EXPLAINER: Lab results and their interpretation

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482

Dear HepBWife,

“Not on medication currently”…did you husband ever take antiviral medication previously for his HBV infection?

Depending on where you live, an ALT of 43 is close to or within the normal range. Given this and your husband’s normal liver findings, his HBV DNA of < 2000 IU/mL is consistent with inactive HBV. Treatment is not indicated for these kinds of patients provided that they continually maintain this control of infection in the absence of therapy.

When he sees the doctor next, it would be nice to have quantitative HBsAg and HBeAg/HBeAb tested.

Best regards,

483

Thanks for the reply. He has never had any treatment.

484

Hello im from togo! I have been tested hep B positive since 2001!
Im. Getting treatement.
Nice to mert you!
Regards!

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485

Hi Latta, welcome to the forum.

Let us now how things are going.

Best regards,

486

Hi HepBWife, this fact makes inactive HBV more likely.

Good luck at the three month visit.

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487

Hi latta
Welcome to the community and feel free to share your experience with us. This might help.
Kinoti

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489

Hello,
Asbo said before! I’m on treatment and no longer a sick person!
Before the treatment, I have knee pain, frequent headache, feeling dizzy…
Now I’m well!
I’m advising you to go on treatment and get a good life conditions. Do not to drink alcohol…
Regards.

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490

Hello people, sorry if I am not doing this right, or not positing in the right section. New here. And somehow I stabled on this blog, and now I am curious.

Anyways, I am planning to get some more specific Hepatitis B blood work test done soon. But with my attached CMP, CBC, LIPID panel results, etc., do you see anything that might show some signs of Hepatitis B?

I couldn’t upload the pdf. So I have a link to the pdf document.

Thank you so much!

491

Hi @Bigjoetx

I’m not a physician, so please take comments made by a physician over what I write.

None of these tests are specific for HBV, but the bilirubin, ALT, and AST report on general livery health. Your bilirubin is a bit high, but the ALT and AST are both normal. The ALT & AST results say you are unlikely to have ongoing extensive inflammation in the liver. I don’t know how to interpret the bilirubin value, but there are many things that can elevate that value that are unrelated to HBV.

The normal primary test for HBV is HBsAg (the viral surface protein). More detail about a potential infection comes from tests for HBV DNA, HBeAg (a variant of the viral core protein), HBcAg (the viral core protein), and antibodies against HBsAg, HBeAg, and HBcAg. Your doctor will know which tests to order.

I wish you the best.

John

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492

Hello,

Can you look at me result,
my doctor told me that is very good, what our community thinking about it?

  • HBsAg - positive (+)
  • hbv dna - 305 IU/ml
  • alt - 14 U/l
  • afp - 4.48 ng/ml
  • ast - 25 U/l
  • ultrasound - is good, without changed

I have 35 years, I vegan, dont drink alcohol etc, exercise every day triathlon, tennis etc.

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493

Hello, I’m Claire, truly grateful to find this caring, informative community. Thanks @ThomasTu @Joan_Block and all who make this place.

Briefly my situation: I’m 43, female, born in US, healthy lifestyle except for stress. Despite lots of reading I’m still confused about my situation, partly bc I’ve had results in two places and no doctor has spoken to me yet. I’m hoping someone can help me sort through what I’m facing and what to ask for, in light of gaps in care and my brain! I have an abdominal ultrasound scheduled for 8/12 following raised ALT/AST levels and some basic HBV tests that indicate exposure- after that I get lost.

This ‘started’ when I had a 102 fever in mid June, with aches and chills and stopped having to urinate until I drank buckets of water. Next week developed cough that is mostly gone now. Was not Covid as very sure as can possibly be these days.
-I thought it might be a flare bc in 2020, when living elsewhere, I got diagnosed with early/mild rheum condition- has been pretty stable since medication.
-I saw my doctor here for possible flare. He ordered panel and my relevant results were:
June 7:
ALT:196 U/L.
AST:94 U/L.
ALK Phos: 168 UL.
Albumin 4.8 g/dL.
Bil: .6g/dL.

