Hello! I express my respect and gratitude to the esteemed, dear experts and scientists! Please help me understand the dynamics of my illness. 08.2023 - HBsag 2002, Anti Hbs 1.5 Plr DNA 236. 11.2023 - HBsag 2555, Anti HBs 4.65, Plr DNA 0. 03.2024 - HBsag 1401, Anti HBs 4.57, Plr DNA 110. 09.2024 - HBsag 1601, Anti HBs 3.90, Plr DNA 220. 05.2025 - HBsag 2415, Anti HBs 7.87, Plr DNA 590. 12.2025 - HBsag 2230, Anti HBs 7.09, Plr DNA 1100. Over 2.5 years of illness, the levels of ALT, AST, F0, vitamin D, AFPT are normal. HBEag is negative. All liver tests are normal.
I have a question. In most cases, what is the level of Anti HBs in chronically ill people usually? I have a dynamic increase in the number of Anti HBs from 1.5 to 7.09 now (it was up to 7.87). This is not enough for protection. But there is not much left to the mark of 10. The level of HBsag, DNA is constantly fluctuating. With such dynamics of the disease, is there a probability that Anti HBs will increase to 10?
Does this level of Anti-HBs in chronically ill people reach 7-8 and then not increase and will be a carrier of the virus for the rest of their lives? What do I need to do to reach the mark of 10? I will retake the tests in 6 months. I plan to take a course of vitamin D, selenium, magnesium and zinc during this time. I read that vitamins will help my T-cells, T-lymphocytes get help. What path am I on and what should I do to cross the Anti HBs level of 10?
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I will preface this by saying that I am not a doctor, but I actually asked my hepatologist about this a few months ago. He said that generally, the quantitative anti-HBs tests can’t accurately measure very small amounts of anti-HBs. The cutoff is generally between 2-4 mIU/mL. You are above that threshold, and it seems clear that your anti-HBs levels have been gradually increasing, but my understanding is that this is not a common presentation of hepatitis B. Most people have antibodies below the level of quantification.
The thing that surprises me the most looking at your results is seeing how much surface antigen you’re still producing, even with low levels of antibodies. The presence of anti-HBs is actually not part of the definition of functional cure. The official criteria are that you need to have undetectable HBV DNA and HBsAg for a minimum of 6 months, without treatment. When you reach that threshold, having a higher level of anti-HBs will reduce the likelihood of your infection reactivating, so the antibodies are still useful.
Do you know by any chance whether you were infected with hepatitis B as an infant/child, versus as an adult? My understanding is that if you caught hepatitis B as an adult, you may be more likely to clear it in the future. Unfortunately, we don’t have convincing evidence that lifestyle changes or supplements will lead to HBsAg loss. Still, eating a healthy, well balanced diet, getting enough exercise, and sleep, and maintaining a healthy weight is a good idea regardless. It’s unlikely that taking a multivitamin will do any harm, though it would be preferable to get those nutrients through your diet instead.
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I was infected 2.5 years ago. Anti-HBs has a tendency to increase. But the level of HBsag also changes in a lower and higher direction over 2.5 years.
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Hi @antony,
Thanks for sharing your story. I agree with @et5656, that the HBsAg level has to come down before you would can clear the infection fully - this is the number to keep an eye on.
The fact that you got the infection later in life (that is, not as a newborn) is correlated with better chance of clearing the virus infection, so keep your monitoring up to keep an eye on this!
Cheers,
Thomas
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Thanks for the answer! What is the usual level of Anti-HBs in chronically ill people? Do I have a typical situation with my indicators?
Hi @Antony, the usual level is below 10mIU/mL - when it goes higher, then this is a good sign that your immune system is becoming more active and on its way to clearing the infection (but this isn’t done until there is no more HBsAg in the blood).
TT
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