EXPLAINER: Lab results and their interpretation

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515

Hi there I’m new here from the uk !! I have some questions please @ThomasTu

March 2020 I did a finger prick blood test that was positive for Hep b surface antigen

I then went straight to my dr and he had the following labs performed with the following tests with results

Hep b surface antigen x 2 NEGATIVE
Hep b surface antibody NEGATIVE
Hep b core antibody NEGATIVE

He then told me I didn’t have hep b so I left this as I felt fine

I then had covid in feb this year with right upper pain and lots of other issues and was worried about hep b so I had the following done again

Hep b surface antigen NEGATIVE
hep b core antibody NEGATIVE
Hep b DNA NOT DETECTED

do I am unsure what is causing this pain ! I have had 3 liver function tests with one that had raised ALT once but has since come down to normal levels the last 2 times

Can you shed any light or help at all please

516

Hi Kinoti,

Your results are consistent with HCC but a liver biopsy should be done to confirm.

Any other symptoms? Also a complete blood work should also be done.

Good luck…

517

HI Beneallace 1984 , welcome to the forum!

It really looks like you do not have HBV infection but also that you have not been vaccinated. I strongly advise you to get vaccinated for HBV at your earliest opportunity.

Like many other respiratory viral infections, moderate to severe disease from SARS-CoV2 infection can be associated with transient elevations in liver enzymes which self resolve and do not cause liver complications after resolution of infection. My guess is that this is the cause of your liver enzyme elevation.

Best regards,

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518

Ha @availlant
Thanks for your timely response.
I am well aware of HCC but would wish to hear from you the options available for me.
Well, that’s where I am and the best in life is to accept what one cannot change. The mass has not affected in any place in the liver nor the surrounding organs.
I needed to prepare enough for my exit and more so because of my family, a wife and three young children.
Thanks again.
Kinoti

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519

Hi Availlant
You wanted to know if I have any symptoms. No, I just gone for routeen monitoring.
My blood work us remained the same for over five years. LFT, only GGT is elevated at 89.
What is interesting is last year my doctor said I had multiple rounded echogenic deposits, which he said was steatosis S1. This time there is non a part from that mass.
My fibroscan reads 6.8 KPa from last year’s 7.0 KPa
Kinoti

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520

Hi @Caraline, sorry to have missed responding to this question. I think there are several factors that can lead to this (e.g. other drugs you are taking), and that really needs to be seen in context with your medical history. Perhaps some @HealthExperts could comment though.

Cheers,
Thomas

Hi @ethan,

This result would indicate you don’t have hep b. It would be helpful to get an anti-hbs test to see if you’re protected against hep b. If it is negative then you should get a course of vaccination to protect yourself from any future exposure.

Regarding your other issues, this is really outside the expertise of this community and it is best to get another in-person medical opinion, if you don’t feel like you’re getting helpful answers.

Hi @natti,

Raised liver enzymes do not indicate that you have HCC, they mean that there is liver inflammation. This can be a good sign (your body is fighting off the virus), but can become a problem if extended over many months to years. Increased liver enzymes have been reported by others starting on antiviral therapy and in many cases lower back to normal without any symptoms, but it is important to keep having your regular blood tests to keep track.

Dear @12345678,

While you are right that is high, the HBeAg levels can change quite a bit in a short period of time based on the person’s immune response to the virus. I haven’t seen data on whether the level does match up with the speed at which HBeAg becomes negative, though.

Dear @Beneallace1984,

Welcome to the community and thanks for sharing your story. I agree with @availlant and your tests are consistent with you not having Hep B. There are other causes of right upper quadrant pain (see Upper right quadrant pain) that perhaps you should investigate.

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521

No comments about this from a clinical point of view, as this needs to be confirmed before saying anything really. However, I wanted to say I’m very sorry to hear about your situation, @kinoti, and I am wishing for the best outcome for you in the near future. I really appreciate the level of engagement you’ve had in this community and we can support you through this tough period as you have others.

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522

Hi. I’m sorry to disturb again but I’d like to discuss my test results. Prior my last visit to the hospital, I was told to carry out some tests which included HBV DNA and HBcAb IGM core antigen and scan which I did.
But before then, when I just found out about status, I did some test the result goes thus:

  1. Hbsag- +ve
  2. Hbsab- -ve
  3. Hbeag- +ve
  4. Hbsab- -ve
  5. Hbcab- +ve
    Also, I did liver function test the results
    TP- 8.9
    ALB - 4.3
    TB - 0.82
    CB- 0.35
    AST- 33
    ALT-34
    ALP-37
    These were the results.
    This was about 2 months ago.