July 29
HBVsAg: negative
HBsAB: positive (quant 443.82)

Albumin 4.3 g/dL
Bil: .3 g/dL
Bili, Indirect - one component out of range
Bili, Direct <0.2 mg/dL

I was astounded and frantically went back to 2020 bloodwork because I know rheum had been thorough but never said a word. Sure enough found:
June 2020:
HBcAB - not detected
HBsAb - 723.2 immune >9.9 IU/L
HBsAg - not detected
ALT: 13 U/L
Alk phos: 58 U/L
Albumin 53 U/L

I understand the very basic of antigen (active infection) versus antibody (past exposure/vax) but have read so many posts now my head is spinning about what tests say you have HBV and then if it is chronic etc. For instance, I saw ‘Hepatitis B core antibody (HBcAb or anti-HBc) - this tests for an exposure to the hep b virus. If it is [+] then a person has been exposed the hep b virus. If it is [-] then the person has not been exposed to the virus.’ But the HBsAb says I have exposure, yes?

If I have HBV, was this a possible ‘reactivation’ of the virus- my immune system has been off since Covid in Jan? Or maybe autoimmune? If I need more blood testing what might I focus on?

Thanks so very much for any help.
Claire

494

Dear @Leonk, welcome to the community. Your lab results show that you have a low viral load, normal US and normal ALTs. This is linked with good health outcomes. Great that you are so active, well done and keep up the good work!

Dear @ClaireLake, welcome to the forum and thank you for sharing your story. I’m sorry to hear that you have been so confused about your lab results and haven’t found any explanations.

The lab results you’ve shared indicate you’ve been vaccinated against Hepatitis B (HBsAb-positive) and that you haven’t been exposed to the virus (HBcAb-negative). You can therefore be pretty confident that you haven’t had a virus reactivation because there’s no virus there to reactivate!

Hope this helps ease your worries,
Thomas

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495

Oh wow! Yes it does relieve me greatly (zero memory of getting this vaccination though…!). Thank you so much.
Quick follow up- the raised ALT etc during that infection- that indicates liver inflammation? Do you have any suggestions on why that might have occurred?

Claire

496

Great to hear, @ClaireLake! Not a problem.

Raised ALTs can happen with other infections as well: we have previously talked about COVID infection causing this even without liver involvement (e.g., How are you dealing with COVID? - #63 by ThomasTu). It is likely true with other acute diseases as well.

Thomas

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497

Hi ancious1, I would love to connect with you. I too have a coexistence of HBsAg and hbsab and was vaccinated as a kid. Please send me a message so we can connect

498

Hello, John, thank you so much for your response. I really appreciate it! I went and did some tests, please see the image attached. I am wondering if I need to do more tests to confirm?

Thank you very much!!!

image
image1238×1854 421 KB

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499

Dear @Bigjoetx,

These results indicate that you have never been exposed to Hepatitis B (both HBsAg and HBcAb are negative). It would also be good to get your HBsAb levels tested to see if you need a vaccination to help protect you from any possible future exposure.

Hope this helps,
Thomas

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500

Thank you @ThomasTu . Much appreciated.

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501

Hello, please help me to understand the ultrasound results.

February 2020
Right lobe: 130 mm
Left lobe: 58 mm
Gallbladder: deformed

May 2020
Right lobe: 124 mm
Left lobe: 52 mm
Gallbladder:61x27 mm, walls 2-3mm

July 2020
Right lobe: 119 mm
Left lobe: 42 mm
Gallbladder: 56x24 mm, walls 2-3 mm

May 2021
Right lobe: 117 mm
Left lobe: 65 mm
Gallbladder:50x18 mm

March 2022
Right lobe: 115 mm
Left lobe: 70 mm
Gallbladder: 65x18 mm

502

Hi @Bigjoetx,

I’m pleased to see that your serology indicates you are not infected with HBV. I fully agree with Thomas that getting your HBsAb levels tested would be a good idea to see if your vaccine is still protecting you. If the antibody levels are low, you can get a booster vaccination to push them back up. Your doctor can help you with those things.

John.