EXPLAINER: Lab results and their interpretation

My understanding is that there is a chance that your HBeAg will become negative and that the reduction of levels is a good sign. I am just not aware that there are any good numbers of the probability of such a case given your case.

Thomas

Greetings community,

My partner recently tried to donate blood and was flagged as having Hep. B. It came as a complete shock to us both.

Since that time, he has seen his primary care doctor and had blood work done. Results are below. The wait time to see a specialist is long, so in the intermediate, we are hoping to understand what exactly the following results mean (other than he is positive).

Results:

-Hep B. DNA Quant = 1,458 IU/mL
-Hep. B DNA LOG10 = 3.16 log IU/mL

Some of our questions include:

  • Is he a carrier? Is it chronic?
  • What do the results mean? I’m sure one needs additional lab work or imaging to get a complete picture, but in general, how is this looking?
  • I tested negative for it, and we’ve been together for years. I’m not vaccinated prior, but just received my 1st shoot of 3!. Is it accurate that the higher the viral load, the more contagious one becomes? Is it just because his viral load is low? I’m lucky? Something different?
  • What does the quality of life look like for someone with Hep. B?

Thank you for any input anyone has! This is a scary time.

Dear @Aria_Wrenn,

Welcome to the forum and hope you find the help you need here. Yes, long waits for the specialists are par for the course and it can get pretty anxiety-inducing. I hope you are able to support each other through this stressful time.

To answer your questions:

The blood results that you’ve provided can’t answer this question. Your partner would need a anti-HBc (IgM) and anti-HBc (total) test to find out. A recent infection (within a few months) would generate a positive anti-HBc (IgM) and anti-HBc (total) test; a chronic infection would only be positive for the latter.

This is a relatively low virus load, which is generally linked to better outcomes. However, as you say, additional tests (e.g. Liver function tests) should be carried out to confirm this.

That’s great that you found this out and are safe. Your suggestions are reasonable.

For people who maintain monitoring and get treatment when necessary, for the most part quality of life can be on par with people without HBV infection.

Hope this helps a bit,
Thomas

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Hello @ThomasTu

I recently got my tests done and my results are showing decreasing viral load trend
Nov 2022- 16100 iU
Feb 2023-5050 iu
May 2023- 3710 iu

My ALT, bili, AST all within limit.
I do have hbeag negative CHB with mutant strain.
My last fibroscan on nov was 5.5kpa but my HbsAg came out to be higher than 25000iu
Do i need to be worried about it?
Also my decreasing viral load means anything here?

I am really worried and want some guidance if i should start treatment considering the high HBSag.
My doctor said to see me back in nov 2023.

Please advice

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Hi @ThomasTu, experts.

Can you please explain this to me?

I order this test:

This is the result

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Hi @Gokul,

One of the experts will have answers about your results shortly. Until then, I just wanted to welcome you to the community!

-Paul

Dear @GodisGood,

This is good news, it shows that your body has cleared the HBV surface antigen from your blood: consistent with viral clearance.

It is important to make sure that this is a sustained loss and maintain monitoring as suggested by your doctor (e.g. another blood test in a few months’ time), but it is very promising!

Congrats!
TT

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Dear @Gokul, please note the best practices for posting your test results - IMPORTANT: Best practice for posting lab results.

These results suggests that there is some liver inflammation because your ALTs are higher than normal. If this remains high, antivirals are usually recommended to prevent further liver injury.

Dear @Ash_Malhotra,

Your low fibroscan score is good news and is consistent with an uninjured liver.

High HBsAg isn’t in itself harmful, it just give an indication that the virus is present in the system. It sometimes gets tested when considering if the body is close to clearing the virus (it is low when this happens).

Lower viral loads can come because your immune system is clearing virus-infected cells and stably low levels is generally linked to better health outcomes.

Hope this helps,
Thomas

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Dear @ThomasTu,

I wanted to express my heartfelt thanks for your invaluable suggestions. I will certainly make sure to adhere to best practices when posting the results next time.

Thank you @PuallyHBV for your support.

Best regards,
Gokul

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Hello all , i have been infected by hep b when i did test for embassy in aguat 2022 and after 8 month i did hepi surface antigin test it is negetave ahtbdose it mean

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Hi @lemlem,

Sorry to hear you were diagnosed with Hep B. I am not exactly sure what this means because I am not one of the experts. Maybe you only had an acute Hep B infection and it resolved itself. Is this the only test results you were given? It might help the experts to have more data.

-Paul

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Dear @lemlem,

As mentioned by @PuallyHBV, the loss of HBV surface antigen usually indicates an acute infection (or clearance of a chronic infection). This is great news and if this is stable over time, then it is an excellent outcome for your liver health!

Thomas

@lemlem

Hello, When you had the test in August before it became negative. Did you have any symptoms throughout the 8 months? And if yes, what was it?

I tested positive 3 weeks ago and I was told to wait it out and test again in 6 months. So I want to be sure about my case too. Thank you

hello yes i was positive before 8 months and have symptoms of rush in my neck and chest and other like tiredness and all related … i am not sure acute or chronic since i know when i test for embassy, but i did the test before one month in between 7 month difference they told me it is negative , i never mention in i posetive in my second i just ask them to test me full tets and all negetive , so yes you have to wait 6 to 7 month and do the test again

@lemlem oh okay. Thank you so much. Did you have jaundice? Like yellow eyes or skin throughout?
I’m seeing rash and I have feeling of malaise and feel tired. I guess that is one of the symptoms.

yes all except jaundice, but I think symptoms vary depend on the person, do not worry just take rest and food properly sure will clear since you are young or more .

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@lemlem thank you. So much.

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Hi paullyHBV
I am doing well, out of hospital with lenvatinib (12mg)for my HCC pulmonary metastasis.
I have gone through alot of threads and I am unable to trace one that you give your story which I remember reading a while ago… How you have survived against all medical predictions. It’s very encouraging especially for me would you mind emailing me at: anthonykinoti04@gmail.com
My doctor found that I have features of cirrhosis which were not there before. Your experience will go along way in enlightened and encouraging me.
Kinoti

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Hello Experts,

Can u pls help me with the difference in following tests;

  1. Hepatitis B Surface Antigen Confirmation
  2. Hepatitis B Surface Antigen Quantitative (CMIA)
  3. HBV DNA Qualitative (Real Time PCR)
  4. HBV DNA Quantitative (Real Time PCR)

Are tests 3 and 4th practically same with only difference being the quantification ?

Regards,

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Hi @ThomasTu ,

Thanks for your response. Mine was an acute case hence the clearance. Should I still make sure that it was a sustained loss?

Also, if I may ask, is it safe to get vaccinated against hep B? Or natural immunity is already enough?

Additionally, is it also wise to vaccinate against hep A and vaccinate against flu? What other vaccines can you recommend? I know my mistake now, and that is not safeguarding myself. Cheers!

Regards,