Hi experts, I was wondering if you could help interpret my lifetime HBV test results:
According to my parents, shortly after I was born, I was very sick, and when they took me to the hospital, doctors told them I had hep B. I obtained my test results and they were as follows:
I think the doctor also wrote “GPT 260”, which I believe might mean ALT level?
I was tested again at 7 months old and 5 years old, negative for all 5 of these markers each time. All of these childhood tests were done in a developing country with questionable medical processes. At age 21 I took a total HBcAb test (this time in a developed country), which was negative.
Based on my understanding, it’s not possible for HBeAg to be positive and HBsAg to be negative. Given the 3 subsequent negative tests, is the most likely scenario that the first set of tests were unreliable, and that I actually had something like mono or another viral infection as a newborn?
Hi @throwawayhb321,
Welcome to the community and thanks for sharing your story and results. If HBeAg was positive at 3 months old, but was negative on subsequent tests then it is possible the first positive test was false. And you are correct to point out that without someone having the virus in the first place they cant replicate something they don’t have. This makes me strongly believe the false positive incident. With the GPT being 260, it is possible to have had some liver issue that was not hepatitis B related. Some babies develop jaundice at birth and with light therapy or exposure to sunshine they get over it.
Have you been vaccinated? If not, I will recommend you do so as soon as possible. I hope this is helpful.Bansah1
Yes, I’d agree with @Bansah1 that some of these tests may have been false positives and that vaccination (if you haven’t already been vaccinated and seen your anti-HBs Ab at protective levels) should be strongly considered.
The four new recommended options for meeting treatment eligibility will substantially expand treatment access to most individuals testing positive for HBsAg. There may also be individual circumstances in which, although individuals may not meet any of the four options for treatment eligibility, there are specific individual concerns regarding infectivity, transmission, associated stigma, the risk of oncogenicity and progressive liver fibrosis and a strong individual motivation
to consider treatment, despite the lack of direct evidence. In such cases, a patient-centred approach with discussion between individuals and their health-care provider will be key in helping them make informed decisions about whether to begin treatment or not. This should consider the uncertainties resulting from lack of direct evidence for treatment benefit and low risk of transmission for those with HBV DNA <2000 IU/mL, overall lower benefit-to-risk ratio, the financial implications associated with long-term treatment and importance of sustained treatment adherence.
Hi,
I am 36 years old i was accidentaly diagnosis with chronic hep b 5 months ago… my hbv dna was 890iu/ml
And my hbsag was 2800 , hbeag was negative and anti hbeab was positive, fibroscan was 5.8kpa and lft was normal ultra sound was also normal no damage of liver… dr started my treatment with TAF 25 mg once daily… its been 5 months my hbv dna is not detected now lft are normal but my hbsag is fluctuating after i have started the treatment , i have done my hbsag test twice once it was 2000 in april and in june24 it was 2600…
Am i at the risk of liver disease… or its inactive hbv… will it damage my liver???
As mentioned in the other thread, the risk of disease progression from Hep B is low when you’re on antiviral therapy and particularly if you don’t have existing liver disease the risk of cancer is also low.
These testes were done recently on my follow-up check up after 9 months of taking Tenofovir.
I have been asked by my Hepatologist to stopped Tenofovir treatment base on the result. What’s your advice please?
Hello dear friends, I am new to this group and I was diagnosed by accident last year on 8-2023 and I was positive in chronic form.
I don’t know how many years I have had this disease. So my questions are:
Can I take hepatitis B medication based on the hbsag marker?
How can I know how many years I have had this disease?
what is the factor that changed the amount of hbs ag in a significant way ?
Hello dear friends, I am new to this group and I was diagnosed by accident last year on 8-2023 and I was positive in chronic form.
I don’t know how many years I have had this disease. So my questions are:
Can I take hepatitis B medication based on the hbsag marker?
How can I know how many years I have had this disease?
what is the factor that changed the amount of hbs ag in a significant way ?
Hi @Mas,
There is no test to tell exactly when one was first exposed or got infected. The test only can tell whether you have been exposed to the virus in the past or currently have the virus. HBV can stay in the body for a very long time without showing any symptoms.
Under the new guidelines I think you might qualify for treatment (surface antigen above 2000, normal ALT and AST). But have a conversation with your provider to determine the best path forward for your care. Things to consider might be availability of antivirals, we don’t want a situation where you start treatment but don’t have frequent access to such medicines. This should be considered in the decision with your provider about starting treatment.
I don’t think the change from 3750 to 3740 for HBsAg quantitative is such a big difference. Labs tend to have some small variations from time to time so, this change can be negligible.
Thank you very much for your answer Bansah1. I will talk to my doctor. Before I thought that to be eligible for treatment you have to do the DNA test. The question is what is the big change that happened after 6 months on my ag hbs ?
The change in HBsAg level could be due to many things (e.g., immune system acting against the virus), but is not usually linked to differences in liver health.
Thank you very much for your answer Dr ThomasTu and bansah1. My 3rd visit is in September and I will discuss my concerns with the doctor. So my questions are: I felt a slight discomfort in the liver area and which sometimes becomes constant and sometimes I felt nothing. Is it due to HBV?
I have no other symptoms.
My second question is, I have been epileptic for 5 years and I have been taking the drug phenobarbital for 4 years. So can this drug trigger hepatitis lesions?
Can I stop this drug if it has major effects on the liver?
If you have any recommendations and opinions, share with me. Thank you.
Hi Mas.
According to your first question, I think that your right upper quadrant discomfort may be nonspecific , it may be occurred in some conditions like dyspepsia. If it was caused by HBV , it should be considered from stretching of liver capsule that condition your laboratory findings may show elivation of liver enzymes and you may have other symptoms like anorexia, nausea and vomiting.
From your second question, long term use of phenobarbital rarely causes hepatitis , it usually occurs after about weeks or months after phenobarbital usage and manifests as DRESS ( Drug rash with eosinophilia and systemic symptoms) or Steven Johnson Syndrome which is life threatening conditions and phenobarbital must be stopped urgently. The more common antiepileptic drug that may induce hepatitis is sodium valproate but you haven’t used it. So I think phenobarbital doesn’t trigger hepatitis in your cases or you should consult with your doctor. I hope this help you
chul_chan
