EXPLAINER: Lab results and their interpretation

Thanks for the encouragement. I appreciate it.

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Hi @Bonaparte,

Welcome to the community and thanks for sharing your story. I’m sorry about the situation you find yourself in.

The results you have posted suggest that you have Hep B, though some follow-up tests will be needed to show if you have an acute or chronic infection.

Hypoproteinaemia just mean low levels of protein in the blood. Your liver makes important proteins in the blood (in particular, albumin which is low in your case). This may mean that your liver isn’t functioning as well as it should.

Jaundice means yellowing of the skin and eyes, which is due to an increase in bilirubin in your blood. Bilirubin is a normal breakdown product that the body makes. Usually the liver filters this out, but if it isn’t working as well as it should, then bilirubin will build up in the blood.

This is why the interpretation is impaired liver function.

You should now consult with your health specialist to work out what follow-up tests to do to find out the underlying cause of this and how best to treat it. Likely that will include some additional blood tests and an abdominal ultrasound or fibroscan to find out if your liver is damaged or not.

Basically, the best way forward is to keep on top of it by consulting with your doctor.

Thomas

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I have a question about the Hep B DNA (Viral loads) results.

  1. My DNA is oscillating between “HBV DNA not detected” to “<10”. Do I need to worry too much if it’s <10? Maybe a virus is becoming stronger to put away resistance from antivirals ?

Vemlidy helped me bring down viral load significantly but now it’s not always “HBV DNA not detected”.
I do have an appointment with my consultant this month to review the latest results. Hopefully, I will get some answers.

Thank you!

Dear @pradeepmlk,

If your HBV DNA is very low, you get very close to the sensitivity of the PCR assay that is used to measure the HBV DNA value. “HBV DNA not detected” means that your value is not different from a negative value. “<10” means it is too low to accurately count how many copies there are in that sample. It is normal for lab value to waver like this, even if nothing changes. For example, if a very low sample is run several times, it can result in “HBV DNA not detected” in some reactions and “<10” for others. I don’t think that this is anything to worry about.

Hope this helps,
Thomas

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Thank you, Thomas sir! have a good one.

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Thank you so very much for this information.I
Diagnosed recently but I have no symptoms and my liver is still okay with no inflammation
Am waiting for my second test after three months . I don’t know when I got infected and I don’t know whether it’s chronic or not how can I tell this?

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Hi @kiria,

There are a couple of ways to check if it is an acute infection or not:

  • Test after 6 months to see if you are still positive for HBs: if you are, then it is a chronic infection
  • Test for HBc-IgM and total anti-HBc: if the first is negative and the total anti-HBc is positive, then it is likely a chronic infection.

Most chronic HBV infections are acquired in early childhood or as newborns. It may be impossible to find out when or how you were exposed to begin with.

Thomas

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Thank you so much
I appreciate it

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Hello to all members of the forum,

New results after 2 years with TDF;

Hbsag 10.4 positive
Hbsab ?
Hbeag negative
Hbeab positive
ADN HVB not detected
GPT 20 UI/L
GOT 18 UI/L
GGT 16 UI/L
Platelets 195.000

Results Year and average treatment:

Hbsag 1381 positive
Hbeag negative
Hbeab positive
ADN HVB not detected
GPT 19 UI/L
GOT 16 UI/L
GGT 16 UI/L
Platelets 191.000

Waiting for the hepatologist to see what he tells me.

Greetings to all of you

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Dear @Luis,

Thanks for sharing. It looks like a good result with your HBsAg levels coming down quite a bit and your HBV DNA levels still being undetectable. Congratulations!

TT

Hello everyone. First of all, you guys are doing great work by building community and helping people.

I had an exposure 4 months ago. It has been 3 months since I have symptoms (Stomach pain, Urine with bubbles and small white particles, skin gets red when i touch and sometimes rashes, I also feel pain in right side groin sometimes) , I had done test after 4 weeks which was negative.

I have just done HBsAg test and result was negative (more than 4 months post exposure). Today I read an article which says HBsAg may or may not be shown during acute window phase. So my question is: After how much time can we consider HBsAg test negative result to be conclusive? Sorry for my lack of knowledge but I am overwhelmed with the information I am reading.

Also, Ultrasound for abdomen can be helpful in detection in this case?

Thanks and

Hi ethan,

Welcome to the community! I have been with hepbcommunity since it began and I am always overwhelmed by all the information, so you are in good company… lol

I just wanted to say hi and welcome you and let you know that one of the @HealthExperts will be responding soon.

