Dear Marian,
It’s hard to interpret these as I do not speak the language nor do I understand what the numbers for the HBsAg means (it could be international units, but it could also be fluorescent units the lab gets from the machine). I do not think I can comment at all on these.
Thomas
Dear @Tusername1,
Welcome to the forum and thank you for sharing your story.
Yes, these are confusing results and not “textbook”. Probably the first thing the doctor will suggest is making sure that the HBsAg result is not a false-positive and repeat it. You are correct that if you have been infected, either anti-HBcAb (either total or IgM) should be positive. If your anti-HBs is positive and protective (more than 10 mIU/mL), then that is even more suggestive of a false positive HBsAg result.
I understand it is easier to say, but you have little to worry about right now until you know the full story. No matter what, there is a community here that can help support you through whatever you’re going through.
Hope this helps,
Thomas
Hi @Tusername1,
Great questions:
Both of these are not common according to the scientific literature, but that doesn’t mean they do not happen. This is why confirmatory/repeat tests are done, as per information about this program: Hepatitis testing in the emergency department (A&E) - Overview | Guy's and St Thomas' NHS Foundation Trust
If your test is positive for hepatitis B or C, we phone you and ask you to come to the hospital. We then repeat the hepatitis test to confirm your diagnosis.
Sometimes the result is not clear. In this case, we must see you again to repeat the test.
If it is a chronic infection (exposure since more than 6 months ago), total anti-HBc should be positive.
If it is an acute infection (exposure since within 6 months), anti-HBc IgM should be positive.
If the exposure has occurred within 4-8 weeks, it is possible that HBsAg is positive and anti-HBc is not yet positive.
As far as I know, these mutant variants are generally associated with HBsAg and not HBcAg. I’m not sure they would explain your negative anti-HBc results.
It might also be worth clarifying what was meant by “Pre Hepatitis B Vaccine (Hep B Core Ab)” (e.g. does this mean total anti-HBc) and what your levels of Anti HBs were.
If there is confirmation in follow up tests, it may be worthwhile to get a referral to someone who is a specialist in the area.
Hope this helps,
Thomas
Hi @tusername1,
Yes, i would think that the pre-vaccine anti HBc would be total anti-HBc.
Taken as a whole, it would really be worth getting a repeat of your HBsAg test, given the following:
If the clinic is not willing to repeat the test at your insistence, it might be worth asking your GP to refer you.
Any @HealthExperts have any comments here?
TT
@Tusername1 Push for a repeat surface antigen test. Lab errors and mistakes happen more than doctor’s offices and labs want to admit.
Hello! I’m confused about my results and my doctor has forwarded them along so to someone else so I’m waiting to hear back. My hbsag test was reactive but the neutralization test came back non confirmed? What can cause a false positive like that?
Hi @Bbeale,
Welcome to the forum and thanks for sharing. I’m not entirely sure what the “neutralisation test” means. It would be worth clarifying and getting a copy of the results so we can provide you with more information.
Cheers,
Thomas
Dear @Tusername1,
It’s great to hear that you were able to get another test that shows that you are HBsAg-negative, which is more consistent with all of the other test results. It is most likely that the original hospital results were a false positive.
Thomas
Hi Experts,
I would like to have a deeper understanding of my results:
Age: 32 Years Old (First diagnosed at 23 years of age)
Sex: Male
AST: 12 U/L
ALT: 20 U/L
Total Bilirubin: 0.7 mg/dL
Albumin: 4.4g/dL
Alkaline Phosphatase: 81 U/L
HB e Antigen: Non-Reactive
HB e Antibody: Reactive
HBV DNA IU/ML: 26 IU/ML
HBV DNA LOG10: 1.42 Log 10
Alphafeto Protein: <3.0ng/mL
I would greatly appreciate the help!
Hello Thomas,
Could you please help me the the meaning of my report in brief?
HbsAg: Positive
HBV DNA: 1233.85 IU/mL
Anti HCV: Negative
IgM anti HEV: Negative
Anti HBe: 0.01
HBeAg: 0.37
HIV: Negative
ALT: 36.9
AST: 34.1
Can someone explain to me what this actually means? My blood tests are starting to come in. Still waiting for liver tests
Hi!
Can someone confirm I’m interpreting my test correctly;
I believe this means I’m immune, right?
Thank you!
Dear @nzkhan90,
Welcome to the forum. Your results are consistent with the immune control phase of chronic Hepatitis B. The low HBV DNA and normal ALT levels are good indicators that your body is suppressing the virus well. Your low HBV DNA levels also indicates that you have low chance of transmitting the infection to anyone else, but there is always a risk.
