Dear @anonymous39,
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.
With best regards,
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.
HI @Jjcourage
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.
Best regards,
Dear Experts, @availlant @ThomasTu
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.
Regards,
Red spots in palms, Red lines in legs, Light colored stool, Severe Constipation, Vitamin D deficiency. Aren’t these related to Liver ?
Hi @rjktgj ,
Yes HBsAg can wobble like this.
Are you on antiviral therapy? If so which one? For how long?
Best regards,
Hi Mr Avvailant,
I am not on any antiviral therapy.
I was told by doctors here that Hbsag would never change hence I asked.
Regards
Hi @rjktgj,
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.
Best regards,
Hepatitis B Foundation I have hepatitis B detected by chance (degree 2 steatosis was an indication) 18 months ago, the first HBV DNA test 64 (positive) and Aghbs quantitative 441 and after 6 months I repeated the tests and they came out like this: HBV DNA < 10 and Ahhbs 212 and after another 12 months HBV DNA came out 11 . Otherwise, all routine blood tests are good. Only steatosis and the Fibrotest are problematic.I have hepatitis B detected by chance (degree 2 steatosis was an indication) 18 months ago, the first HBV DNA test 64 (positive) and Aghbs quantitative 441 and after 6 months I repeated the tests and they came out like this: HBV DNA < 10 and Ahhbs 212 and after another 12 months HBV DNA came out 11 . Otherwise, all routine blood tests are good. Only steatosis and the Fibrotest are problematic. Aghbe negative and antibodies quantitatively positive anti-hbe 7. I have never taken antiviral hepatitis B, only hepatoprotective (silymarin, vitamin E, vitamin B complex). The liver is not homogeneous. Grade 2 steatosis. The size of the right lobe of the liver was 140 mm 6 months ago and now it is 120 mm, so the liver is no longer so enlarged, I kept a diet. An opinion, please… 17 months ago (2021) I had fibrosis 0.11 and inflammation of the liver 0.21… and now in 2023 practically the percentage by which the inflammation of the liver decreased, exactly 0.9, all this percentage was added to the fibrosis in 2023 … in conclusion, the percentage that decreased in liver inflammation also increased in liver fibrosis. Can someone explain this to me? It is normal? I expected the fibrosis to decrease because I kept a diet! Is AFP good 6,
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9 ?
Dear @MARIAN,
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.
Hope this helps,
Thomas
OK, this seems to show that your liver has minimal fibrosis, so it is not damaged. These are all good signs.
On 09.08.2022, I did routine tests, anti-hbs antibodies were negative (0.5), the day after collecting the tests, I had the misfortune of getting the covid SARS-CoV infection and they admitted me with monoclonal antibodies for covid SARS-CoV, after about 30 days (29.09.2022) I repeated the anti-hbs antibodies and they came out quantitatively 3, unfortunately the HBsAg is still positive. In conclusion, I have the coexistence of HBsAg and Anti HBS antibodies.
Dear Marian,
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.
Thomas
Dear @Tusername1,
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.
Hope this helps,
Thomas
Hi @Tusername1,
Great questions:
Both of these are not common according to the scientific literature, but that doesn’t mean they do not happen. This is why confirmatory/repeat tests are done, as per information about this program: Hepatitis testing in the emergency department (A&E) - Overview | Guy's and St Thomas' NHS Foundation Trust
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.
Hope this helps,
Thomas
Hi @tusername1,
Yes, i would think that the pre-vaccine anti HBc would be total anti-HBc.
Taken as a whole, it would really be worth getting a repeat of your HBsAg test, given the following:
If the clinic is not willing to repeat the test at your insistence, it might be worth asking your GP to refer you.
Any @HealthExperts have any comments here?
TT
@Tusername1 Push for a repeat surface antigen test. Lab errors and mistakes happen more than doctor’s offices and labs want to admit.
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?
Hi @Bbeale,
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.
Cheers,
Thomas
