How accurate is a Hep B test?


I Got testet for hep b 25 days ago, but still fil sick some times.

Is 7 months ago when I think I could have got it, and Got testet around 6 months Mark with all negativ.

How accurate is a Hep B test at this point?
Should i maybe be getting a new test?

Im getting the first shot at vaccine in 11 days.

Dear @nick0912,

For all of these tests to be negative is a very good sign and you can be very sure that it is accurate. My understanding is that you will get a panel of blood tests at the end of your vaccination to make sure that it has worked. This panel will also show if you have an infection, so I wouldn’t have thought there’s a reason to separately get tested again.

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Dear @ThomasTu

I have a question about my results. I got tested only for:

  • hbsag: non-reactive
  • anti-hbc: non-reactive

My ALT, AST and bilirubin are now high for more than a year (doctors can’t find the reason why, I did tests for autoimmune hepatitis and many, many other illnesses).

There is no problem in diagnostic window, because I tested for hbsag and anti-hbc 9 months after I discovered my high liver enzymes.

My question is, do you think I can trust these negative results (hbsag, anti-hbc), or would it be sensible to do a HBV DNA test?

If so, which test do you recommend - HBV DNA qualitative or HBV DNA quantitative?

Thank you very much in advance.

Kind regards

Hi @marina,

The chance that two of these HBV tests are false-negatives is very low, it is much more likely that there could be other causes for the elevated ALT and ASTs. I’m not sure if fatty liver disease has been excluded, as this is becoming one of the most common causes of liver disease in the world.

I don’t think a HBV DNA test is the recommended procedure, particularly if you are paying out of pocket for the tests (it is more expensive than the EIA/CLIA tests for anti-HBc and HBsAg). The more important one would be to test for anti-HBs: if this is positive, then you know you are protected from HBV infection (and you definitely don’t have chronic HBV infection), if negative, a vaccination course would probably be recommended to protect you against any future exposure event.

Hope this helps,

Dear @ThomasTu,

thank you for response. We ruled out everything for now (also fatty liver, wilson disease and many other things). I also never drink alcohol and dont take any medicine.

Was there anyone ever in your career that had positive hbv dna but negative all of serology parameters (hbsag and anti-hbc)? Is this scenario possible?

I took a again anti-hbc test yesterday just to check again and it was negative just like 4 months ago.

I don’t know what to do anymore, I also have pain under right rib for 1 year now, so I am thinking of taking hbv dna test.

Kind regards,

Dear @Marina,

No, I am not aware of any case where hbsag and anti-hbc are consistently negative but HBV DNA is positive. There are some supplements or genetic conditions that can lead to ongoing liver damage. If these are not applicable, then your doctor may recommend a liver biopsy to visualise what the liver looks like to try to diagnose the issue.


Dear @ThomasTu

Thank you for you time!

Kind regards!