EXPLAINER: Lab results and their interpretation

Dear @availlant

Thank for explanation. I got FibroScan a few days ago. My score is 4.9 kPa ( F0-F1 )

I supposed it shall be safe with this score?

Thank

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Hi All,

So I’ve done my first 6 month check up and was told it was a liver function test. First off, if someone could give some advice on what my results mean I would be very appreciative. My doctor’s English isn’t the greatest so the conversation was a little confusing.

Also, I noticed no measurements for HBV viral DNA etc. Should I get another blood test for this or is the LFT sufficient to know where I’m at?

Many thanks :heart:

I think lab results can jump around a bit when they are that high. To make sure that it is a real change, you would need to see it remain high over a period of time. I am not sure there is any good scientific data that would be able to explain with confidence why people’s HBsAg levels can increase or fluctuate during a chronic infection. Also, clinically, it doesn’t really make a difference to your treatment.

I think all you can say with these results is that your liver is not actively inflamed. Your ALTs are in the normal range so there shouldn’t be any progression of any liver disease.

HBV DNA and HBeAg/anti-HBe levels would be useful to find out if you would benefit from antiviral treatment in future. HBsAg/anti-HBs would be useful to show if you still have Hep B or have cleared it.

Thomas

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Thanks @ThomasTu much appreciated :heart:

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Hi,

I’m really glad I’ve found this forum as I’ve been going mad trying to find answers on Google.

I’m a 33 year old female and I recently found out I’m hep B positive after routine antenatal screening. I’m pregnant with my first child and this has been a really devastating way to find out. I was born in Africa but lived in Europe since the age of 5. I don’t believe I was vaccinated as a child but I believe one of my first jobs as 20yr old required a Hep B vaccine - I think I got it then but I can’t be sure. I’ve also never engaged in high risk activities and have only ever had sex with my husband- we were in a monogamous relationship for 2yrs before marriage so never bothered to get tested. He hasn’t been tested yet so for now we’re abstaining.

These are the results I’ve been given and nothing was explained except that I’d be referred to various consultants who’ll be able to tell me more.

Could you please help me make sense of these results and what this means for me and my family.

Hepatitis B Ag Confirmation REACTIVE
Hepatitis B ‘e’ antigen negative
Hepatitis B ‘e’ antibody REACTIVE
Hepatitis B core antibody IgM negative
Hepatitis B core antibody REACTIVE
Hepatitis B DNA (iu/ml) 240

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Hi Wallflower, welcome to the community.

You have come to the right place for answers and we are glad you have found us.

You have chornic HBV infection and your HBV DNA levels are very low so it is fairly safe to assume that the infection has been around for a long time. Your very low HBV DNA levels also suggest that you have “inactive HBV” (we would need to see your liver function tests to be sure) which would not normally be treated since people with inactive HBV don’t develop liver disease.

Your pregnancy changes this. Even though your HBV DNA levels are very low, there is still the chance that you can transmit your HBV infection to your baby and this now becomes the focus of therapy for you.

You should speak with your doctor as soon as possible about the following:

Initiation of antiviral therapy with TDF (Viread) or TAF (Vemlidy) to further suppress the viral replication in your liver. These medications are safe for your baby and have shown to be effective in preventing maternal transmission of HBV.

Vaccination at birth for your baby. In cases like yours, very early vaccination in the newborn baby also is effective in preventing the development of chronic HBV infection. This vaccination will happen very early, ideally within a few hours after birth.

As you can see, there are several safe and effective options to protect your baby from getting infected.

Your husband should be tested right away. If he is HBsAg negative, he should be immediately be vaccinated.

Hope this helps.

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Thank you so much. This is the most information I’ve gotten since getting my result.

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Hello again Sir @ThomasTu @availlant @john.tavis @Joan_Block

I have completed all my labtests result today. I am respectfully asking for your knowledge about these. Im 36 yrs. old, I am 28 weeks pregnant when I performed the tests. As far as I know i was infected by birth, my mother died becuase of liver problem, and my elder sister died because decompensated liver cirrhosis. I tried taking antiviral for 1 month only and then stopped, that was year 2019.





Thank you
Jen

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Dear Jen,

Your HBV DNA is undetectable, are you currently taking therapy for HBV?

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No sir. In year 2019, I tried taking antiviral for 1 one month only and then I stopped.

When I had my HBV DNA tested, my doctor did not require me for fasting.