My reading of the inclusion criteria of the B-Well Study (ClinicalTrials.gov) suggests that you meet inclusion criteria, but you would need to visit a doctor and perhaps have more tests to make sure that you do not meet the exclusion criteria.
Dear @anonymous36, it’s hard to say what’s going on with your HBeAg and anti-HBe without the units. What specific information you want to know from these results?
Dear @Penguin50, this says that the level of virus in your blood is very low.
It shows you probably have been vaccinated. To be sure you’re immune, you should have your antibody levels checked to see if they are above 10mIU/mL.
Thomas
Dear Experts:
Please explain the findings from two ultrasounds done in March of this year:
Ultrasound of complete abdomen: Coarsened hepatic parenchymal echogenicity. No evidence of fatty infiltration. No focal lesions, cysts or masses. The sagittal dimension of the liver is 15.2 cm.
Ultrasound of elastography: Mild to moderate fatty infiltration of the liver. Increased echogenicity noted within the portal triads which can be associated with hepatocellular disease, hepatitis or possibly a normal variant for this patient.
Does the echogenicity distinguish between liver fibrosis and liver steatosis? The liver ultrasound finds no evidence of fatty infiltration, but the ultrasound elastography finds mild to moderate fatty infiltration.
And what does “increased echogenicity within the portal triads” mean? Which other organs are affected by this? Is this a natural progression of hepatitis B despite the treatment of Vemlidy since 2019? The mild fatty infiltration was noted in a 2020 ultrasound report. Prior to that year, the findings were normal. So I’m thinking it has progressed to a moderate degree. The fibrosis score is a normal Metavir score of F0.
I’m 5’4",105 pounds, cannot afford to lose 10% of my weight. I eat healthy, exercise, don’t drink. What more can I do to halt the progression of the fatty infiltration? How serious is the fatty infiltration?
So interesting to see peoples are hard working to find cure for hepatitis-B infection
Dear @Tehminbrown,
My understanding is that elastography (e.g. Fibroscan) will give 2 scores:
Ultrasound isn’t a very sensitive measure of fat accumulation in the liver, so that might be where the differences come in.
I’m actually not sure what “increased echogenicity within the portal triads”, and it doesn’t quite make sense to me.
Fatty liver can happen independent of HBV. Regarding treatment, this is something that you’d have to talk to your doctor about. It sounds like you’re doing the right things and it can take some time to correct the fatty liver. Many people (on average 1 out of 3 people) live with fatty liver and don’t know about it because they don’t do the tests like we do due to our Hep B care.
Thomas
Hi! Thank you for the reply. The neutralization test is considered a confirmatory test. The results are attached here!
Unfortunately, I can’t upload photos. Here are the results copy and pasted.
TEST 1:
HEPATITIS B SURFACE ANTIGEN W/
REFLEX TO CONFIRMATION
Hepatitis B Surface Antigen
Your Value: Reactive
Standard Range: Non Reactive
Reactive Specimen considered repeatedly reactive.
HBsAG Neutralization Reflex Confirmatory ordered.
TEST 2:
Component Results
HBSAG Confirmed Neutralization
Your Value: NOT CONFIRMED
Confirmed Positive: Specimen confirmed positive for HBsAg
Not Confirmed Positive: Specimen repeatedly reactive but not
confirmed.
The presence of HAg cannot be confirmed with
neutralization.
This may be due to the presence of a nonspecific reaction
(false positive) in the specimen. If clinically indicated, the
patient may be evaluated for other serological markers of HBV
infection such as total anti-HBc or IgM anti-HBc, and/or that
the patient be reevaluated for the presence of HBsAg in 4 to 6
weeks.
Hi, everyone! I posted a little over two months ago and I am back a little less panicked than I was before, thanks in large part to the information in this community. I’m still waiting to schedule an appointment for my liver ultrasound, but I was finally able to get the results of my bloodwork:
Based on the results above I was hoping you would be able to answer a few questions:
Thank you so much to all of the researchers and medical professionals supporting and educating us through this! Your help is really invaluable.
Thank you, Thomas. I have an appointment with the doctors next week. It seems I get different results depending on where the ultrasound and the Fibroscan are done. The only consistent finding is that the kPa is in the F0-F1 range. So I guess there is some truth to it. But doesn’t fatty infiltration leads to scarring as well?
