EXPLAINER: Lab results and their interpretation

Dear @Sirbay,

These results are consistent with a chronic Hep B infection, in HBeAg-negative phase. This means your viral load is likely low because your immune system has reacted to the infected cells in your liver.

Thomas

Well are there any other test need to be done

Regular monitoring should include a fibroscan or ultrasound of your liver to find out if it is damaged.

Also, a liver function test and HBV DNA test would be useful to know if treatment is recommended.

Thomas

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That was the liver function test I did with the hepatitis b profile at 16/6/2021

Hi Thomas and Community,

I hope I am posting in the right place. If not, I apologize. I have new medical information to report.

Background
Surviving since (aka Diagnosis): March 2021
Chronic Hep B Quant: 320 (April 29, 2021)
HBV log 10: 2.505

I visited my Gastroenterologist last week and it was a positive visit. A summary:

. He told me to stop worrying about the results because he was not worried about the results. He must see this kind of thing a lot. I am worrying so much that it’s impacting my gut system and I tend to think every organ in my body is impacted by the HBV. I exercise a lot or work on breathing and I feel better – that and a nice cold can of Ginger Ale help.
. He said that all things considered, it’s likely that I may have contracted at birth (of course no certainty).
. He also said that I can be classified as “Inactive HBsAg Carrier” on this printout I gave him. He also said that this classification is associated with “vertical transmission, most common at birth.”
. He also did not recommend treatment because that could cause the virus to mutate and get worse at this point.
. He told me to focus on 3 numbers which are in the good range as of November 2020, including good liver enzymes: Alkaline Phosphatas (30), AST-SGOT (13), and ALT-SGPT (8).

Questions:

  1. Are these “comfortable” numbers or “bordering” numbers? I guess I’d like to know if these numbers are closer to barely good or closer to really good if that makes sense.
  2. Based on the stats, would you concur with my “Inactive HBsAg” classification?
  3. Overall, think I got sound advice?

Also, I had an ultrasound done and the results are:

. Normal liver size
. No hepatic masses
. CBD: 6 mm
. Mild intrahepatic biliary ductal dilatation (of course I rushed home to Google this)
. Other organs are fine
. Conclusion was other than the mild intrahepatic issue, “otherwise unremarkable examination.”

I see my primary and gastro again next week to review the results and basically get clarity on the mild intrahepatic issue.

Any insights based on the ultrasound results? How am I doing?

As always, I am continuously grateful to you and this community.

PS: I start a new executive job soon in a really different environment – the very conservative location worried my gastro doctor more than my HBV results. :grin:

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Dear Sirbay,

Thank you for sharing the screen shot of your lab results. I really appreciate seeing a column that provides the normal values so you can see for yourself. Often, doctors simply say results “look normal” but we really don’t know how normal is normal. In my non-medical opinion, it seems like there are certain degrees to what normal is. As for me, I want to be comfortably in the “normal” range instead of “barely” in the normal range.

Stay strong.

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Dear @Sirbay, your results indicate that your liver in not currently inflamed, which is a good sign. It is still worthwhile getting a liver scan or fibroscan to see how your liver is going.

Dear @hopefulone,

  1. I think your numbers are quite low and don’t indicate any ongoing liver damage at all. They don’t seem to be borderline at all.
  2. This is an old name for the phase, but yes, these would indicate that your body is suppressing the virus successfully. You should maintain monitoring so that you can catch it if the virus suddenly flares back.
  3. I think so. Antiviral treatment is not recommended because your viral loads are so low anyway. Also, the “stop worrying so much” advice is good: you’re in a low risk state.
  4. The ultrasound results look fine. Some people without any other liver disease have mild intrahepatic biliary ductal dilatation and if it’s not accompanied by obvious changes in your blood results or any symptoms, then it’s probably fine.

Hope this helps,
Thomas

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Hello I was hoping to see if you could explain a lab result to me.
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Hi @Brittneybc01,

This is a bit of a non-standard result and it’s hard to know what is actually going on.

You don’t have HBV surface antigen in your blood and you are positive for antibodies against the virus. Taken alone, this would indicate that you have either been successfully vaccinated or have cleared the virus. Either way, you are protected and can’t pass it on to anyone.

The confusing thing is the HBeAg result, which is positive. It’s highlighted a different colour, so I’m not sure what that means. Maybe it’s a borderline result, I don’t know. I would probably repeat the test to make sure it is true.

Perhaps some @HealthExperts might be able to comment? @MarkDouglas?

Hope this helps,
Thomas

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Remind me of the anti-HBc status ?

Anti-HBc = cccDNA and viral presence in the liver

Dr Gish

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Thank you Thomas!

Your feedback is incredibly helpful…and hopeful. Another question comes to mind which I should probably let go of and stop going down this path: “Do the ultrasound results support the theory that I may have still contracted at birth or perhaps much later as an adult or even more recently?”

The ultrasound results (nor your recent blood tests) can’t really give this information.

Thomas

Dear @Brittneybc01, Dr. Gish brings up a good point. It would be helpful to provide any other tests that you may have had (including Anti-HBc antibody tests).

Thomas

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The labs were drawn yesterday as soon as I get them in I will share. Thank you so much! @ThomasTu @rgish

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Dear Britney, you may also want to get a repeat of these tests in six months if they are your first HBV blood tests? It would be helpful to know if you were tested because you an exposure to the virus? Is it possible you have an acute infection that could resolve? Just wondering because of your positive HBe-antigen result… Always, Joan

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@Joan_Block Hello, I was tested due to prenatal routine testing they also added std testing this was the only thing that popped up. I’m due to give birth in 3 months and I think they just check for these things. I received more testing on Friday and am waiting for the results. When I get them in I will tag you also thank you.

Dear Brittney, thanks for your response to my questions. Yes, please do let us know what you learn from your blood tests on friday. In the U.S. it is recommended that ALL pregnant women be tested for hepatitis B. This is to make sure that if the mother tests positive for hep b, then the newborn can be protected at birth from an infection with the first dose of the hep b vaccine and one dose of HBIG (hep b immune globulin). Hopefully you will learn that you do NOT have hep b, though. Thanks again for sharing your lab results. Always, Joan

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@Joan_Block I really appreciate you reaching out. I’m very concerned and worried as I already have plenty of health conditions including mastocytosis and recently reversed type 2 diabetes with a gastric sleeve surgery. My doctor hasn’t even spoken with me yet just sent for more labs so I appreciate the people reaching out and helping anyway they can.

@ThomasTu @john.tavis @rgish @Joan_Block
Thank you all again for taking a look for me. I did find out that I was previously tested for HBV in 02/2021 and was negative. I also received my recent results this morning I have attached all labs concerning HBV. Thank you for any info you can give as I’m extremely confused and my doctor is really no help.



I removed PHI below

My opinion is: HBeAg is a false + provided that anti-HBc was negative

I can do a telemed consult if you wish more clarity

RGG