Should I worry about my result sir?

Jen

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Dear Jen,

It looks like you have functional cure (HBV DNA is not detectable) but you would need a HBsAg test to be sure. This is very good news for your baby as the risk of transmission of HBV is very low (as good as with antivirals). You still need to consider antiviral therapy and birth dose vaccine for your baby and vaccination for your husband. However I suspect that we can rule out HBV infection as a possible source of elevated AFP in your case.

Thomas is right that AFP becomes elevated during pregnancy and especially during the second trimester. However, serum AFP is not a good test to examine the potential for birth defects. This is normally done with AFP testing in amniotic fluid as the levels of AFP in your blood do not represent what is happening in your baby. Your result does not mean that there is a defect with your baby as most women with elevated AFP during pregancy carry normal babies. Is is possible you are carrying twins?

I suspect your doctor is well aware of this test result. I encourage you to discuss the matter further with your doctor.

Best regards,

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Dear Jen,

I am not a physician, so I recommend that you speak with your doctor about this.

However, from what I can tell (and I emphasize that I am not a medical doctor), this appears to be a very good set of lab values. No sign of liver fibrosis or spots of concern on your liver. HBV DNA is not detectable in your blood, which is really good news, especially if you are not on an antiviral drug. I agree with Andrew that getting HBsAg and HBsAg antibody tests will be very informative. In short, to the best of my knowledge, this looks like a good set of lab values for someone late in pregnancy.

I wish you a safe delivery and congratulate you on your impending motherhood!

John.

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Thank you so much for your explanation and sharing your knowledge Sir @availlant @john.tavis

Im just a little confused sir ,how come my HBV DNA became undetected, when as far as I know I was infected by birth, is it still possible that the virus will not replicate for 36 long years?

What does it mean I am likely to have a functional cure sir?

Does this mean Sir, that fasting is not really required before the blood test?..

At first, I thought my HBV DNA was not detected because I did not have fasting before I had my HBV DNA test.

I am not sure about carrying twins sir, I had thrice pelvic ultrasound, and the remarks always says that there is only single live intrauterine pregnancy in cephalic presentation.

Happy holidays sir @availlant @john.tavis
Jen

Dear Jen,

Functional cure is the recovery of immune control of HBV infection after having chronic infection. It is characterized by having undetectable HBV DNA and HBsAg and normal ALT (you have 2 out of three of these). People who establish functional cure are not infectious and go on to have normal lives without needing antiviral therapy.

This does occur in a very small fraction of people who develop chronic HBV infection.

Fasting or not has no impact on the test used to detect HBV DNA. It can be required for other tests your doctor may have prescribed.

Happy holidays to you as well!

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Many thanks sir @availlant

I have not shown my result yet to my doctor, I have not visited him yet, after I got all the results. He is in a far province. I will visit him after the holidays.

After all your interpretations about my result sir, is it best for me to start medication again? or not yet as of this moment?

Always grateful,

Jen

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Dear Jen,

Although certain NUCs like TDF are considered safe during pregnancy, their use is always considered as part of the risk/benefit analysis for your baby and recommended during the third trimester only. TDF therapy is generally introduced only when significant levels of HBV DNA are detected (> 150,000 IU/mL)

In your case, your recent undetectable HBV DNA would normally mean not introducing antiviral therapy. Again this is something you need to consult with your doctor on.

Don’t forget discussing birth dose vaccination for your baby.

Happy holidays to you as well!

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@Kinoti
I wish well in this and i will pray for your long healthy life. May God give you long healthy life.

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Hello

I have a question regarding DNA dynamics. My results are below, I also added 2016 for a reference.
I’m a bit confused that viral load changed that much in 6 month, I feel like result are not trustworthy. I had no treatment. I was going to start an antiviral treatment and now I don’t know what to do.

Could virus load change that much in such a short period ? And could it get lower without treatment ? Should I do some other tests ? how this could be explained ? Thank you, K

So I had Hep B quantity DNA:

2016 - 1.2 x 10^4 IU/ml

3rd July 2022 - 2.4 x 10^4 IU/ ml

3rd Jan 2023 - 1.3 x 10^4 IU/ ml

Hi @Selfseen ,

Are you current taking antiviral therapy?

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Hello

No, I don’t take any therapy and I never did. I was going to start it, because my viral load was 2,4 and now a bit confused about lab results.