EXPLAINER: Lab results and their interpretation

Kindly see my results…is it high or not…? Should i start treatment…or if it is low viral load there are chances it become more in future…? Kindly reply

Hi Surbhitiwari,
Sorry for the delayed response to your question. One of the science experts will be able to help answer your questions about your lab results soon.

Hi @Surbhitiwari,

As mentioned in the other thread, in the absence of any liver function abnormalities, advanced fibrosis/cirrhosis, or family history of liver cancer, people with this result would fall outside of treatment criteria.


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@ThomasTu I’ve been reading through the forums, I am chronic Hep B carrier since I was a kid, currently age 38 and my latest HBV IU/ml is currently at 34,200. Previous result on 8/27/2022 was 7,190 and prior to that was less than 10 in 2021.

I do not have any liver function abnormalities in my blood test, and ultrasound is all normal. no family history of liver cancer.

Do I need to start the life long meds or keep monitoring ?

Hi @Mr_Lin,

Welcome to the forum, this is something that you’d have to talk to your doctor about and consider the positives and negatives. The consensus guidelines would suggest that you can consider treatment if you are HBeAg-positive: “Patients with HBeAg-positive chronic HBV infection, defined by persistently normal ALT and high HBV DNA levels, may be treated if they are older than 30 years”


After crazy nightmares of lots of tests, I finally found something today. I had unprotected exposure around 1.5 years ago. As I had no clue which disease it could be, I had to do multiple tests multiple times (Almost all STIs including HIV DNA, Urine PCRs and what not…multiple times). I kept having symptoms despite negative results…I remember couple of incidents 6 months ago when if I even just barely touch anything I would get bruise (even bleed). I can’t even describe. I had a strong feeling that it has to be related to liver. I know I should have done Hep B Panel test but since I had multiple negative HbsAg, instead of Hep B Panel I did HBV DNA & HCV RNA test. I barely had money to these tests and hence I skipped Hep B Panel because past exposure or vaccine was not in my priority at that time. After all negative results and multiple doctors assuring me there was no chance that I could have any STI. Though during this time, we found out my Vitamin B12 was very low and D2+D3 was insufficient and CD4 counts were very low (around 270, Ref Range 400-1500). I took injections for B12 and I started feeling somewhat better (The random pains were gone). However, I still kept having problems and I did more tests.
HbcAb-Total: Positive
HbsAb: >1000mIU/ml
Aparantly this is good news as it shows that I have resolved acute HBV infection. However, I still keep having problems
1. Digestive Problems. sometimes stomach making weird watery noises and feels strange/uncomfortable. I can clearly see lot of undigested food in poop. sometimes It burns very bad and blood comes out. The poop color is pale (Sometimes very dark surprisingly). I can also see yellow particles there. The poop looks so different like it’s dry.
2. Skin Problems: I have red red dots on palm. I can see blue & purple veins through palm skin. I can see red lines on my feet below ankle ( like Telangiectasia) and blue veins too. I don’t get bruises by touching like before but still I easily can see marks on my skin when I hold a bag.
Everything is so crazy. Though I feel relatively better than before, I just keep wondering if I have HbsAb >1000 ml/UI, why I am not feeling normal again? I know it for sure that everything changed after that exposure and I have very strong feeling, I am not fully recovered after 1.5 years despite the test results. I am so confused and feeling low. I would love to connect with someone over facebook. On one hand I am happy that I have immunity, but on other hand I am wondering till when I will keep having problems. Not knowing the exact problem can make you restless.

P.S. HbsAg Negative at 3 weeks, 3 months, 11 months and 12 months post exposure
LFT normal at 12 months & 18 months post exposure.
HBV DNA & HCV RNA: (-)ve at 11 months post exposure
Whole abdomen USG normal at 11 months post exposure
HbcAb Total: (+)ve Just received results today
HbsAb: > 1000 ml/UI Just received results today
Fibroscan: Yet to be done.

Sorry for the long post but it’s hard to understand that precise diagnosis can be so difficult…Be it Occult HBV, Mutants, Cold Chain maintenance sample blood or Low limit detection of Assay. Fibroscan or even Liver Biopsy have own limitations. Has someone ever known a case where problems persist after 1.5 years of exposure and after developing Surface Antibodies? I wish I can connect with people beyond this forum…Facebook probably? So grateful to find this community :slight_smile:

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Dear @ethan,

Thanks for sharing your story, and sorry that this is so stressful for you.

Regarding your test results, they are consistent with clearance of an acute infection. I am not sure what the results were of your HBV DNA test, but if they were negative, it would not be considered occult HBV.

Regarding your symptoms, they are not commonly associated with Hepatitis B (occult or otherwise) so is outside the experience of this forum. It would be best looking to see if there are other causes and talking to a specialist about these issues (e.g. a gastroenterologist about your digestive complications).

Hope this helps,

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Am finding it difficult to upload my lab test but I think I can write it here for some interpretation. HAV-Ak =positive HBs-Ag=negative. HBS-Ak =<5. HBcAk=positive. HcvAk=negative. And this is also the elevated on the liver function test. GPT=67+ GoT =356+ . I hope can get some interpretation here

Dear @Kwaku_Gyamfi_boateng,

I am assuming you are in a German speaking country and that Ak means anti-koerper (or antibodies, in English).

