Just been diagnosed with Chronic Hep B - Need help

Just diagnosed or new to the community
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Hello @ThomasTu @MarkDouglas @availlant @john.tavis and Other Experts,

I have just been Diagnosed with Chronic Hep B. I was never aware of it. Due to holidays , all Dr are on holidays in Canada. Walk in clinic Dr’s are not very helpful.

I went through all my previously available blood results and found that in 2012 i was positive for HBsAG during a life insurance medical test. No one cared to educate me or inform me at that time. Life insurance was not denied.

Here are my current details

  1. HBsAG - Non reactive ( In my first blood report it came as positive.) Second blood test was done a week later where it came back as Non Reactive
  2. HBsAB - Negative ( 6.6 U/L )
  3. HBcAB(Total) - Positive
  4. HBeAG - Negative
  5. HBeAB - Positive
  6. HBV DNA Viral load - (Using Roche Cobas HBV Assay) Detected but below the lower limit of quantification
  7. ALT - 166 U/L - (Dr thinks this could be due to Fatty Lever)
  8. AFP tumor marker - 4 ug/L
  9. Liver ultrasound - Fatty liver - As per the Dr

Please help me understand where i stand.

  1. Why does latest result show me HBsAG Non reactive when a week ago it was positive ( Blood tests were done by different lab ). What does it mean?
  2. Do i have OBI or Mutant variation?
  3. What does HBsAB - 6.6 mean? i understand its below the limit.

Any guidance and help is appreciated.

Thank you

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Hi @bmj1982,
I will try and answer some of your questions. It is possible for your HBsAg test to be false positive or negative, because a week between tests should not change the results. I will do this test again with confirmation added. The first test that was non-reactive(negative) indicates that you do not have HBV. But the second result being positive indicates that you have HBV. So one test says you don’t have HBV then a week later another test says you do. False positives and negatives can happen with these tests. Having the blood work done at different labs should not necessarily affect the results unless for human errors.

HBsAb tests indicate whether someone has immunity/protection against HBV and can also be used to measure the level/quantities of antibodies one has. Anything above 10 U/l is considered strong. Your results of 6.6 U/l means you have a low antibody level and a low level of protection. If your HBsAg results come back negative, I will suggest that you get an HBV booster to help increase your antibody levels so you can build a strong immunity. Best, Bansah1

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Hi @bmj1982,

I am not a physician, but I’ll give you my opinion on what your situation is. Your doctor will know better.

You are right at the detection limit for HBs and HBV DNA, have antibodies against HBc and HBe but not HBs, and moderate ALT levels implying moderate liver inflammation.

You clearly have been exposed to HBV, apparently at least as far back as 2012, and as your DNA is positive, you have a very very low level chronic HBV infection.

The variation in lab values from different labs can happen. Different labs often use different assay kits that can have different sensitivities, and if a marker in your blood is very low, that can lead to discordant results.

I recommend you see your physician and ask her/him your questions as she/he will know your full case much better. There is no urgency to get this done immediately as your very low HBV infection will progress slowly, if it progresses at all.

I wish you the best.

John.

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Thank you for your insights

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Thank you for your guidance @john.tavis. This is really helpful and assuring. I am struggling to find an appointment with specialist.

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