Is Hep B chronic if no immunity?


I recently found out I have Hep B when I recieved my notes from my IVF treatment. I had blood tests done 3 times and they all came back Hep B core antibody positive and Hep B surface antigen negative but no one told me at the time so I was really shocked when I saw the results on my notes.

I had a blood test for Hep B surface antibody 8 months after the 1st positive core antibody test, but this came back negative.

Do my test results mean I have chronic Hep B since I have no immunity?
Do I have an active infection and can I pass it onto others?
Do I need to have other tests?
Is it possible for the surface antibody to be positive then turn negative (and vice versa)?
Any idea if Hep B affects IVF treatment?

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Hi Newbie, welcome to the community.

Given that you are undergoing IVF, it will be important to have a HBV DNA test as soon as possible. However, based on the information you have provided, you have resolved your HBV infection. This is not to say that the infection is gone from your liver but that your immune system is keeping it efficiently under control. It is very unlikely that you have chronic HBV infection but a HBV DNA test will help.

In these cases the absence of detectable antibodies to HBV does not mean you do not have immunity. They are just occupied doing their job of keeping the infection under control. Detectable surface antibodies can fluctuate but this is not normally observed.

HBV infection does not appear to affect fertility.

Get back to us with your HBV DNA results. Your doctor may want to consider prophyalxis with antiviral therapy during your pregnancy to prevent transmission.

Best regards,

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Thank you so much for your response @availlant !

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Hi @availlant, can you please advise on my last post please? Many thanks

Dear Newbie,

Normally HBV DNA is not detectable when HBsAg is negative. However, since you are undergoing IVF and concern about transmission to the fetus is paramount, I would ask for a HBV DNA test just to be sure.

Best regards,

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Thank you for your response @availlant !

Hi @availlant

I had the HBV viral load test so just updating the results:

Hep.B core total antibody : Positive
Hep.B surface antigen : Negative
Hep.B surface antibody : 10-100 miu/ml
Hep.B viral load : Not detected
Liver function tests : All normal

Just a few questions:

  1. Am I correct in thinking I have recovered from an acute infection?
  2. Does this mean I am not infectious anymore?
  3. Is it necessary for my husband to get vaccinated?
  4. Is there a risk of liver damage from past acute infection? Just wondering if it’s necessary to arrange for liver scans and continued monitoring.

Many thanks

Dear @newbie,

These results are consistent with recovering from acute infection and you are not infectious.

While your husband is not at risk of getting HBV from you, it is recommended for everyone to be vaccinated so that they are protected against any possible exposures in the future.

Most past acute infections results in no long-lasting liver damage, and no ongoing risk of liver disease. If you have checked out your liver by fibroscan already and do not see any abnormal signs, then I think ongoing monitoring for Hepatitis B-related disease is not necessary.

Hope this helps,

Thank you so much for your response @ThomasTu !

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