EXPLAINER: Lab results and their interpretation

Good day, is it possible for HBsAg to be reactive and HBcAb to be non reactive for chronic hepatitis B?

Dear @Smart55,

Thanks for your questions and welcome to the forum.

This would generally indicate you have never been infected with Hepatitis B. If you are HBsAg-positive (which would denote you do have an infection) this is possible, but not very common. It probably happens if you’re in transition phase between HBeAg-positive and HBeAg-negative phases.

Edit: sorry, misread the original post. This is not a common occurrence, but can happen. It would still denote you probably have a chronic HBV infection. If this was the case, your doctor would probably repeat the test to confirm.

Hope this helps,
Thomas

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Hi Thomas,

I didn’t get this. Can you please elaborate more or may be you want to correct your self.

Hi @HopeForCure, you’re right, I misread the original post. Thank you for noticing and picking it up.

Thomas

Thank you for your reply @ThomasTu, I also had quantitative HBeAg which comes out to be 0.00037, Is this value high or low, and what is the normal range for quantitative HBeAg ?.

Quantitative HBeAg isn’t really a standard test (so it may be different around the world), but if it’s in PEI-U/mL then it’s very very low (as I know that it can be in the thousands).

Thomas

Hi all,

I hope experts here can help interpret my HBV results and advice what number to look at for future reference.

HBV Quant DNA 7.38 X 10 E2 IU/mL
HBV DNA Log10 2.87 IU/mL

I found out to have hepatitis B when i was 20, through a check-up as part of a recruitment process. My mother is protected against hepatitis B and had no history of past infection. So i guess i did not get it through vertical transmission.

I find this place is safe to talk about my hepatitis B and professional to get advice.

Thank you
Siqi

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Dear Siqi,

Welcome to the forum and thanks for your question.

The results are actually the same number, 7.38 X 10E2 and Log10 2.87 are just different ways of saying 738. Your lab results for HBV DNA levels show that your virus load is relatively low, so the chances of transmitting it on is also relatively low. Low HBV DNA levels have also been linked to lower progression of liver disease.

In general for monitoring, you should be getting liver function tests (to check ALT/liver damage markers), HBeAg/Anti-HBe Ab (to determine which phase you are in), and HBsAg/anti-HBs Ab (to see if you’ve cleared the infection). It’s a good idea to find out what condition your liver is in by either fibroscan or ultrasound.

Hope this helps,
Thomas

Hello, Thomas!
My test shows negative HBeAg and positive anti-HBe. My doctor says that’s the result we wanted. What does that mean practically? Is it true that negative HBeAg lessens likelihood for severe disease? What does these results mean in terms of danger of transmission to others?
Also what constitues undetectable viral load?
(Btw sorry for creating I new account I completely forgot the passowords)
Thank you!

Dear @Drew_rous,

People who are HBeAg-negative and anti-HBe-positive generally have a lower viral load and lower risk of disease progression, so yes you are correct. Because of the lower viral load, there is a lower risk of transmitting it on to others. For example, HBeAg-negative mothers have been shown to be >10 times less likely to transmit the virus to their newborns compared to HBeAg-positive mothers (citation here).

The definition of undetectable really depends on the specific test kit used, but the most common one defines “undetectable” as lower than ~30 viruses per mL.

Hope this helps,
Thomas

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Dear @ThomasTu,
Thank you very much! That’s very helpful. I have one more quesion. Do these values stay the same forever or might change?

Always,
Drew

Hi @Drew_rous,

These levels can definitely change, so it’s important to keep monitoring your levels (usually blood tests every 3-6 months).

Cheers,
Thomas

Hi again,
Thank you very much for your prompt response.
I do my usual tests every 6 months. The reason I asked is because my hepatologist mentioned that HbeAg is a test you only do one as it doesn’t change.
He recommended anti-Hbe blood test so I guess that might change.
Best,
Drew

If you are HBeAg-negative, generally you will stay that way though there have been reports of reversion to HBeAg-positive (e.g. when immunosuppressed). I guess the thinking will be if anti-HBe goes down then HBeAg will come up. In the end, it’s probably more important to monitor HBV DNA levels: if those go up, then you would get a full panel of blood tests to work out what was going on (including HBeAg and anti-HBe).

Hope this makes sense.

Cheers,
Thomas

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Hello,

I’m new to the community. I found out I had chronic Hep B about 8 years ago. I see my doctor yearly and have been putting it in the back of my mind due to shame and the stigma.

I now want to learn more about Hep B and how to properly read my labs. When I was first diagnosed only my surface antigen and core antibody were reactive. Yesterday I received the following results. Why are more things (especially the antibodies)becoming reactive? Does this mean the disease is progressing? Are my hepatic levels relatively high , normal or low? I would love support with reading these labs. Thank you so much for starting this community!

Lab Results:

Virus DNA-
128 log IU/mL
2.11 log IU/mL
Hep B Surface Antigen- Reactive
Hep B Surface Antibody QL- Reactive
Hep B Core AB Total- Reactive
Hep BE Antibody- Reactive

Bilirubin- 0.6
AST- 22
ALT-22

Dear @Jax

Welcome to the forum and thanks for your questions.

  • The antibody levels coming up means your immune system is actively fighting off the virus. This is reflected by HBV DNA going down to low levels.
  • The surface antibody is promising, suggesting that you may be on the edge of clearing the virus. It might be worth asking for a quantitative HBsAg test to see if this is going down.
  • This doesn’t mean that the liver disease is progressing. Your ALTs (a measure of active liver disease) look normal, suggesting no active liver damage. To find out whether there has been past damage, fibroscan/ultrasound should be done.

Hope this helps,
Thomas

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Thank you so much for this information!

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Hi everyone. If I have chronic hep b. Will HBsAg alway test positive? Or could HBsAg be negative after being on enteciver ?

About 1% of chronic HBV patients per year lose HBsAg. Entecavir will not induce this, but it will not stop it either.

Thomas

Thank you very much for this clear explanation.

Best,
Drew

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