All my LFT parameters were normal except ALP which 9 units above normal range.
The doctor, whom I later found out is not a specialist asked me to take Lamivudine, I read online about Lamivudine, then I opted for Tenofovir.
Recently I went to a different Lab and repeated the Profile with different result.
HbeAb and HBcAb are now reactive.
When I enquire from the Lab, he explained to me that the last two markers are indirect test, that is if the T-band of the test strip is negative, it means the marker is reactive, he showed me the test strip’s manual and he was correct. I later found out that the previous test was actually like the later but the laboratory didn’t study the manual of their test kit.
My problem is, is it right to start medication at that time? Because it seems I was an inactive carrier. But now that I have taken Tenofovir for six months, if I stop it would I have a flair or my immune system will continue to suppress the virus?
Any HBV DNA or HBsAg results before and or after starting TDF?
For HBcAb, there are two tests, one for IgM and one for IgG. Which is yours?
HBeAg seroconversion (HBeAb positive) is a positive step on therapy for HBV.
You were right to choose TDF over lamivudine; the latter is much more prone to drive the development of drug resistant HBV. Please do not stop your TDF therapy until you (with our help) have figured out your situation better.
Thank you so much for your prompt response @availlant .HBV DNA was not done, HBsAg was reactive, he capitalised on slightly elevated ALP to put me on drugs. I had no complaints of abdominal pain or fever of any type. My latest test result showed that my HBeAg is non-reactive and HBeAb is reactive, the previous one was HBeAg Non-reactive and HBeAb-Non-reactive. The latter could not interprete the test correctly and was corrected in the former. My Doctor relied on the latter and slightly elevated ALP to put me on drugs.
Here are my other blood test results.
Bilirubin, total mg/dL = 0.7
alkaline phosphatase IU/L = 95
Albumen, g/dL = 4.6
Platelets x10e3/uL = 176
ALT (SGPT) IU/L = 40
AST (SGOT) IU/L = 31
I have set up an appointment to perform an ultrasound or fibroscan.
So given that HBsAg was reactive, there was clearly active viral replication going on. Most treatment guidelines advocate for withholding NUC therapy until evidence of liver disease is present. However this approach does deal with the problem of accumulating integration of HBV DNA and the development of liver cancer. When NUC therapy is started too late, there is very little impact on preventing these aspects of liver disease. So you should feel good that you started NUC therapy and that you are taking TDF.
When you are consulting with you doctor next, you should consider a quantitative HBsAg test. Your HBeAg seroconversion demonstrates that some aspects of immune control have recovered (but not all). If you become HBsAg negative (qualitative assay) or < 0.05 IU/mL (quantitative assay) for a period of at least 6 months, your gastroenterologist can consider the removal of NUC therapy.
Should we be advocating to our doctor to go on TDF therapy even with a low virus load? Mine fluctuates between 20-1000 but no raised ALTs and one time I did HBsag quantitative - it was 15,000 iu. What you said about accumulating DNA integration now has me worried because I don’t meet current treatment guidelines but the doctor told me that because my viral load was low there was no point in taking medication to suppress it when my immune system already is and medication won’t bring down the HBsag.
Please enlighten me on my results. These are my HBV DNA results from the 4 last years. Tests were done in different countries so they’re written in different ways. What do they say?
You have touched upon the problem with current treatment guidelines: they were largely written before the role integrated HBV DNA was playing in HCC was well understood. HBV DNA integration is progressive even with low viral titers.
My personal opinion is that any patient who does not self resolve their initial HBV infection (this usually happens within 6 months of the initial infection) should be placed on NUC therapy (ETV, TDF or TAF) until they become HBsAg negative.
Thanks for question. HBsAg is an indicator of a chronic infection. HBeAg is a measure of how well your body is reacting to the virus - it goes negative when your immune system has cleared much of the virus from your liver.
Your HBV DNA levels show a moderate level, meaning your risk of transmission is also moderate.
These sorts of results can happen due to false positives or if the situation is in a state of change (e.g. your immune system is starting to get rid of the virus and it is going from HBeAg-positive to HBeAg-negative).
Hello I’m worried about some lab results I got at a Plasma donation center… They are part of routine screening and I donated twice but I think the results only apply to one donation specimen.
HBSAG Positive SCREENING
HBSAG NEUT (CONFIRM) Negative 24 HOURS LATER
I also was tested for STDs a couple weeks before this donation with urine and blood because of my last relationship was not a relationship to say the least and found out it was not just me he was having a “relationship” with. I was also screened as part of routine OB/GYN during my pregnancy last year. All these tests were negative for everything. And this timeframe applies for about a year of testing.
I was told at first it could be a false positive but they deferred me and placed me on the NDDR and basically I just felt like they really didn’t understand how this news affects me… Not only because of the result but what it means to me as far as even being put on a list like that they even said they may have to respond to public health agencies… And I am upset and confused. I’ve tried to wait for an appointment with my doctor I can’t. I just don’t know what to think about this…
Thank you for any information you can help me with…
Hi Anastasia
Welcome to the community and I pray and hope you will get the support you need. Meanwhile, remaining composed knowing whatever the results, you have a life to live like any one of us
Kinoti.
Thanks for sharing your story. That sounds really frustrating and I absolutely understand you being upset. These results are consistent with a false positive case. I’m not sure if @Joan_Block@Suwang88 or @chari.cohen could reply with some better context here (they are from the US and I’m in Australia, so I don’t really know the system) and whether there’s any way of getting off the NDDR and perhaps get better peace of mind about your blood results.
My husband has alt of 43 and HBV DNA of 1157. How do i interpret these results. Not sure how severe this is? All other scans including fibroscan say normal liver size and reflexivity.
Doctor want bloods again in 3 months. Is this normal?
I don’t usually respond to technical questions about labs and leave that for the experts. Until one of them responds, you might want to give a little more information.
Is this your husband’s first time having these labs done? If so, then you will probably have to wait 6 months to determine if it is an acute or chronic infection. Maybe 3 months is enough time to determine this? One of the experts can define this better.
Providing data like HBeAg, HBeAb, HBsAg, to name a few, would be helpful for the experts to give you more insight.
As a layperson, from what you have provided thus far, the numbers don’t seem very bad, especially for someone new to HBV. Also, with the info you have provided, it’s possible that this is an acute infection, which would be a better diagnosis than a chronic infection. Again, I am just trying to ease your mind some, as the numbers you provided don’t seem too high. Although, I understand that ANY number seems too high. If you can provide any more data, that would be helpful, one of the experts will respond soon. Until then, please don’t stress too much and try to ease your husband’s mind about it, as increased stress won’t be helpful for him… or you.
Again, welcome to this community and I hope for the best possible outcome for your husband.
-Paul
You can read about the terminology of labs at the top of this thread. Here is a link to the first post:
Indeed PuallyHBV is right, the more information we can get the more helpful we can be.
Also please answer the following:
How is your husband feeling?
Is this the first diagnosis of HBV your husband has had? Is he receiving any therapy for his HBV infection?
If you don’t have HBcAg IgM and HBeAg / HBeAb, please ask your doctor to perform these tests. They will help diagnose the stage of HBV infection your husband has.
The fact that your doctor wants to see your husband in three months is a good sign that they are being proactive in the care of your husband.
Thanks both - he feels fine no symptoms though he does get itchy skin at times. His condition is chronic (at least 15 years). Not on medication currently.