Functional cure vs Occult Hep B

What do my lab results mean?
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Dear @HealthExperts , @availlant , @ThomasTu , @john.tavis ,

Kindly help with understanding my latest results as my appointment for specialist is a month away.

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  • In my latest Blood test my ALT has become normal.
  • I have never been on any treatment/drugs/medication for Hep B.

Do my latest ALT results and Last Viral DNA test results mean functional cure or Occult Hep B or anything else?

In some articles, functional cure is described as when Unquantifiable Hep B DNA and HBsAG negative

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in Some articles functional cure is when no Hep B DNA is detected.

https://www.gutnliver.org/journal/view.html?pn=myread&uid=2175&vmd=Full

Functional cure, defined as sustained (≥24 weeks posttreatment) HBsAg loss with or without seroconversion to hepatitis B surface antibody (anti-HBs) and undetectable HBeAg and serum HBV DNA after a finite course of therapy

Also , some articles mention Occult hep B as

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Kindly advise,

Thank you

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Doesn’t NA on your result sheet mean it just wasn’t tested on a given date? For example, on 24 Dec 2024 your ALT value was NA. It doesn’t mean it was 0.

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That is correct. NA means It was not tested on that date. So far i have only had one Viral DNA quantification test ever (Dec 24,2024). In that test it was unquantifiable.

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Dear @bmj1982,

The latest proposed definition for HBV functional cure by Lok et al (HBV DNA unquantifiable and HBsAg target not detected) is largely based on recent follow-up data after completing siRNA treatment in clinical trials and has no clinical validation. Unfortunately this off treatment follow-up data after siRNA is still in the the presence of siRNA in the liver (which lingers at active levels for more than a year after stopping therapy).

The previous (and only clinically verified) definition of HBV functional cure requires both HBV DNA and HBsAg to be not detectable.

That being said, your recent ALT flare (now normalized) and HBsAg becoming undetectable are strong signs that you have achieved good immune control of your HBV infection (and perhaps even functional cure). Come back to us when your HBV DNA has been tested again. This should be in June of this year.

@availlant

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Thank you @availlant , that helps. Yes my next hep b DNA Test is scheduled for June.

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