The most pressing concern are the lesions in your liver and the elevated AFP. These may signal the presence of liver cancer (but these lesions could also be benign). You should have an IMMEDIATE follow-up with your doctor to discuss these results and how to proceed.
During this visit, you should also discuss antiviral therapy for your chronic HBV infection - this normally includes a test (HBV DNA) to see how strong the viral replication is.
Am I correct in understanding that a Hepatitus B core IGM antibody test would/could come back negative for someone with chronic HBV?
Sorry-- newby here and I’m having difficulty understanding all the various tests results.
Newly developed HBV infection will first drive the production of IgM core antibodies. About 6 months later, with the establishment of chronic infection, core antibodies switch from IgM to IgG.
To total HBcAg antibodies or IgG HBcAg antibodies tell us that at some point you have been infected.
IgM HBcAg antibodies tell us that this infection is recently acquired.
Perhaps your doctors were referring to achieving HBsAg loss. This is indeed rare in the natural course of HBV infection.
HBsAg can fluctuate over time as the turnover rate of HBsAg in the blood is very fast (within days) although I would agree that the speed of fluctuations in your case are somewhat unusual.
Did you have your HBV DNA tested as well? This would give us some extra clues.
I will try to understand your post as best as I can, as I cannot see the pictures you are uploading. Low HBV DNA, low HBsAg, and lower fibrosis are good signs. Being on a diet will help decrease steatosis over time, but this may take many years as will recovery of the liver fibrosis.
It’s hard to interpret these as I do not speak the language nor do I understand what the numbers for the HBsAg means (it could be international units, but it could also be fluorescent units the lab gets from the machine). I do not think I can comment at all on these.
Welcome to the forum and thank you for sharing your story.
Yes, these are confusing results and not “textbook”. Probably the first thing the doctor will suggest is making sure that the HBsAg result is not a false-positive and repeat it. You are correct that if you have been infected, either anti-HBcAb (either total or IgM) should be positive. If your anti-HBs is positive and protective (more than 10 mIU/mL), then that is even more suggestive of a false positive HBsAg result.
I understand it is easier to say, but you have little to worry about right now until you know the full story. No matter what, there is a community here that can help support you through whatever you’re going through.
If your test is positive for hepatitis B or C, we phone you and ask you to come to the hospital. We then repeat the hepatitis test to confirm your diagnosis.
Sometimes the result is not clear. In this case, we must see you again to repeat the test.
If it is a chronic infection (exposure since more than 6 months ago), total anti-HBc should be positive.
If it is an acute infection (exposure since within 6 months), anti-HBc IgM should be positive.
If the exposure has occurred within 4-8 weeks, it is possible that HBsAg is positive and anti-HBc is not yet positive.
As far as I know, these mutant variants are generally associated with HBsAg and not HBcAg. I’m not sure they would explain your negative anti-HBc results.
It might also be worth clarifying what was meant by “Pre Hepatitis B Vaccine (Hep B Core Ab)” (e.g. does this mean total anti-HBc) and what your levels of Anti HBs were.
If there is confirmation in follow up tests, it may be worthwhile to get a referral to someone who is a specialist in the area.
Hello! I’m confused about my results and my doctor has forwarded them along so to someone else so I’m waiting to hear back. My hbsag test was reactive but the neutralization test came back non confirmed? What can cause a false positive like that?
Welcome to the forum and thanks for sharing. I’m not entirely sure what the “neutralisation test” means. It would be worth clarifying and getting a copy of the results so we can provide you with more information.
It’s great to hear that you were able to get another test that shows that you are HBsAg-negative, which is more consistent with all of the other test results. It is most likely that the original hospital results were a false positive.
Could you please help me the the meaning of my report in brief?
HbsAg: Positive
HBV DNA: 1233.85 IU/mL
Anti HCV: Negative
IgM anti HEV: Negative
Anti HBe: 0.01
HBeAg: 0.37
HIV: Negative
ALT: 36.9
AST: 34.1