Help with lab results

I tested positive for hep b antigen 2 years ago when I was in Sao Paulo, so I never had treatment and now Im leaving in the US and started seeing a Doctor, Ive been taking Descovy(200mg emtricitabine and 25mg tenofivir alafenamide) for at least 3 months now, a week ago I had these lab results that Im attaching to this email.

So my concern is hep b antigen is reactive and viral load is undetectable.

Can I pass hep b to others? Im concerned about passing it to my boyfriend (he started hep b vaccination but they said he will be fully vaccinated on sept this year)

My doctor said I have no hep B active, Can it re activate if I stop taking prep?

My doctor said I cannot pass it but Im just confused about the antigen still showing reactive.
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Hi Royer, thanks for joining the community! In answer to your question about testing positive for the hep b surface antigen (HBsAg reactive), this is expected for those of us living with chronic hep b. It doesn’t become negative even if our viral DNA levels become undetectable with medication. With that said, there are new promising drugs in the research pipeline that may be able to eliminate the surface antigen. But that’s another discussion.

In regards to your infectiousness to your boyfriend - the fact that you’re hep b e-antigen negative and viral load undetectable, you are at low risk of transmitting the virus to others. BUT, to be on the very safe side, you ideally want to practice safe sex until your boyfriend completes his vaccine series (and he could be tested about 30 days after his last dose to test for the production of the protective hep b antibodies). Again, that is the most conservative advice so others on this forum might have less restrictive advice! Thanks again and I look forward to hearing what others have to say. Always, Joan

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Thank you so much for your reply, this makes more sense from what my doctor said to me

Hi Royer, Descovy as PrEP could be a problem for a person with hepatitis B if it is discontinued. Fortunately, you were tested for hep B so you are aware. You will not want to discontinue use without careful monitoring by your doctor. Now that you have been diagnosed with hep B, you’ll want to continue with regular monitoring every 6 months.

Everything Joan said is certainly true! I just wanted to be sure you were aware of possible issues with Descovy discontinuation. Maureen

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Hi Royer,
I am in agreement with Joan. It is highly unlikely that you can pass it on to your boyfriend. But to be safe, I think Joan’s advice is great until he completes his vaccine series. It might be an inconvenience, but maybe a good one to protect him and to be safe until he is fully vaccinated against Hep.B virus. Be sure to stick with any plans you and your doctor have put in place. Try not make any changes without consulting with your doctor first. It is very important that you work with your doctor. I hope it helps. Good luck. Thanks, Bright.

Hi, Here are direct answers to your questions:
"Can I pass hep b to others? "
Yes, but the risk is extremely low (virtually zero), unless via blood transfusion. Therefore, you can’t donate blood.
“Can it re activate if I stop taking prep?”
Yes, reactivation is almost a guarantee if you stop taking the medication. So, don’t stop taking it, and take it everyday.
“confused about the antigen still showing reactive”:
Hep B surface antigen HBsAg will always remains reactive/positive, unless you are lucky enough to become cured (or functionally cured) of hep B. When you are cured of hep b, surface antigen will turn into negative. If you were infected as an adult, you may have a good chance of being cured. Surface antigen is not infectious without hep B DNA, which is undetectable in your blood. However, surface antigen is still expressed from integrated and cccDNA inside your liver cells, that are very difficult to get rid of. Your doctor prescribed Descovy, probably because you might have a risk of contracting HIV, otherwise, monotherapy using TAF/Vemlidy is enough for suppressing HBV.

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Hello.
Please can someone interpret my blood results.
I am 43 years old and 6 months ago I have been diagnosed with Hep B during a blood donation.
My Viral load was 10,054.
My fibroscan was 5.13 kpa
Few days ago I made the following test and Urea is low also EO%, MONO%, LYM% and some others are not in the range:

Thank you very much have a good health

Dear Aleksi,

As far as I know, Hepatitis B would not really affect urea levels, or eosinophil, monocyte or lymphocyte percentages by itself (particularly given your other results being fairly standard).

Thomas

Hello again.

Please can you give me your views if I should do intermittent fasting in order to losse weight. I am 8 kg over weight and I have two months on plant based diet but still not losing but I also havent gained since on plant based

Cheers

I think it is too difficult to tell over the internet what is the best way to lose weight. As I’ve said in the other threads (e.g.Understanding fatty liver desease - #7 by ThomasTu), nutrition and metabolism is very complicated and there are a lot of factors that are involved. Everyone is different. The best way for healthy weight loss is to talk to a certified dietician to help you in your context to lose weight appropriately.

Thomas