The most recent test I carried out goes thus

  1. HBV DNA [viral DNA] - undetectable
  2. HBsAg- +ve
  3. Antibody to hepatitis B surface antigen- -ve
  4. Hepatitis B envelope antigen - -ve
  5. Antibody to hepatitis B envelope - +ve
  6. Antibody to hepatitis B core antigen - +ve
  7. IGM antibody to hepatitis B core antigen - -ve

Tumor biomarkers
Afp- 3.10

PT test- 12.0secs ( 8.9-10.9 secs)
INR- 1.27

PCV - 40%

FBC test
WBC- 4.8×10⁹/L
N- 37
L- 49
M- 05
E- 08
B- 01
Plt- 225×10⁹/L
MCB- 80FL
MCH- 26pg
MCHC- 33g/DL

Abdominopelvic USS

  1. The liver is normal size [ LS 14.9cm]
  2. Gallbladder and pancreatic bed are Normal
  3. Spleen is at the upper limit of normal span 12.1cm in LS dimension
  4. Both kidney are normal size
  5. No calculus seen RK- 11×4.6CM LK- 12.3×4.9CM
  6. Postrate gland is normal
  7. Urinary bladder is within limits.

I did HCV and HIV tests which came out negative.

These are the results in details. I wouldn’t know how to interpret these, so I do not know what they suggest about my condition.

But I’m worried with the fact that my doctor didn’t prescribe any other drug than hepalab forte which I’ve been on for about a month now.
I don’t know what to do as I’m worried about my medication and I feel I’m not doing enough to control my situation.

I feel pain around the upper right parts of the stomach sometimes when I lean on that part and sometimes at my knee joint while walking. Most doctors I talk to say it’s my minding that is Messing with me, I find if hard believing it’s that.

I wouldn’t know if her method of treatment is the best or I should look for a new doctor to treat me better.

kindly advise and interpret these to me.
I am to revisit the hospital in November, but I’m to carry out another liver function test before then so I can be diagnosed based on that.

Plus, does hepatitis B envelope antigen status change that quickly within a short time, because, comparing the test results in July with that of August, one is positive while the other turns out to be negative. It’s a little unclear too.

Thank you.

523

Dear @Adedeji_Joseph,

Thanks for sharing your situation. Your most recent blood tests show that you are in the immune control phase, where you body is successfully suppressing the virus infection. This is linked to good health outcomes and lower risk of liver disease progression.

The thinking behind you not being on treatment is that your HBV DNA is already undetectably low. The medications work by lowering HBV DNA, so if there is no way to lower it any more, then it is not worth taking the treatment.

Regarding your pain, it may be driven by something that is unrelated to your Hep B (see the discussions here: Upper right quadrant pain, Titling feet and pain on the righ shoulder blade and I am feeling a sharp pin pain in my stomach. Why am I feel thay).

Regarding the HBeAg status, that can change quite quickly, yes.

Hope this helps,
Thomas

524

Hi Thomas
Thanks alot. This group has given me alot of inspiration and foresight.
My friend has connected me to an oncologist who says I have to take a biopsy next week before she can confirm anything.I pray all goes well otherwise living my 5years and 18 months old children cannot be celebrated. My wife is very down and I really pray for her strength.
Kinoti

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525

I’m sorry to hear Knoti- I also appreciate your involvement and support you have shown others on this forum. I hope you receive some good news , we are here to support you.

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526

Hi albasil808
Thanks a lot for giving a part my back. I happy to have friends like.
I am also delighted to hear that my little contribution in our community has never in appreciated.

Kudos you have lifted my spirits.
Kinoti

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527

Thank you @ThomasTu.

528

Kinoti, my thoughts are with you in this trying time. It’s not easy to feel like this. What wasn’t expected

529

Hello my brother,
I am just reading this… I can only wish you well. The most important thing is that there is only soo much we can control.

May you please consider a second test just to be sure of things?.
Regards

530

ThomasTu and other experts, another question sorry to be swamping you! ALAT and Asat are constantly on the rise despite Tenofovir, they recently reached their highest at 3 and 2 times the norm respectively. Y-gt is rising as well although it is still in the norm but there is a clear tendency. My doctor isn’t worried and I feel he thinks I am overreacting and expecting too much. I am on Tenofovir for 10 months and the viral load was not detected after 2 months of starting the medication (maybe earlier but we tested two months after the beninning of therapy). Clearly it is not hep b that is causing liver damage. What can I do? How can I convince him to start testing? Or is it best to wait? Thank you!

531

Thanks alot.
I have connected with an oncologist and she recommended I do a biopsy which I will tomorrow.
Those who are believers, kindly continue mentioning me to your creator.
Kinoti.

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532

Hi @ThomasTu

Thanks alot for Your swift response. I’m glad my body is able to fight this virus, I hope I’m able to get rid of the virus totally. On that note, do you think just liver supplements is what I need this time or some extra stronger treatment would be better?

Thanks for the links too, the discomfort on the upper right side of my belly is just persistent. I hope it can just stop. I always feel like there is a bug on that side. Though, it causes no pain, but it’s weird too.
Also, what could have cause the pain at my knee joints?
I just wish I can get answers to my worries

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533

Tsbs
Thanks for your comforting words. I must admit that I haven’t slept well for some days. I am unable to look at my children and make funs with them.
But, I am healing but by bit.
Kinoti.

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534

I hope the 2nd opinion will be better. For almost a month since my diagnosis of fatty liver grade 3 coupled with CHB, I haven’t been sleeping well too. I live in constant dread of death because each day my symptoms is getting worse. Couldn’t even tell my wife the truth. I told her I have no symptoms. Dreading what my biopsy result will be.