EXPLAINER: Lab results and their interpretation

Hi @hepb1,
You are correct about the increase in your viral load. It looks like there have been a steady increase here since 2020. Your ALT number is up a little in November 2023. If your doctor recommends it, I will go ahead and start treatment. You don’t want to wait until severe damage is done to your liver. Bringing your viral load down will certainly help. I hope this is helpful, Bansah1.

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I agree with @Bansah1’s interpretation. Your doctor feels you fall within the treatment guidelines and would benefit from therapy. Tenofovir is one of the 2 best drugs for HBV (the other is Entecavir, and the 2 drugs are essentially equally potent). Tenofovir is extremely well tolerated in almost everyone and is usually taken as 1 pill once per day (follow your doctor’s prescribed dosing pattern). Your doctor knows your case the best, and if s/he recommends starting Tenofovir, then that is a good option for you.

I wish you the best.



Please I need better understanding of this results
HBsAg - Reactive
HBsAb - Non Reactive
HBeAg - Non Reactive
HBeAb - Reactive
HBcAb - Non reactive
Pls should I take medication. And can I spread it to my sexual partner or not?

Dear @Basheer_Sani,

Welcome to the forum and hope you get the support you need here.

These lab results are consistent with a chronic infection with Hepatitis B (assuming the HBcAb results are for IgM and the anti-HBc total antibodies are positive).

Regarding medication, the current guidelines require more tests to determine if you would be eligible for treatment. These additional tests include liver function tests (including ALT levels) to see if you have active liver injury, fibroscan to see if you have past liver injury, and HBV DNA test (PCR) to see how high your viral load is to see if antivirals would be effective.

The last test (HBV DNA PCR test) would also show how likely you are to pass it to other people (higher viral load = more risk of transmission), but the current understanding is that if you are HBsAg-positive there is a chance of transmission. You can lower the risk of infection by using barrier contraception (condoms) and ensuring your partner is vaccinated.

Hope this helps,

Thank you so much for the information, I will try and get those tests.

@Bansah1 I meant I got myself tested for HBV DNA PCR which is 27 IUml and sgpt is 45, should I get antivirals, should I need to worry?

Hi @Bismillah,
The answer remains the same as the previous response. Your numbers are still very low and do not meet the guidelines for treatment. But It is important that you remain under care. Thanks, Bansah1.

Hi, I was diagnosed with Chronic Hep B in May 2022. Currently, I am on treatment/medication with my Doctor.

Just recently, the blood test and sonogram result came out. Could you please help me interpret this?

Tumor Marker Alpha Fetoprotein
March 2024 Value <2.2
October 2023 Value <1.8

Glucose Level
March 2024: 107mg/dl
October 2023: 86mg/dl

Alanine Aminotransferase (ALT/SGPT)
March 2024: 56 IU/L
October 2023: 63 IU/L

March 2024: 190 IU/mL
October 2023: 700 IU/mL

Hepatitis B Surface Ab, Qual
March 2024: Non Reactive
October 2022: Non Reactive

Hepatitis B Surface Antigen
March 2024: Reactive/Abnormal
October 2023: Positive

2nd Question: Am I allowed to take HIV PrEP even if I have Hep B?

Thank you so much!

Hi @Larry,
Welcome to the platform. Your labs indicate that you have hepatitis B. You do not have antibodies or protection. Your HBV DNA has decreased from October 2023 test which shows the impact the treatment is having. The ALT is a bit high but not by much, lower from your 2023 test. Your glucose is high, you might want to keep an eye on that. I don’t see any reason why you cannot be on PrEP, I think it should be ok. I hope this is helpful. Bansah1.

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Hello @Bansah1 Thank you so much for your reply.

Is it possible that the Hep B Viral Load fluctuate? I am currently on Observation Study right now and last November 2023, they drawn blood from me with a Viral Load of 130 and now this March 2024, it shown that I have a viral load if 190. Do I have to worry about it?

The second question, is it okay to take HIV PrEp and Vemlidy at the same time in a day? Does it has long term effects in my body?

Thank you so much for answering my questions!

Hi @Larry,
Yes, it’s possible to have your numbers fluctuate from time to time.

Regarding PrEP, I will encourage you to talk to your provider. I think it should be alright. But some PrEP medicine might contain similar ingredients in a antiviral for hepatitis B. You don’t want a situation where you are taking too much of something. Please talk to your provider regarding this issue and they will be in a better position to answer your question. I don’t know what you are taking for your PrEP. I hope this helps. Bansah1

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@ThomasTu or @availlant
CNN here. Given these test results, what should worry me a lot? I am waiting for my Viral load results this week.

Hi @CNN,

These results are not worrisome.

