Instance of false positive

*lab results attached in order. March 2013, April 2013, March 2024.

Hi everyone! I joined this group because back in the beginning of 2013 I had read about hepatitis B. I was paranoid about all sorts of germs & infections being a new healthcare worker at a hospital. I decided to test on my own at an independent lab. My results came back with surface antibodies just below immunity levels (8.2 mIU/ml), positive total core and negative antigen. 12 days later I follows up with my primary doctor and she ordered the same labs plus Core Igm. Came back the same with my surface antibodies being 4.5 mIU/ml. Positive total core, negative antigen and negative core Igm.

Given these results I was told I most likely had an acute infection that I cleared over 6 months prior. I was not offered and did not receive another vaccine. I completed my vaccine series in 2002 as a teen.

I was so stressed out at the time. I thought I had always been so careful. I grew up with my dad having hep c so being careful with blood was pounded in my head from a young age. I had a few sexual partners since I had last donated blood (2008, no flags) so I let them know I may have been infected with them at some point. No one shared their results with me. But given their professions/age I’m sure all had been vaccinated. My boyfriend at the time (now husband) tested negative. I’ve felt bad I haven’t been able donate blood or plasma knowing I had a positive total core test.

Fast forward to this last month I started a new healthcare job after being a stay at home mom awhile. One question was do you want a hep b vaccine? I said no. Then I started looking online and seeing where total core does not provide immunity like my doc said back then. And that I should base immunity off my surface antibodies. Curiosity got me and I went in for a test yesterday. This time it came back negative antibodies (undectable), NEG total core & NEG core Igm. Didn’t do antigen.

So what could be the deal here? Everything I’ve read says total core stays for life and the instance of a false positive is very little. All 3 of these tests were ran at different labs. The first 2 were only 12 days apart. But that was 11 years ago. Has technology gotten better and my positive total core was just a fluke back then? I would love to donate plasma & blood again. I guess I’m just looking for some reassurance and instances of this happening to others.

I’m happy to have a negative everything. I’m definitely going to get another hep b vaccine now. But all my late night reading about hep b had me convinced false positives don’t happen with total core. I’m going to share the lab results of each place. I blacked out sensitive info.

Hi @johnna88,

Thanks for sharing your story and for the great questions. And it’s great that you’re going to get the vaccine to get your protective antibodies up.

Regarding the anti-HBc tests, yes the current thinking is that everyone who has been previously exposed maintains anti-HBc. But it’s not clear why this is: likely it’s due to underlying HBV infected cells still present in the liver at very low levels and all the virus produced by them is being neutralised by anti-HBs antibodies.

Indeed this could be a rare case of false positivity. Alternatively I guess, theoretically, it may be possible to clear all HBV infected cells and therefore any anti-HBc antibodies wane completely over time, but this is really not understood. Indeed, as you mention anti-HBc is not protective, you are only protected by anti-HBs antibodies.

Hope this helps,

Thanks Thomas! My primary doctor put in a referral to my GI doc who is also a heptologist (I’ve seen for different things). I requested this so I can see what his thoughts on this may be, and if it would be safe for me to donate blood/blood products. I will update this thread after I see him. Hopefully in next couple months :slight_smile:

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Great! I’m sure many here (including myself) would love to hear the update when it comes.

All the best,