Your HBcAb is positive, suggesting you have been exposed to HBV.
Your HBsAg is negative, which suggests you either are not currently infected and/or are clearing the virus.
Your HBsAb is negative, which suggests you are not protected from the virus and have not been vaccinated.

Here are some potential explanations for these, in addition to your high liver function tests:

  1. You may have been exposed to HBV recently and your body is in the process of clearing the virus.
  2. The HBcAb is a false positive and you have never been exposed, and something else is causing your liver inflammation.

I would think that it will be important to continue to go to your doctor for follow up tests to get a clearer picture of what is happening.

Hope this helps,

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Thank you very much Thomas. Although I couldn’t upload the photos of the test for you to see all but your explanation have let me understand. I was transferred to gastroenterologist last week and he took couple of my blood and told me he want to make some tests again and so I have an appointment to see him next two weeks again. But I also want to know why I don’t have hbeag on my hbv profile. I hope I am understood well

CAR-T cell Therapy wonderful, how fortunate you are. I hope you can start treatment asap. Unless one has an open wound others have no idea how complex the dis-ease is.

I’ve been battling with Woldenstroem Macroglobulinemia with Bing Neel Syndrome and was on “a compassionate dose” until recently, I stopped due to certain individuals stalking and intervening access to the medication, and the side effects the last few months were unbearable, extreme infections, swelling, and pain.

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Hello everyone and thomas

I went to a gestrologist and he did some test and he again di my hbv dna and my dna this tym came 13000 something…kindly explain me my reports and should i start treatment? And it will affect my newzeland visa . As my fibroscan and liver ultrasound is normal…should i attach my these reports to my visa application or wait for the embbasy to req. Furture test from panel hospitals.
Kindly suggest me something i’m really confused.

Dear @Surbhitiwari,

You need to discuss with your liver doctor as to whether treatment is suitable for you. There are many factors that need to be considered that we do not have access to here and needs a medical history and physical examination.

As to whether it will affect your visa, again, this is something you need to confirm with your migration agent. Myself, I would not necessarily attach lab results to your application unless they are asking.


Dear @ThomasTu thank you for clarifying this, as I said I had previously resolved HBV that demonstrated a reactivation in pre-CAR-T bloodwork for my lymphoma (HBV DNA = 71 IU/mL, no elevation of ALT). I started daily entecavir 0.5mg promptly and now have undetectable HBV DNA and will go ahead with the harvest of my t-cells pre-CAR-T in 2 weeks.

My doctors don’t know if I will need a washout from entecavir pre-harvest and have left the decision in my hands. I don’t think Entecavir should have a major effect on lymphocytes, however, as transduction of the T cells is done via a lentivirus (which could be inhibited by entecavir), so as to be sure that there is no drug around, I am considering stopping the entecavir for a week before apheresis (t-cell harvest) and resuming the entecavir as soon as the apheresis is done.

However, I don’t want the Hepatitis B to become an unmanageable problem, do you think it would recur given a week off? And to what degree might it return? Also, how long does it take for 3 months of Entecavir to leave the system approximately?

Thank you for your thoughts, my country is quite small and ill-informed in this area!

I am a Hep B patient since November 2021 when I was diagnosed with Acute Hep B and after six months the result reads chronic Hep B. I have been on treatment for seven months and I have undergone three LFT tests but my doctor never explains to me whether I am making a progress or not. Kindly help with the interpretation of this result.
I remain grateful.

Dear @JohnLangston,

What a great question. I have to say, leaving the decision to you is a bit of a big responsibility…

I cannot say what the risk of reactivation in this case would be, perhaps some @HealthExperts (@simone.strasser, @MarkDouglas) could provide some comments.

To answer your question, my understanding is that Entecavir has a fairly short half-life (~24 hours - Entecavir pharmacokinetics, safety, and tolerability after multiple ascending doses in healthy subjects - PubMed), so a week or 2 should mean that the drug is cleared from your body.

However the other point is that entecavir is fairly specific to HBV. In vitro work has shown that entecavir is more than 3000-times as active on HBV compared to HIV (BMS-200475, a novel carbocyclic 2′-deoxyguanosine analog with potent and selective anti-hepatitis B virus activity in vitro - ScienceDirect), which is what the lentiviral vectors would be most similar to. Happy for @john.tavis to check my working out on both of these points.

Hope this helps,

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Dear @Alhaji_Swarray,

It is difficult to see your progress because we have only 1 lot of results. These are only liver test values too, and they don’t show your HBV status or HBV DNA.

The results here are consistent with low/no liver inflammation and normal function.

Hope this helps,

Thank you,

I appreciate your clear explanation and for looping in other ( @simone.strasser
and @john.tavis ) for their comments.

I look forward to hearing the consensus on whether I will need a washout from entecavir pre-CAR-T harvest.

All the best,


Dear Experts,

Can Hbsag Quantitative have three different readings like mentioned below in a short period

15th Jan : 16209 iu/ml
18th Feb : 8135 iu/ml
21st March : 10824 iu/ml

All of these tests done at same lab.


Hello everyone,

I am 34, recently diagnosed with hepatitis B.

My recent test results:

HBsAg: positive
HBeAg: negative
HBcAb: positive
HBeAb: positive
Serum albumen: 46
Total bilirubin: 4
HIV: negative
HCV: negative
ALT: 42
ALP: 52
GGT: 26
AFP: 53
Liver MRI shows 8mm lesions

Other tests normal

Please advise.