EXPLAINER: Lab results and their interpretation

Hi @PuallyHBV. Thank you so much for taking the time to explain this in detail. Now I have a much better understanding.
I wonder how the HBIG assessment is positive, since I have never been given HBIG. At least not that I am aware of.

Hi @ThomasTu. Thank you so much for the response. This is good news.
At these viral levels, am I still infectious? And are there any medication options to lower the viral levels even more or completely get rid it it?
Thanks again.

Dear @Max, not clear what you specifically want to know, but this shows that the level of HBV DNA in your blood is very very low.

Dear @t202309, welcome to the forum and thanks for the questions. I actually had not heard about this before and can’t seem to find anything on this. Perhaps some @HealthExperts can comment on the difference in HBV DNA PCRs between serum and plasma samples.

Dear @brnie80, at <10IU/mL the risk of transmission is very very low, and would essentially require you to donate a large amount of blood to someone for them to be at risk. No medications would be recommended to lower this even more. There is currently no approved medicine that would completely get rid of it.

IU/ml of serum or IU/ml of plasma is the same…………

PL

Prof. Pietro Lampertico, MD, PhD

Full Professor of Gastroenterology

Chief, Gastroenterology and Hepatology Division

Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico

Director, CRC “A. M. and A. Migliavacca” Center for Liver Disease

Department of Pathophysiology and Transplantation

University of Milan

Via Francesco Sforza 35

20122- Milan

Italy

Phone +390255035432

Fax +390250320410

Email pietro.lampertico@unimi.it

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Thank you for the replies. Now looking at these two reports, can I conclude that the viral load went up 3 times ( from 459 to 1394). What can I do to ensure it doesn’t continue going up.

On the other report it shows that I need medication when it goes above 2000IU/ml and on the other report it’s shows that I need medication if it goes above 5000IU/ml.

I am really confused.

Dear @ThomasTu thanks for responding, I don’t understand how much IU/ml is in my blood und what is mean referenz-bewertungsbereich NEGATIVE?

Dear @t202309,

The notes at the bottom (that mention 2000 IU/mL and 5000 IU/mL) seem to be talking about genotyping and drug resistance, not treatment. My impression from this is that if the person taking the test was on therapy and their HBV DNA levels were above this limit, then the proper procedure would be to test the virus DNA for drug resistance mutations (or find out the viral genotype). The decision to treat would be based on viral loads >2000IU/mL (as per EASL guidelines -https://easl.eu/wp-content/uploads/2018/10/HepB-English-report.pdf) among other factors. I wouldn’t worry too much about the difference in cut off that the different labs are suggesting as they should not be applicable to your case.

There aren’t any proven ways specifically to keep your viral load low, but it is recommended that you give your body the best chance to fight the virus off by sleeping well, eating well, and getting regular exercise.

Hi @Max,

The test can only quantify levels down to about 10IU/mL. If it is anything lower, then it is hard to give a specific value, but it can still detect whether there is HBV DNA present or not. So essentially this result is saying that you have between 0 and 10 IU/mL. The reference level refers to what a “normal” result is. In this case, a completely negative result (not between 0 and 10 IU/mL) is the unremarkable result.

Hope this helps,
Thomas

Hi. Family iits a pleasure once saying hii. Had my recent blood tests and this came out seemingly with high figures that kept me worried and sacred more especially after developing nausea, body itching and abnormal pain at the right hand said of the abdomen.
Kindly waiting for your interest interpretation


Dear @opa,

Your ALT levels are mildly elevated, suggesting some liver inflammation. This may the the cause of your symptoms.

The doctor has calculated your APRI score, which is a way to see if you have liver damage. From my calculations, the score is low (~0.2) which does not indicate any significant damage.

Hope this helps,
Thomas

Thanks @ThomasTu and other health experts here. Your quick response gives great hope to many hopless patients here especially those not yet on medication.
Just forgot to add that my dr recommended for other health test given the symptoms I have and turned out that I am pylori positive. Could this be real cause of the pains and other symptoms or ALT alleviation has something to do with this.
Thanks for your usual positive response

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Indeed, h pylori infection could explain the pain and is apparently occasionally associated with increased alts. But it is best to keep monitoring as your h pylori is being managed to see if the alts and other symptoms normalise before being sure.

All the best,
Thomas

Hello everyone,

This is my first post on this forum, and I would like to seek the expertise of the community regarding my recent blood test results, specifically related to my liver function.

