Hepatitis B recovered person resuming sexual activity

Hello,

I was diagnosed with Hepatitis B infection (HbsAg positive), but after 3 months I cleared the infection and HBsAg turned Non-reactive and the viral DNA is Not-detected.

Tests:
HBsAg - Non reactive
HBVDNA : Not detected
Anti Hbs : 7.5 mIU/ml , took this test after 20 days of testing negative for HBsAg
I am Just wondering that if I could go ahead with family planning to have a baby? But the confusion is whether the virus is cleared from the semen as well? (As semen is stored and being protected from immune surveillance, viral particles may still be there) Or maybe I need to wait for sometime or even take any further tests ?
Can I infect the wife if semen anyhow still has the virus? The research work shows some viruses persist in semen even after systemic clearance ex. Zika and Ebola.

(Wife is vaccinated with two doses now and Anti Hbs titer is 165 mIU/ml)

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Pls @ThomasTu @MarkDouglas @Joan_Block @john.tavis @chari.cohen @cscoffin @PuallyHBV @HealthExperts

I think my response was not meant for Ajk hence I have withdrawn it. I am sincerely sorry for the error
Kinoti

Dear @AJK,

The test results you’ve posted indicate you’ve cleared the virus and are not at risk of passing on the virus at all. My understanding is the virus would be cleared in the semen too.

Nevertheless, given your wife has very high antibody levels (way higher than the protective level threshold) the risk of her being infected is negligible and you should feel confident in planning to have a baby.

Hope this helps,
Thomas

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Hi AJK,

Thanks for your confidence but I am not a health expert or a science expert. I do not post on lab results as I have no expertise and in fact, often times don’t totally understand my own lab results.

I do however post when there are topics about particular things that someone is going through, that I have experienced and I want to give advice based on my own experiences or even just give moral support.

So based on Thomas’ response, I wish you the best with your plans for having a baby!

-Paul

Okay Mr Paullly. Still appreciate your reply. Thanks.

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Thank you very much Mr Thomas for taking time out to answer the query. Really appreciate that.

I have few more queries, hope I would get the response from you all.

  1. As my Anti-HBs titer is low, should I get the vaccine to boost it or wait another few months to see if levels go up ?
  2. If during this time, I get exposed to the virus again, will I get infected as the titer is not yet > 10 mIU/mL?
  3. I have developed OCD and scared to touch things I used to use when I had virus month back …like personal care things, bed, couch etc ? Do these things would have virus on the surfaces?
  4. My Hep A test says IgM non reactive, and IgG reactive …does that mean I don’t need to take hep A vaccine?
  5. I am thinking of getting tested again to see Anti-HBs levels. Just wondering if I need to get quantitative HBVDNA levels checked again?
    Last time I get tested a month back for HBsAg, DNA and Anti-HBs. What do you suggest?
  6. Lastly, I didn’t check Anti-HBc IgG/IgM …so scared whether this was really Acute ?
    I had got severe jaundice with both ALT and AST levels in thousands! Very high bilirubin levels. High DNA ( > 20000 IU/ml).
    Later LFT became normal with the time.
    And almost after 3 months, my Anti-HBs levels came up 5 mIU/mL. Next day I checked HBsAg and DNA, both tested negative (non reactive/not detected).
    Later after 15 more days, Anti-HBs came 7.5 mIU/mL with both HBsAg and DNA not detected.
    Can you confirm with this data that the my case was Acute?
    Also, fibroscan came absolutely normal.
    (I had a surgical procedure exactly 3.5 months before the appearance of symptoms).

Hope I am not offending you with so many questions.:blush:
Thanks.

Hi AJK
I have read your first text and so is your second.I see what is going round your head.At this point,I can only wish you well and pray you very quickly digest the information at your disposal so you can be able to make up your mind on where you are and what you ought to do.
Otherwise, from where i am, I see you as among the lucky few. :smiling_face_with_three_hearts:
Regards
Kinoti

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@ThomasTu Can you please reply

Hi @AJK,

I had my COVID booster two days ago and have been recovering from the immune activation, so hadn’t been able to get around to answering all of these good questions. I am feeling a bit better now, so here it goes:

  1. I would expect that your Anti-HBs titres will continue to go up. The vaccine is simply made up of HBsAg, which you have been exposed to now, so you have essentially been “vaccinated” by the infection. There is always the opportunity to boost later, if you doctor thinks it may be necessary.
  2. It is not likely you will be infected again if exposed to the virus because you have a decent amount of Anti-HBs present. In addition, you likely will have activated T-cells (another important part of the immune system in clearing the virus) that target the virus which will help clear any subsequent infections.
  3. Given the answers of 1 and 2, you shouldn’t worry about these things too much. These present a negligible risk to you.
  4. IgG-reactive means you have antibodies to Hep A, so my understanding is that additional vaccination is not required. Some @HealthExperts may be able to confirm or comment further though.
  5. In most cases, HBV DNA level is undetectable when someone is anti-HBs-positive. In a small number of cases, there is a phenomenon called “occult HBV”, where people can present with anti-HBs as well as being HBV DNA-positive. This is uncommon though and is not strongly linked with liver disease progression (but needs to be taken into consideration for liver transplantation or if you become immunocompromised). I would go with whatever your doctor recommends.
  6. It may be too late to check for Anti-HBc IgMs now as they start going away after a few months of the initial infection. So you wouldn’t get a clear answer either way. With the results you have posted, there is no real way to know if your infection was acute or a clearance of a chronic infection.

Hope this helps,
Thomas

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Thank you very much @ThomasTu … so kind of you to reply to all queries.

I have a few points to add…like wrt point
3:
I may not get infection from using the same bedding or couch, chairs etc, but what if guests come to visit? Though I have sprayed 70% ethanol disinfectant spray ? Is that okay ? Also, virus seems to survive for 7 days on surfaces ?

Wrt to point 6:
I forgot to add that before the surgical procedure I got tested for viral markers including Hep B and it was non reactive!
Even 3 years before too I had tested negative before taking an employment!

I get dead scared to see my blood or even precum in the morning… though recovered but 4 months trama is still there :sweat:
I still doubt I may spread the virus… I somehow accept the bleeding but still doubt that semen/precum may still have the virus … it’s been more than six weeks now since tested Anti Hbs 5 mIU/mL …will virus be still there?

Hi AJK,

Yes I agree with Thomas’s comments about HBV. It is probably too late to test for anti-HBc IgM so we may not be able to confirm.

However it is probably worth checking anyway along with anti-HBc IgG to confirm that you have actually been infected and have not just got antibodies from a previous vaccine you may not remember.

However the important thing is that you are negative for HBsAg and HBV DNA so you do not have active hepatitis B.

You can repeat your anti-HBs in 3-6 months and if the infection was acute this will probably increase.

Concerning Hepatitis A, yes if you have HAV IgG you are immune and do not need vaccination.

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Thank you for your kind reply. I had got myself tested before the surgical procedure (about 3.5 months before the symptoms appeared), and it was non reactive.
Pls see my previous comment if possible.

Thank you :relaxed:

To come back to this question, bedding and couches are a negligible risk for transmission. I would not worry about it.

With this level, the risk is almost zero that there is infectious virus in these fluids.

Then it is possible that this is an acute infection to do with the surgical procedure, but as Mark says it may be too much time between now and then for the IgM to be positive to confirm that was the case.

Thomas