EXPLAINER: Lab results and their interpretation

Hi Marion,

Thank you for your response. When I arrived in Korea in March 2022 I had to do a medical check for my visa and it was flagged then. I did a second round of blood tests which then apparently said I was infected but it was inactive. Unfortunately I never received any paperwork for this whatsoever.

In late 2022 I did another blood test - not realising I needed a PCR and DNA profile my doctor only did a liver function test which came back entirely normal.

In July 2023 I did another proper test and my results were the photograph and post my initial post was a response to.

Fast forward to last week when I did my blood work and HBeAb, HBeAg and HbcAb were all negative. So my doctor ordered more tests for my HBsAg and HBsAb, which both came back negative as well.

I’m very confused, especially because I could potentially have been really emotionally traumatised by something I never needed to be worried about. Any insight is greatly appreciated :slight_smile:

Dear @EH1999 ,

The test for HBcAb has two variants: IgM (which is present during initial infection) and total (IgG + IgM). If you have been infected you will produce IgG HBcAb your whole life. As such you would always be positive for total HbcAb.

HBV < 10 IU/mL does not mean negative. It is not possible to prove the absence of HBV DNA with any test currently on the market. Most major HBV DNA test platforms will produce outputs of < 10IU/mL (which means the test cannot quantify the tiny amount of HBV DNA present) or target not detected (which means the test could not detect HBV DNA). This latter result is often not reported (left as < 10 IU/mL) out of caution and needs to be verified with the test lab but does not necessarily mean there is no HBV DNA present.

However, if you are total HBcAb negative and negative for HBsAg and HBsAb this suggests you have never been infected and should attempt vaccination.

@availlant

Hi availlant,

Thank you for your response, especially for clarifying the <10iu/ml being used as a kind of “being on the safe side” of diagnostics. I was always confused when they said I was “negative” if there was some DNA detected. It’s an entirely bizarre situation to be honest as I can’t fathom any sort of clerical error that would cause me to be “misdiagnosed” over the course of two blood tests. However, I have decided to go ahead with vaccination and then worst comes to worse I have HBV but it’s under control and hopefully a definitive answer can be reached if I start producing antibodies after vaccination. :slight_smile:

Hi @EH1999,
That is a good idea. There is not much to lose but you probably might gain more if you never had this virus. At least you will be protected. Once you complete your vaccine series, they can do a test to see whether you have immunity (HBsAb) and they can measure the antibody titers as well. That will provide another way of finding out whether you have HBV or not. If you do have it, you should not develop any antibodies. But if you do not have it, then you will develop antibodies from the vaccine which can then be tested and measured. HBV can be complicated at times, so try not to overwhelm yourself with all this. I know it is not that easy to ignore something like this. Hopefully, you can take care of the vaccinations soon. Best, Bansah1.

Hello again,
Sorry for the late reply, but i see that the other science experts took over with nice and extensive replies so hopefully it brought you some peace of mind.
I would just suggest to see if you could get back your results from when you initially arrived in Korea (i.e the ones you mentioned never had the paperwork in the end), as from your current results it seems indeed you might never had it, so it would be great to check these initial results and what led the diagnostic conclusion.

I agree you should attempt vaccination but keep monitoring your HBsAg level and antibodies to confirm further your negativity.

If you are/were indeed negative this whole time, i am very sorry for you, especially in term of mental health, worry, trauma and even stigma that the diagnostic might sadly have generated. I hope you found at least some help in this community.

Best,
Marion

Hi @Bansah1,

Thank you for your response. Yeah, there’s no harm in doing the vaccinations, they’re relatively inexpensive in Korea so we’ll see what happens after the 6month mark. :slight_smile:

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Hi again Marion,

No need to apologise! Everyone on here has a life outside of this forum so I understand entirely!

Yeah, I’m going to try and get my initial results from the hospital I went to when I first arrived. The way I see it there are three outcomes here: 1: I never had it which is great but annoying it took two and a half years to notice. 2: I do have it but it’s really well managed and just needs to be monitored. 3: I am some sort of mutant and did have it but now for some reason do not (I am of course joking)

Either way 6 months until I know for sure. The one thing I will take away from this at least is being told I did have HBV spurred on a whole host of lifestyle changes that definitely needed to happen and I’m living much healthier because of it.

:slight_smile:

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