It says so in the results I received today. 
Dear @Javer,
Thanks for sharing your story. The most robust way of determining if your infection is chronic is still testing HBsAg-positive 6 months after your initial diagnosis.
Your viral load is still relatively low and your liver damage marker (ALTs) is in a normal range, so it is not worthwhile worrying about this if you are feeling physically OK.
It’s great that you are being referred to a gastroenterologist. They will be able to get you more specialised tests (e.g. fibroscan to assess your liver health).
Thomas
Thomas
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Hi Dr . I have a question I would be grateful if you could assist me. 7 months ago I had an unprotected sex. I had jaundice, weakness , red pimples and vision problems that gone after 3 months. I tested hcv and hbv several times all of those were negative. Last month I took another blood test for hbv and the related results were as follows:
Anti hbs 1000
Hbsag negative
Total core hbc negative
Hbv pcr negative
I was vaccinated 3 doses of hbv when I was child.
Considering the value of anti hbs and symptoms, am I resolved from acute hbv? Can I get married?
Thanks a lot
The test results that you have posted shows no HBsAg, and high levels of antibodies. You should be cleared of HBV if you even had it to begin with.
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Hi @ryan,
I agree with @A7xImpulse here. From the results you shared you do not have hepatitis B and even better you do have a very high level of antibodies. Nothing should stop you from getting married. Please just a friendly advice, if possible try using protection because there are other diseases out there that you might get exposed to. I hope this helps. Thanks, bansah1
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Dear @Ryan,
I agree with the assessments from the others that these results suggest no current infection with Hep B. Given that your anti-HBc antibody levels are also negative, this suggests you were not infected in the first place and those symptoms may have been caused by another condition.
Hope this helps,
Thomas
Thanks, for your comments.
I did full STI all of them were negative.
If I assume that was self- limited acute hbv, does this situation infect other people? Such as my future wife?
If your HBsAG is negative and stays negative, there should be no way to infect anyone.
Hi @ryan,
Yes, @A7xImpulse is correct that the HBsAg-negativity (and HBV DNA negative) means that the risk of infecting anyone is negligible.
The only situation where it becomes an issue is if you become severely immunosuppressed (e.g., receiving an organ or treatment for severe autoimmune diseases) where the disease may reactivate. However, this is very rare and can be controlled with appropriate measures (e.g., prophylactic treatment with antiviral meds).
Hope this helps,
Thomas
Hi everyone, im a singaporean male age 27 and i was tested reactive for Hep B Antigen and non reactive for Hep B Antibodies. Im currently waiting for the subsequent blood test to reveal if im acute or chronic, viral load etc.
Previously, i experienced no symptoms and the only reason i discovered this is thru a routine STD test. I had unprotected sex earlier in the year & im guessing thats how i got it.
Would like to check if i am asymptomatic, is it more likely that i will develop chronic hep b?
Also, i have seen online that 90% of adults are able to fully recover from this. Is this really true? or is this only for case where the person experiences symptoms?
I also have a new gf. we’ve been together for 2months. We didnt have sex but we make out & she did her wisdom tooth extraction last month. What is the likelihood she will catch it from me?
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Dear @sgeanguy,
Welcome to the community and hope you’ll find the support you need here.
Thanks for your question. There are a couple of components to this:
Yes it has been shown that adults exposed to Hep B have a 90% chance of clearing it. Many people are asymptomatic upon infection and clear the virus, so it is not necessarily an indicator that you will/will not develop chronic Hep B.
The likelihood of transmission is determined by your viral load (there is a higher risk the higher your viral load is). That said, kissing is not an efficient way of transmitting Hepatitis B.
Chronic Hepatitis B is asymptomatic for many decades, so it is not necessarily guaranteed that this recent encounter of unprotected sex is the cause of the infection. You may have had it since birth (unless your previous blood tests for Hep B have been negative).