In my recent full blood test report, I noticed that my white blood cell count (WBC) is below the normal range, measuring at 3.4. Furthermore, my neutrophil count falls below the normal range, measuring at 1.4, and my platelet count is also below the normal range, with a measurement of 185. It’s worth mentioning that in my previous blood test results, my WBC has consistently remained within the normal range. In my full blood test conducted in November 2022, my WBC was 5.4.

Upon discussing these results with my doctor, they advised me to undergo a Peripheral Blood Film test due to my low WBC. The results indicated “White cells show relative monocytosis.” I have not experienced any noticeable symptoms thus far. But, the unusual result makes me worry.

I have attached the screenshots of my 2022 blood test results and the recent blood test results for your reference.

Given these findings, I am growing increasingly concerned about the health of my liver. Therefore, I kindly request the experts in this forum to review my case and provide any advice or insights that could help me better understand the significance of these results. Your expertise and guidance would be greatly appreciated.

Blood Test Result on 2022

Blood Test Result on 2023

Thank you in advance for your time and help.

Best regards,
John

Hi @John,
Welcome to the platform. I hope you take some time to check out all other discussions on here.

Yes, your WBC and neutrophils are low. Do you have any current infection or are you recovering from a recent infection? That could cause your numbers to fall as WBC helps our bodies to fight infections and other ailments. Your liver function numbers are normal ALT/AST 20, 20 in 2022 and 24, 23 in 2023. Both within normal range, which makes me doubt that your lower WBC numbers has anything to do with your liver. Your platelet count is normal for both years. The range is between 150-400 and your 2023 results is 185 but was 230 in 2022. Some of these numbers can fluctuate from time to time, but 185 is still within the normal range.

Try having a conversation with your provider to dig further into what is causing you to have lower WBC and neutrophil count. Share your concerns with the provider about this, maybe he/she will need to do further testing on this.

I hope this is helpful. Others will chime in on this as well. Best, bansah1.

Hello I am Edd from Ghana. I’m a chronic Hep B carrier and as far as I know, was born with it. almost everyone in my extended family has it.
At the moment I take Tenovovir Alafinamide 25mg proscribed by my doctor.
Please can you explain these labs to me

Thank you very much for this informative platform.



Hi @Edd ,
Welcome to the platform and you take some time to look/view other discussions on here. Your results are great, HBV viral load was not detected (undetectable) meaning it is too low in your blood to be measured. It is a good thing. Your ALT/AST are also normal. The range for AST is 0-40 and yours is 33. ALT range is 0-41 and yours is 28. As you can see they are both within the normal range.

The medicine is doing its job, keep up with your treatment and follow-ups with your provider. You are doing a good job here. I hope this is helpful. By the way, Bonti was my dads middle name. That is just by the way. Best, bansah1.

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Dear @john,

There doesn’t seem to be anything in your blood results indicating any active liver damage given the normal values in the liver function test. The reduced levels of neutrophils may be caused by another condition, which might be outside the expertise of this group.

Hope this helps,
Thomas

Hello @Bansah1
Thank you very much for taking the time to explain this in detail. Now is have a much better understanding.

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hello @ThomasTu and @Bansah1
I keep getting sharp pains and some itching on my right side under the ribs i have done a CT scan and everything is fine.
Please can you recommend any test for me to do.
The thing is, any doctor i go to see does not make me do any other labs once they hear of my hep B history. The just assume it my liver that’s acting up and so the keep prescribing pain medication for me
i have been managing this discomfort for over 5 years.

Sorry for the late response. There are other things aside from the liver that can cause sharp pains on one’s side. Bloating or having more gas can cause pain as well. Some pain medicines might have side effects so check on that as well. Do you have any ulcers? Do you have any yellowing of your eyes, skin, etc? Have you had a dewormer recently? Some of these worms can cause one to itch. It is hard to tell exactly what is going on if it’s been going on for over 5 years. I can’t think of anything else, but maybe Thomas can chime in here as well. I hope you find some solutions soon. Best, Bright.

Indeed, @Bansah1 has mentioned, there can be many causes of upper right quadrant pain and itching. It is worth looking at the other threads on this to see if anything reported by others might be relevant to your condition: Upper right quadrant pain, Titling feet and pain on the righ shoulder blade and I am feeling a sharp pin pain in my stomach. Why am I feel thay ).

Thomas