Welcome again,

-Paul

Hi Ethan, my understanding is that a first exposure to the hep b virus can take 4-6 months to clear from your body. Therefore, if one tests HBsAg negative after 6 months, then I would expect you are negative. Four months could be a bit soon to be definite, but again, it’s likely you could be negative. To be conservative, I would recommend getting tested again after 6 months. In addition, you would want to be tested for the full hep b panel and if the results are the same as below, then it would be indicate that you’ve recovered from an exposure to the hep b virus. Hope this helps and keep us posted. Always, Joan

  1. HBsAg negative (nonreactive)
  2. HBsAb or anti-HBs positive (reactive)
  3. HBcAb or anti-HBc postive (reactive)
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Hi Ethan
Welcome to out community and be assured of our support. I agree with what @Joan says save to remind you that exposure to hep b does not translate to obvious infection and I doubt if you can have symptoms of a deases which you test negative.
Further, I think your concern is on the incubation period for hep b virus. This can only be answered by an expert and they are not scarce here.i am also eager to be informed appreciately here although I have read it is 3 months.

Kinoti

Hi Ethan,

Yes I agree with Joan,
Repeat full serology (as above) at 6 months to be sure, as otherwise it can be difficult to interpret.

Kind regards
Mark Douglas (Infectious Diseases specialist)

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Hi Paul,
Thanks for your warm welcome. And I surely believe now that I am in good company with everyone trying to help others.

Hi Joan,
Thank you so much for your help. I will do hep b Panel test after 6 months as you have told.

Kinoti & Mark Thanks for the help. And yes Kinoti, it’s likely that I am not infected but the reason I am cautious is all other test results (HIV & Urine Panel for STI) were negative. So I want to be sure as I am feeling some symptoms. Thanks for your kind words.

My greetings to everyone

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Dear Thomas Tu and members.
As always helpful.
Please help me interpret this.

LIVER: There is minimal increased liver size measuring 17.5 cm and hyperechogenicity in the liver parenchyma, with loss of the highly reflective edges of the peripheral portal vein and not appear intrahepatic portal vein. no Ascites, and no mass lesion noted.

AFP is 18.
HBV DNA less than 20IU/

AST (IU/L) 41.5 reference range 5–49

ALT (IU/L) 35 IU/ML with reference range 5–46IU/ML

Platelet Count (109/L)
Result:
Fibrosis 4 (FIB-4) Score 1.43

I am extremely worried with increasing AFP.
Please advise.
This result is today.

I recently got tested positive for Hep B. After that we did couple of followup tests. Here are the readings

HEP B SURFACE ANTIBODY - Indeterminate
HEP B SURFACE ANTIGEN - Positive
HEP B CORE AB,TOTAL IGG IG - Positive
HEP B CORE ANTIBODY,IGM - Negative
HEPATITIS B DNA LOG IU/ML 1.301
LOG10 HBV IU/ML 20

Please help me with the following

Do I have Chronic Hep B from the above results
Am I infectious to others currently
Are there other tests that can help to understand how long i have been having this

I have got appointment with a GI next week to do followup and discuss treatment options.

I have got appointment with a GI next week to do followup and discuss treatment options. Please help me understand this more.

Dear @Wadani1,

I think we have discussed your AFP results in the past and there doesn’t seem to be a clear upward trend, given your previous results (12 just before this test and 15 before that). Some studies have suggested a normal range is <20 ng/mL (Relationship of hepatitis B surface antigen to serum alpha-fetoprotein in nonmalignant diseases of the liver - PubMed and https://www.pnas.org/content/pnas/81/12/3869.full.pdf). Given you are getting ultrasounds as well, I think you are doing the best in terms of monitoring for any liver cancer.

Dear @chirajkumar74,

Welcome to the forum and hope you find the support you need here.

These results are consistent with you having chronic Hep B (more than a few months). Your virus load is very low, so the risk of infection to others is also low, though theoretically possible. There aren’t really any other tests you can do to find out how long you’ve had the infection, it could even have been from birth.

Hope this helps,
Thomas

Thanks for the response. I will be doing more tests next week after my GI appointment will share to get inputs from the group.

Is there any significance with Hep B Surface Antibody being Indeterminate. When the doctor called the lab said when they did the test 1 time it was positive and the next time it was negative, they repeated the tests multiple times and everytime the result was different.

Does this indicate anything?