Hope this helps,
Thomas
Hi Thomas,
Thank you for the clarification. This thinking came from seeing alot of people online who display symptoms which usually is an indication that the body is fighting the infection i think?? So i thought if my body is not responding might it progress to chronic status.
I have attached my results into this post. It seems that my HBV DNA & HBsAg is rather low. What do you think is the risk of transmission in this scenario (via saliva to wisdom tooth open wound). Just to note, i did not have any open wounds, ulcers, open sores in my mouth so im mainly wondering on the saliva transmission to her wisdom tooth opening. This has been driving me crazy am i just worrying too much about it?
I am quite sure cos i tested for it last year & it was negative plus i generally practice safe sex so im quite sure it was from that encounter.
Also another thing, in what instance would HBeAg & HBeAB be both negative?
I just wanna thank you for your inputs & this forum. It has helped me alot through this ordeal.
Hi sgeanguy
Your ALT is slightly elevated but your HBV DNA quite low , so your liver inflammation may be caused by other etiologies such as alcohol, fatty liver, herbs etc . You should consult your doctor to find out the causes of elevated ALT.
Regarding to your HBeAg and HBeAb simultaneously negative in CHB infection. If your HBV DNA is low , it means that your body immune response can control and suppress the viral replication and HBeAg will be cleared in the blood by the appearance of HBe Antibody . If your immunity is suppressed, you may have HBeAb from positive to negative and HBeAg may turn from negative to positive that we call HBe serorevertor. So it is unlikely to have negative HBeAb along with negative HBeAg except for laboratory error or waning of immunity which rarely occurs in short term period of infection. You should consult with your doctor.
Hi chul_chan,
Yes i think that my ALTs are elevated due to alcohol consumption roughly about 2 weeks ago. Before i was diagnosed…
With regards to the HBeAg & HBeAB negatives, yes i am quite confused of it since for what it see it should usually be opposite of each other. I will be seeing a specialist next week for his input. I have 2 theories but im not sure if they apply would gladly accept comments/inputs on it:
-
Could it be in the small area of non overlap between the HBeAg & HBeAB?
-
Or could it be that it is the very beginning of the infection? where HBeAg has not been developed but Surface Antigens are detectable?
Also, would like to check if you have any inputs on the transmission from saliva to wisdom tooth extraction site? (no cut/ open wounds/ ulcers/ open sores on my end)
Thank you!!!
Hi sgeanguy
In your 1st question.I agree with you that it could be in the small area of non overlap between HBeAg and HBeAb that we call “ e-window period “ . In chronic hepatitis B , as in my experience about 30 years ago that I had been followed up HBeAg / HBeAb serially every 3 months during flare of CHB(phase2) I found that before HBeAg seroconversion, there were HBeAg and HBeAb positive simultaneously and when repeat 3months later, HBeAg turned negative and HBeAb positive . I didn’t see the “e- window “ may be due to it shorter period to followed up and I didn’t know about it at that time.
In acute hepatitis B , the “ e-window “ period mostly shorter than 2weeks .https://aasldpubs.onlinelibrary.wiley.com/doi/epdf/10.1002/hep.1840040408 so your understanding is correct and I agree with you.
The answer of your 2nd question
maybe due to the fact that HBeAg/HBeAb are lower than the cut off point that the commercial test kid can’t detect it.
Regarding to your concern about transmission from saliva , it is possible as in this paperhttps://www.sciencedirect.com/science/article/abs/pii/S1341321X20303986 , so your gf should have HBV vaccine complete series if no immunity to HBV. I think you may be more understanding and clarity.
ในวันที่ วันเสาร์, พฤษภาคม 4, 2567, 10:21 PM singaporeanguy via Hep B Community info@hepbcommunity.org เขียนว่า:
Hi,
I am 28yo male and was recently diagnose with Hep B in Feb 2024. I don’t know how long have I had the virus but my doctor already determine my condition to be chronic so I have some question I need to ask.