There are very MINOR abnormalities in your hematology and liver function tests.

Bilirubin is slightly elevated but this does not necessarily mean anything without some other time points to see if there is a trend. Your liver enzymes (ALT AST GGT) are generally fine - even the minor elevation in ALT.

You will have to remind me are you on treatment? If so for how long? We will look forward to seeing your virology results.

Best regards,

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@availlant was more worried about high basophils and high MCHC and Low monocytes. Was also thinking of taking vitamin B12 and folate for two months. What’s your take on those two?
Am.not on treatment but my Viral load in Oct 2022 was as below
14. Alanine Transaminase 29U/L
15. Viral load 264 from 121 8 months ago
16. No DTV from Doppler test
17. High AFP 6.6ng/ml with or using a ref range of 0 to 5.8
18. 3.9 kpa on fibroscan meaning absent or mild fibrosis. No mass or nodules seen
19. CAP 270 dB/m grade 2 steatosis

Dear @CNN,

Chronic HBV infection can also have hematological effects - these may be the underlying cause of the mild alterations in your hematology results but they are not too concerning. Absolute WBC, RBC and hemaglobin are good and the other out of range results are only really slightly out of range.

HBV does not cause steatosis (fatty liver) but it is not uncommon to also find fatty liver in persons with HBV infection. This may be the underlying cause of mild elevations in bilirubin and some of your liver enzymes. Increased fat in the liver also leads to increased inflammation.

You have partial cure of your infection (pending your latest virology results): HBV DNA is < 2000 IU/mL and ALT is normal with normal fibroscan. Mild AFP elevation (which you have) is also not uncommon in chronic HBV infection but does not signal the presence of liver cancer. AFP levels > 20 usually warrant further investigation for HCC.

With such low HBV DNA, your risk of developing HCC is much lower than someone with chronic HBV infection so starting antiviral therapy may not be the best course. You should discuss this with your doctor.

Supplementation is always a good idea but this will not likely have any impact on these results.


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CNN here. My hospital Lab DNA viral load results for April 2024 are now out at 171 IU/ML up from 121 in August 2021 (same lab ).

In Nov 2022 I went to a different lab from the above that gave a result of 264 . Both are good hospitals. From a mathematical perspective if difference was machine calibration maybe today they would be giving me btn 350 and 373(but can’t rely on maths here)

My last question for now, and I have asked this before. From existing research et al (forget guidelines) if I were to begin treatment say Velmidy, what would be the projected reduced risk for HCC? And what added risk? I am 44yrs old now. Despite your response, I understand this decision needs to be ultimately made between me and my doctor. I truly appreciate your honest reflections @availlant This platform is the best .

Dear @CNN ,

The differences in your HBV DNA values are normal wobble in HBV DNA which happens during chronic HBV infection.

Given that your HBV DNA values are so low, the benefit from taking NUC therapy in terms of reduced HCC risk will be minimal. The only way to get lower risk of HCC in some one with partial cure (such as yourself) is by achieving functional cure. This cannot be achieved with NUC therapy.



Thank you and appreciated


My respect to you, doctor!
I found out about my presence of HBV by accident. I do not take antiviral drugs. I received the results of my tests.
August 2023:
HBsag - 2002,
DNA plr test - 2.36*10^2,
HBeag - 0.012, negative. ALT, AST - normal.

November 2023:
HBsag - 2555,
DNA plr test - not detected, negative.
HBeag - 0.012, negative.
ALT, AST - normal.
fibro scan - F0.
Anti-HBs - 4.67.

New analyzes have recently arrived.
April 2024.
HBsAg - decreased by almost two times, in three months to - 1400.
DNA plr test - 1.35*10^2
HBeAg - 0.15 negative
Anti-HBs - 4.47.
AST, ALT - normal.
Alpha-fetoprotein AFP-2.

In 6 months, my HBsAg decreased from 2555 to 1400. DNA viral load is low and changing -
08.2023 - 236
11.2023 - 0
11.2024 -135.
Maybe my DNA went from 0 to 135 due to stress?
Can HBsAg disappear forever (decreased from 2555 to 1400)?
Anti-HBs appeared, but not yet enough to reach the norm of 10.
What is my prognosis HBV?
(Wrote via google translator).

Hi @Antony,
Welcome to the platform and thanks for your question. I think it is possible that one’s surface antigen (quantitative) can disappear if the person has cleared the virus or does not have hepatitis B. But this happens in less patients with chronic hepatitis B. Your HBsAg of 1400 is actually low and so is your DNA viral load. Treatment might not be an option for you currently. But you need to continue with your scheduled follow-up and monitoring. I hope this helps. Bansah1