanks in advance

IMG-20240203-WA0005
IMG-20240203-WA0005648×756 71.4 KB

1087

Dear @Opa,

This does not provide much data on your Hep B status, but it does show that you have have high cholesterol and your amylase levels (a marker of pancreatic injury) are quite elevated. This is generally not caused by Hepatitis B, so it is a bit outside the expertise of this forum. It is best that you get information from your doctor to determine what could be causing this elevation and what the next steps are.

Hope this helps,
Thomas

1088

@ThomasTu

please help me to interpret my test results here.

image

note still have not started any medication.

thank you

1089

Dear @lemlem,

These test results are consistent with someone with chronic HBV infection in the HBeAg-negative phase (which is generally linked with low levels of HBV in the blood).

Hope this helps,
Thomas

1 Like
1090

Dear @ThomasTu

thank you very much .

Regards

1 Like
1091

Good every one my name is jay I just did a full blood test and I was diagnosed of hep b chronic I’m so scared right now I don’t know what to do I live in Ireland but the have giving an appointment to see a specialist on the 5th of march I’m scared right now and my family is back in Nigeria I’m scared of them as well because I feel I have also exposure my wife and son to this I planned a beautiful family but this now as taken away my joy I don’t know what do I glad I found this platform I need advice because I’m scared of my family losing them and even my self anytime I see my son picture I just want to end my life this my test result below can some one explain this to me I’m so tired

HBsAg(Architect) positive

Anti-HCV(Architect) negative

T.pallidum Total (Architect) negative

HCV Ag(Architect) negative

Anti-HBe(Architect) positive

HBeAg(Architect) negative

Anti-HBc lgM (Architect) negative

Anti-Hbc total positive

Anti-HDV total (liaison)negative

Please can some explain this to me my heart is so heavy I feel my life counting by the day

1092

Dear @Jay,

Welcome to the forum and thanks for sharing your story with us. I’m sorry to hear that it has been so hard on you, but rest assured that you are not alone and many people on this forum have been through the same situation.

As others have mentioned, there is no need to wear the guilt of this. Most people with Hep B have had it for their entire lives without knowing. The good thing is that you know about it and can do something proactive about it. I understand that this diagnosis is hard on you at the moment, but it does get better over time.

Regarding your lab results, these are consistent with a chronic hep B infection. HBeAg-negative and anti-HBe positive are indicators of low risk of transmission and generally line up with lower disease progression.

To be completely sure, you will need some follow-up tests including a liver function test (which will check your ALT levels, a marker of current liver inflammation); fibroscan (which is a painless abdominal test and measures any damage to your liver built up from the past); and HBV DNA test (a measure of how much virus is in your blood and will help determine if you need treatment as well as your risk of onward transmission).

Hope this helps,
Thomas

1093

Hey all thanks for accepting me into the group! My question is cause I’m all confused. In 2021 I tested positive for Hep b core ab IGG and IGM nothing else. Then went got retested 2 weeks later with different doctor only IGG was positive I’ve attached below all bloodwork from 2021 and then in 2024 I brought it up to the doctor again and they retested but only retested the core ab and if I was immune and the Viral load. why didn’t they check the surface antigen etc like 2021? I don’t know I’m so confused if someone could please Help id really appreciate it. I also have Crohn’s disease and on immunosuppressive infusions (I know not good for this) if it’s what I think. But they monitor my liver enzymes often since blood is constantly drawn and they have always been perfect only once was it ever borderline still within range but just at the top of the healthy range. So since I’m confused if someone could please look at these and interpret for me? Also The note from The second doctor saying concerned bout false positive was the one that retested the first photos r the first tests from another doctor after those are his that he redid about 2 weeks after those other ones came in. Never heard back from the guy though which messed me up I’m assuming for almost 3 years now. But all photos r in date order oldest to newest.
July 1st 2021
Hep B core AB IGM reactive,
Hep B core ab IGG Reactive.
Hep b surface antigen non reactive,
surface antibody non reactive.
Hep be ag non reactive,

hep be ab non reactive.

July 19th 2021 met with different doctor these are his notes before he retested what does it mean?Assessment/Plan:

  1. Hepatitis B core antibody positive, R76.8
    Patient appears to be low risk for hepatitis infection, will repeat hepatitis
    serologies concerned that we may be leading to a false positive. If positive
    will discuss with patient and hematology whether or not to monitor LFTs (He never did this by the way)
    and periodically monitor hepatitis B
    viral DNA versus entecavir/lamivudine prophylaxis given low risk. May need
    to get revaccinated
    Results to his retest :
    HBV IU/mL HBV Not detected

Log 10 HBV IU/mL Unable to calculate result since non-nuberic result obtained for component test. Test information:
The reportable range for this assay is 10 IV/mL to 1 billion IU/mL.

Hep B surface Antibody Qual : non reactive

HepBsaG screen negative

Hep be Ag Negative

Hep Be AB negative

Hep b core AB. Tot positive

Hep b core Ab IgM Negative

Why did IgM go away so quick from july first to the 19th?

November 2021 unrelated MRI I had done for an unrelated reason months after 2021’s positive test. They labeled it fatty liver to be exact the report says “There are some loss of relative signal intensity on out of phase imaging of the hepatic
parenchyma compared to in phase imaging compatible with some fatty infiltration of the
liver. No enhancing hepatic lesion is identified.
The portal and hepatic veins are patent.” Consistent with Fatty liver. could that be confused with Hep issues on liver or Hep b cause the fatty liver? Or is it just fatty liver and unrelated to Hep B ?

Now 2024 results

hepatitis B core AB total reactive

Hep b surface antibody non reactive

Hep b surface ab immunity :<5 not immune

Also 2024. Hep b virus DNA IU/mL :not detected

Hep b virus DNA Log IU/mL : not detected.

Why didn’t the doctor check surface antigen envelope stuff etc like last time?

So my main questions are

what kind of damage could have been done from 2021-2024? I have an ultrasound next week.

Is this chronic? Because I know they say IGG could just mean a resolved infection? But I never developed the surface antibodies.

Do I have to disclose this to sexual partners is this contagious based off these results?

And basically what are we looking at as far as life expectancy I know we could never know for sure for anyone what that is but based off the assessment of these results and me on immunosuppressant infusions inflectra to be exact. What kind of life are we looking at?

Thanks in advance I know it’s a lot just trying to get some answers and be prepared.

1094

In my opinions about your limited HBV profile results in 2024, I think that there may be explained by the following reasons.
1 your laboratory tests showed Anti HBs negative , Anti HBc positive, HBV DNA not detected . But you don’t have HBsAg result, 1.1 if your HBsAg was negative , you may be in isolated AntiHBc positive status which mean that your antiHBsAg negative could be from waning of immunity after a long time and if you get vaccinated with 1dose of HBV vaccination,it will boost your immunity or you were occult hepatitis B infection (OBI) status but it look less likely because your HBV DNA was not detected.
1.2 if your HBsAg was positive, you maybe CHB disease and immune control but most patients had detected HBV DNA or you have HCV coinfection which can suppress HBV replication, so HBV DNA can’t be detected.

1095

Thanks for the response this is all so confusing can’t wait to talk to my doctor to get some answers. Just so confused as to why they didn’t test the Surface antigen this time.