My result:
HEP B DNA, SER/PLAS, PCR = 7670 IU/mL
HEP B VIR DNA, LOG, SER/PLAS, REAL TIME PCR = 3.88
ALT = 40
My questions:
- does this result confirm I have a chronic HEP B condition? What factor determine the condition is acute or chronic?
- I am due to have another blood test due on August and my primary care doctor does not put me on treatment yet. So should I wait or contact and start the treat as soon as possible?
Thanks you for your help.
Hi @An_Nguyen welcome to the forum.
I am not a doctor, and as a person who got the news of being a chronic hepb infection the last year and a lurker of this forum I would try to give my understanding
-
The best way to distinguish between chronic and acute condition is the result of the IgM antibody to hepatitis B core antigen (Hbcab IgM). A positive result here indicate a recent acute infection. A negative result of this test, paired with hbsag positive or hbv dna positive indicates a chronic infection. Some places do not offer this test and in this case if hbsag persist more than 6 month then you are considered chronic.
-
Here depends on the country that you are currently living. There are differents guidelines who to treat based on:
- hbv dna levels
- liver enzymes(ALT,AST,GGT, ALP)
- liver function test (Birilubin, Albumin,…)
- fibrosis( imaging test elastography).
Guidelines for america, asia pacific and eu.
**China new guidelines now recommends that if anyone is hbvdna positive, regardless of the value, then treatment could be recommended.
Only one snapshot test in time does not provide much information. Is the trending of the numbers that usually is more useful to assess the progression of the disease.
So I would suggest, I know it is not easy, but try to not think about too much, given your young age and not so high hbv dna levels and wait for the next test.
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Hi chul_chan,
Yes i agree the e window is a typically a short duration but it doesnt seem like there is much other scenarios where both HBeAg & HBeAb is negative. Would this be an indication that my infection is leaning more towards acute rather than chronic infection?
Yes, i did consider that i was recently infect (few weeks ago) although idk how & it is in the very early stage of viral replication.
With regards to the study you cited from Japan on samples with saliva & infected blood. My situation is abit different as my infected blood wasnt present (i am quite sure as i knew i did not have any open wounds/ ulcers in my mouth). Instead it was my gf who did the wisdom tooth extraction. So i was wondering how likely is my saliva infecting her wisdom tooth site.
Thank you for your insights!!
Hi @An_Nguyen
I understand your concern about HBV infection. As @ anonml explain to you that if your HBsAg persist more than 6month after your symptom appear or 1st screening result , then you are considered chronic HB.The problem is that most patients want to know about their status at point of care whether they are acute or chronic HB and waiting for 6 months are too long and make them anxiety. The best way is to use Anti HBc IgM but in some situations the result may be positive in chronic HB with acute exacerbaton(phase2/phase4 chronic HB)but the titer is low in this situation .Differentiation of acute and chronic hepatitis B in IgM anti-HBc positive patients - PMC.
In your case , if you have no symptoms and your blood screening is positive accidentally and your ALT is not elevated then chronic HB is the most likely diagnosis because in acute HB if ALT is low or normal the HBV DNA should lower or undetectable. You should consult with your doctor about treatment plan . I hope this may help you in understanding of your Hepatitis B condition.
Hi @sgeanguy,
Indeed these levels are quite low, so the chances of transmission are also quite low. Just to put this in perspective there has never been a recorded case of transmission between health care workers doing invasive procedures and patients when viral loads were less than 20000 IU/mL (Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections in health care workers (HCWs): guidelines for prevention of transmission of HBV and HCV from HCW to patients - ScienceDirect). That said, I would agree with @chul_chan that a vaccination would be worthwhile for you girlfriend for peace of mind.
I’d agree that it may be HBeAg seroconversion that is occurring causing them both to be negative.
Hi @An_Nguyen,
These results alone cannot determine whether you are chronically infected or not. The best way to determine this is testing for HBsAg in 6 months to see if this is still positive. If it is, then it is a chronic infection.
Also from these results alone, we are unable to determine if you need treatment now and so you should abide by the doctor’s advice.
Hope this helps,
Thomas